The difference between your disability insurance company declaring you totally disabled versus partially disabled is important. It can have a significant impact on how your disability benefit is calculated and the amount of money you will receive each month. Here is a summary of some of the differences between a partial disability claim and a total claim, and the implications for your financial future.
One anticipated distinction between a total disability claim and a partial one is your ability to continue working. However, policies with an Own Occupation definition of Disability may allow a claimant to receive total disability benefits while working and earning money in another occupation.
While under most policies, a partial disability claim can only be paid until the claimant turns 65, insureds with a Lifetime Disability Rider or provision may be entitled to total disability benefits for life. Thus, not making sure your disability claim is properly identified as Total or Partial can be costly. Additionally, partial disability benefits tend to pay less than total disability benefits because they are based on the claimant’s loss of earnings and therefore pay only a percentage of the disability benefit amount. Not surprisingly, most insurance companies will err on the side of finding an insured partially disabled, even though — despite working in some minimal or other capacity, they are actually Totally Disabled under their policy’s terms. Something else to consider is that when an insurance company offers a lump-sum payment instead of periodic payments, claimants deemed Partially Disabled will likely get less money than those considered Totally Disabled.
An insured who trusts the insurance company when they label their disability as Partial runs the risk of missing out on substantially more money than the company should be paying them. The insured can challenge the designation, but if they wait too long, the insurer may claim the time frame for the appeal or even that the statute of limitations has tolled and that the claimant has lost the right to appeal or sue.
Many workers with a medical condition find that their condition deteriorates over time. As their ability to work decreases, they are forced to or chose to take on fewer responsibilities in an effort to keep working. Eventually, this can change the nature of their occupation and how it is defined when they ultimately file their disability claim. When determining if an employee is disabled from his regular occupation, an insurer will often look at the duties at the time of disability and not as they were performed for years. Trying to prove that a claimant is Totally Disabled from a job that involves fewer, less challenging duties than what they used to do can make an appeal more difficult.
Understanding how your insurance company defines Total Disability and Partial Disability will allow you to make sure your claim is properly labeled and that your insurance company pays you the full amount of benefits to which you are entitled under the terms of your policy. The attorneys at Disability Insurance Law Group have successfully handled thousands of these claims and are familiar with the tactics used by insurance companies to avoid paying benefits. Our team of attorneys has more than 50 years of combined experience handling insurance matters. We know what is at stake for you and your family, and we use our deep understanding of insurance law to help make sure you receive the disability benefits you deserve.
Disability Insurance Law Group represents clients nationwide and is located in Florida. Contact us at 954-989-9000 to schedule a free consultation with one of our lawyers.
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