cancer cells

What Conditions Qualify for Long-Term Disability?

Understanding the ins and outs of long-term disability can be so frustrating. The financial stress you may be under as well as the challenges of your disability can compound this frustration. Even the most seemingly basic questions can seem impossible to answer. If you are wondering whether your medical condition, or even a combination of medical conditions, qualifies for long-term disability benefits, then we have answers for you.

What Conditions Qualify for Long-Term Disability?

In general, you should be aware that a long-term disability is considered to be a disabling condition that lasts longer than 12 months or is fatal. The condition itself can include a wide range of medical issues including an injury, one that is genetic in nature, or one that is related to an illness. The truth is that many different medical conditions will qualify for long-term disability depending on the level of severity. Oftentimes, the disability is the result of multiple illnesses, injuries, or other medical conditions.

To verify whether your condition qualifies for long-term disability benefits, you must turn to your specific policy and plan documents. Carefully review these documents as long-term disability benefits eligibility will depend on the terms set forth in them. Some of the more common conditions that qualify for long-term disability benefits include cancer, autoimmune disorders, and mental health disorders.

Cancer involves the uncontrolled development of abnormal cells in the body which, in turn, attack healthy tissues and organs. There are a variety of cancer types, many of which will qualify a person for long-term disability benefits. Some of the more common types of cancer that will lead to qualifying for disability benefits include:

  • Breast cancer
  • Leukemia
  • Lung cancer
  • Lymphoma
  • Melanoma

When a person has an autoimmune disorder, the body’s immune system mistakes its own tissue for foreign tissue and attacks. With your immune system attacking its own health tissue, the damage sustained by the body can be severe. That is why autoimmune conditions will often qualify a person for disability benefits. Some of the more common autoimmune conditions include:

  • Multiple sclerosis (MS)
  • Lupus
  • Rheumatoid arthritis
  • Type 1 diabetes

Mental health disorders will also act as the basis for qualifying for long-term disability benefits. Often, such disorders involve alterations in mood, processing thought, or behavior. Depending on the severity of the condition, some of the more common mental health conditions that qualify for long-term disability benefits include:

  • Anxiety
  • Bipolar disorder
  • Depression
  • Personality disorders

The list of conditions above is by no means exhaustive and some qualifying conditions will vary based on individual policy. The main point to consider is the fact that the terms of your policy will dictate what conditions will qualify for benefits.

The insurance company carries the burden of proving that you do not actually qualify for long-term disability benefits pursuant to policy terms. In order to try and do this, insurance companies will be exhaustive in their requests for your medical records and other relevant documentation. Be diligent in responding to such requests and pay close attention to any reason an insurer provides for a denial of your request for benefits as it may be misinformed.

Disability Attorney

For assistance accessing long-term disability benefits under your policy, talk to the team at Roeschke Law. Contact us today.

woman with long-term disability insurance, looking over paycheck

How Much of Your Salary Is Covered by Long Term Disability Insurance?

Long-term disability insurance can provide critical financial support should an injury or illnesses require you to miss work for an extended period of time. While some employers offer long-term disability as an employment benefit, this is not always the case and people often seek long-term disability coverage on their own. Other times, a person may wish to have additional coverage on top of that offered by his or her employer. In any event, it is important to understand the benefits you are signing up for when you get a long-term disability insurance policy. For instance, you will want to know how much of your salary will actually be covered should you need to access benefits under your long term disability insurance policy.

How Much of Your Salary Is Covered by Long Term Disability Insurance?

The short answer to this is, it depends. More specifically, it depends on the coverage of your policy. The terms of your policy will dictate how much of your salary will be covered under your long term disability insurance. That is why it is important to get long term disability coverage that will provide enough pay out benefits to provide you with the percentage of your salary that you will depend on to get through being out of work due to your disability.

When looking for long term disability insurance coverage, you will need to analyze how much you will need to live on should you be out of work for an extended period of time. The general rule of thumb is that your long-term disability insurance policy should cover anywhere from 60 to 80 percent of your take-home pay. Insurance payments are not taxed like income is so you will not need to account for that. 

To get a clearer idea of how much coverage you will really need, make a list of your monthly living expenses. Start with the basics such as food, housing, utilities, etc. Account for the fact that you will likely have some entertainment expenses such as books and movies. You are also likely to have disability-related costs, such as mobility devices (wheelchairs, etc.) and other healthcare costs. If you have a high deductible on your health insurance or your coverage is not great, account for the fact that you are likely to have a significant increase in healthcare-related costs.

Total everything together to arrive at how much you will need to live on should you be out of work on disability leave. Get long term disability coverage that will meet this need. Enjoy the peace of mind that will come with knowing you will have enough insurance coverage in the event that you are unable to work for an extended period of time due to a disabling injury or illness.

