Many LTD claimants whose claims get denied plan to handle an appeal on their own and then involve an attorney if the insurer denies their appeal. On the surface, it seems like a good way to save money on legal fees. In reality, it can be one of the most costly decisions in the entire process.
If your claim is governed by ERISA (the Employee Retirement Income Security Act of 1974)—which most employer-sponsored group LTD policies are—the evidence that
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Disability Law
Multiple Sclerosis and the Difficult Road to Long-Term Disability Benefits
Multiple Sclerosis (MS) is a chronic medical condition that is characterized by brain fog, fatigue, muscle weakness, and many other debilitating symptoms that limit a person’s ability to function on a daily basis1. For many people living with MS, the hardest part can often be the uncertainty that follows. While symptoms can vary from person to person, these symptoms can often make sustained employment difficult. When that happens, employer-provided short- and long-term disability benefits plans may be necessary to…
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ME/CFS and Long-Term Disability Benefits: Understanding the Legal Challenges
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a serious medical condition that is characterized by severe fatigue, post-exertional malaise, sleep disturbances, and a range of other debilitating symptoms that can severely limit a person’s ability to work and participate in normal activities1. Unfortunately, those living with ME/CFS often have the difficult reality of proving the disabling effects of a condition that may not be noticeable to others in order to receive long-term disability (LTD) benefits.
Because a lot of the…
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Indiana Law Broadens ‘Gravely Disabled’ Standard Effective July 1, 2026
Senate Enrolled Act 285 (“SEA 285”) will expand the statutory definition of “gravely disabled”. The law also creates a new statutory framework prohibiting unauthorized camping or sleeping on public property. This new misdemeanor expressly requires law enforcement officers to first assess whether emergency detention is appropriate before pursuing criminal penalties under the street-camping provisions. As a result, hospital emergency departments and inpatient psychiatric facilities will see an increase in law-enforcement-initiated transports for emergency detention, particularly where the individual is…
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Navigating AI in the Workforce Without Clear Legal Guardrails
Artificial Intelligence (“AI”) is rapidly reshaping the way workplaces function, especially in health care. While AI offers meaningful opportunities to streamline employer processes and increase efficiency, its adoption is outpacing the development of legal standards and governance structures. Moreover, a patchwork of state and local laws that seemingly conflict with current federal policy further muddy the waters for employers attempting to assess and navigate the risks associated with AI use in the employment space.
AI’s Growing Role in Employment…
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How Does Wisconsin Act 29 Help Firefighters and Police Officers With PTSD Claims?
Wisconsin Act 29 is an important worker’s compensation law that makes it easier for certain first responders to bring PTSD claims. Before Act 29, Wisconsin law generally required employees with mental injury claims to prove that their PTSD or other psychological condition was caused by “unusual stress” beyond the ordinary stresses of the job. That standard was especially hard on firefighters and police officers, because even horrific events could be treated as “ordinary” parts of those professions. Act 29…
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Can My Long-Term Disability Claim be Denied Because My Condition is Pre-Existing?
If you have had a chronic condition that recently worsened, you might be wondering if your long-term disability (LTD) claim could be denied on the basis that your condition was pre-existing. Or, you might have already received a denial because the insurance company is saying your condition is pre-existing.
Many LTD policies do have pre-existing condition exclusions and they are a common reason used by insurance companies to deny claims. Being aware of these provisions can help you determine…
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What to Expect When Settling a Long-Term Disability Claim
Settling a long-term disability (LTD) claim is often more complex than it first appears. Most people naturally focus on the settlement amount, since that is the most visible part of the agreement. However, every settlement also includes additional terms that define what rights are being resolved and what both sides agree to moving forward.
At first glance, these provisions can feel overwhelming or overly technical. In reality, they are a standard part of resolving an insurance claim. While they…
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When Work Becomes Impossible: A Guide to Navigating Long-Term Disability While Living with Cancer
There’s a quiet moment in many people’s cancer journeys when you realize that pushing through at work isn’t sustainable. You may still get out of bed, still attend appointments, but your energy, focus, and endurance are no longer what they used to be. Fatigue sets in earlier than expected, mental fog lingers after treatment, and even small tasks feel overwhelming. And then the practical question arises: Can I continue working under these conditions?
For many, that question quickly leads…
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How Divorce Affects Special Needs Children and Support Services in Wisconsin
Divorce can be difficult for any family. When a child has special needs, there can be more questions:
How will care be shared between households?
How will therapy, schooling, and medical needs be handled?
What happens if one parent has been primarily responsible for those routines?
What if parents disagree regarding education, treatment interventions, or medical care?
These are not issues that fit neatly into a standard parenting arrangement.
Divorce involving a child with special needs often requires more…
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When Back Pain Stops You from Working: Navigating Long-Term Disability Claims
According to the World Health Organization, low back pain is the leading cause of disability worldwide. With the prevalence of this condition, many people are living and working through their pain. However, you may reach the point where you are simply no longer able to continue working because of your condition, despite your best efforts. If you have a short- or long-term disability insurance policy through your employer, you might be wondering if your condition qualifies for benefits. Back…
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Why Long Term Disability Insurers Require You to Apply for SSDI (And How It Affects You)
If you have been receiving long term disability (LTD) benefits, you have probably received a letter from your insurance company telling you to apply for Social Security Disability Insurance benefits, also known as SSDI. They may have offered to connect you with a service to help with this application.
You might be wondering why the insurer cares so much about whether you apply for SSDI. The short answer is that it usually saves the insurance company money. However, applying…
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What is the Difference between FMLA and STD/LTD Leave?
Employees who need to take time off from work due to a medical condition often find themselves confused about the various types of leave available to them. With a whole array of different acronyms (FMLA, STD, LTD, PTO, LWOP, etc.) swirling around HR documents, approvals or denials from leave administrators, and seemingly contradictory communications from different sources, it’s very easy to feel totally overwhelmed and lost at a time when you are already experiencing some stressful health-related life event.
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Mistakes Employers Make During the ADA Accommodation Process and How toAvoid Them
Ensuring compliance with the Americans with Disabilities Act (ADA) and state-level disability laws, which require covered employers to provide reasonable accommodations to qualified employees with disabilities unless doing so imposes undue hardship, remains a critical employer obligation. Despite decades of established guidance, ADA accommodation issues continue to drive a significant volume of claims and enforcement actions from the Equal Employment Opportunity Commission (EEOC) and state agencies. These disputes often arise not because employers refuse or are unable to provide…
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Long-Term Disability Benefits Can Help After an Injury, Even While a Personal Injury Case Is Pending
After a serious injury, it’s common to focus on the immediate aftermath: medical care, lost work, and possibly a personal injury claim. But what happens if the injury prevents a return to work for weeks, months, or the foreseeable future?
That’s where short- and long-term disability (S/LTD) insurance claims become essential.
If you were covered under either an individually purchased or employer-provided S/LTD policy as of the time of your injury, you may be eligible to file a disability…
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How Long Do Long-Term Disability Benefits Last?
As the name suggests, long-term disability benefits are supposed to last for the long term. But what does that actually mean? If you’re facing a serious injury or illness, the length of time you can count on benefits is one of the first questions you’ll want answered.
First, Consult Your Policy
Every long-term disability (LTD) policy is a bit different. The “plan documents,” or full terms of the policy, will spell out your policy’s specific rules for how long…
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