Whether you’re still receiving long term disability benefits or are in the midst of an appeal, it is always a best practice to make sure the insurance company has all evidence that supports your claim. This includes evidence from your Social Security disability claim file.

Overview

Once you are approved for long-term disability benefits, your insurance company will almost certainly require you to apply for Social Security disability insurance benefits. This is because most policies regard SSDI benefits as offsettable income – any disability benefits you receive from SSA will reduce your monthly LTD benefit at a 1:1 basis. The insurance company will likely refer you to its own vendor to file for benefits (or, at the very least, require documentation that you’ve filed for benefits on your own).

If you are indeed approved for SSDI benefits, that is probably good evidence that you’re still eligible for LTD benefits! The SSA record probably contains the opinion of one or more independent medical examiners that have determined that you are unable to perform “any gainful activity” for which you are qualified for. The record will also likely contain a doctor’s and/or the administrative law judge’s opinion that your reported limitations are indeed credible and disabling.

However, don’t assume that because you’ve used the insurance company’s vendor that the LTD carrier has access to and is considering the evidence contained in your Social Security file. More likely than not, the insurance company will only have the final notice of award.

Best Practice – Request and Produce the SSA Claim File on Your Own

As soon as you’re approved for SSDI benefits, request a copy of the SSA claim file and send it to the insurer. You can go down to the local Social Security office and request a copy in person, or call the SSA’s toll-free number at 1-800-772-1213 and have it mailed to your home. The SSA will send the file on a CD – make or save a copy to your computer and send the CD to the insurance company along with the password instructions provided. Or, if possible, print the contents of the SSA CD and send the insurance company the paper records.

Consideration of the SSA record is often key in proving that LTD benefits should continue for an extended period of time. The SSA standard for disability is almost always equal to and often stricter than an LTD policy’s standard. Save yourself the hassle of tracking it down later by requesting it and submitting it as soon as possible, even if you’re still receiving monthly benefits.

Related Articles

The Importance of Judicial Standards of Review in ERISA Litigation

The Importance of Judicial Standards of Review in ERISA Litigation

Congress enacted the Employee Retirement Income Security Act (ERISA) law to protect . . . participants in employee benefit plans and their beneficiaries, by requiring the disclosure and reporting to participants and beneficiaries of financial and other information with respect thereto, by establishing standards of conduct, responsibility, and obligation for fiduciaries of employee benefit plans, and by providing for appropriate remedies, sanctions, and ready access to the Federal Courts. […]

ERISA-Governed vs. Non-ERISA Group Benefits: Key Differences and Why They Matter

ERISA-Governed vs. Non-ERISA Group Benefits: Key Differences and Why They Matter

The Employee Retirement Income Security Act (ERISA) affects millions of Americans with employer-sponsored benefits, but most don’t know until a claim is denied. ERISA is an acronym for the Employee Retirement Income Security Act, a law passed by Congress in 1974. The primary intent behind ERISA was to protect employees’ retirement benefits. [..]

ERISA Venue Provisions: Where Can You File Your Benefits Lawsuit?

ERISA Venue Provisions: Where Can You File Your Benefits Lawsuit?

The Employee Retirement Income Security Act of 1974 (ERISA) governs private sector employee benefits plans, including retirement, disability, and health plans. One of the key aspects of ERISA litigation is the question of venue — where participants or beneficiaries file their lawsuits when they believe their plan rights are violated. […]