Disability Attorney

Do you have questions about long term disability coverage? Roeschke Law has answers. We are here to support you in any way we can. Contact us today.

day program for disabled

Pandemic Threatens Survival of Day Programs for Disabled

Q: How has the pandemic impacted day programs for the disabled?

For all the progress made on behalf of the disabled community since the Americans with Disabilities Act was enacted 30 years ago, day-to-day life remains challenging for many. And the pandemic has only made things worse—especially for people who rely on day programs. 

First off, applying for disability benefits in Arizona is a complex and often time-consuming process that many people trust to a skilled disability benefits attorney. The federal government offers two different disability benefits which programs which, other than sharing the requirement of meeting a common definition of what constitutes a “disability” are quite different in their other criteria. 

In a nutshell, one program (SSDI) is for those who previously worked and can satisfy the work credits history requirement, while the other (SSI) is for those of extremely limited financial means. Being “disabled” is defined as “the inability to engage in substantial gainful activity due to a medically determinable impairment that has lasted or is expected to last a minimum of 12 months or result in death”. A comprehensive list of physical and mental impairments that generally qualify an applicant for benefits is the Social Security Administration’s Blue Book. 

Whether an applicant is born with a qualifying impairment or becomes disabled later in life, they may end up needing disability support services like day programs. 

What is a day program?

Unlike a residential facility where residents live on a 24/7 basis, day programs generally provide adults with intellectual and developmental disabilities a place to go during the day to receive services such as:

  • exercise classes;
  • arts classes;
  • job training; and
  • other activities. 

The funding for day programs differs state by state, but generally, these programs are funded through the federal and state government.

As a result of the pandemic, many of the day centers were closed for several months and, even for those who were able to eventually reopen, there’s the continued struggle of dramatically-reduced attendance. Some folks can’t access staff or transportation to help them get to the program, while others may have pre-existing medical conditions that make the virus more dangerous and they fear going out in public at this time. Of course, even those centers that have re-opened may be threatened by future closure orders if cases surge in upcoming weeks and months. Not all centers offer virtual or remote programming and not all disabled people are able to access such programming if it is available due to lack of technology or challenges to using it, or other factors. 

As a result of these serious and prolonged revenue challenges, many day programs are at risk of having to close their doors if the financial situation doesn’t change through government assistance or other methods.

If you or a loved one needs assistance applying for federal disability benefits, or appealing the denial of benefits, or have any other questions, the disability attorneys at Roeschke Law can help you. Contact us today to schedule a free consultation.

From our offices in Tempe, Phoenix, and Tucson, we represent disabled people and their families throughout Arizona in all matters of disability law. 

Disabled woman with crutches

6 Reasons Why Your Long Term Disability Claim May Be Denied

Replacement income from long-term disability insurance can provide tremendous relief in uncertain times. Long-term disability (LTD) insurance provides wage replacement to people who can’t work due to disability. However, policy coverage alone does not guarantee the approval of long-term disability claims.  

When filing for LTD, claimants are pitted against insurance agents whose job is to save their company money by delaying or denying claims. Experienced disability attorneys offer protection against insurance bad-faith practices, and best position your claim for approval. 

Phoenix, Arizona disability attorneys can help you avoid common reasons why your LTD claim may be denied. They understand the tactics used by insurance companies to delay or deny claims and will put their skills to work for your best interest.

6 Common Reasons Long Term Disability Claims Are Denied

Although it is possible for claims to be denied for various reasons, here are six of the most common ones:

1. Incomplete applications 

Applications with missing paperwork, such as medical records and doctor statements, are considered incomplete. Claims lacking critical support documents are often delayed or denied due to insufficient medical evidence supporting the claim.

2. Pre-existing conditions

Medical conditions linked to symptoms, diagnosis, or treatments before a coverage effective date are considered pre-existing conditions. Insurers may deny claims that can be linked to pre-existing conditions. 

3. Not meeting the insurance policy definition of “disability” 

Insurance policies define which disabilities are considered coverable and which are not. They may also specify how many months of coverage will be provided for some specific conditions. 

If a person’s disability leaves them unable to perform their job requirements, or the duties for any occupation, disability plans generally provide coverage. However, exclusions are often noted, such as for pre-existing conditions or substance abuse.

4. Statement of the treating physician

Insurance companies give considerable weight to the opinion of treating physicians. Doctors should provide comprehensive written statements detailing the work limitations resulting from your disability.  

5. Medical condition has improved 

If the medical condition precluding the claimant from working has improved, the insurance company may attempt to delay, reduce, or deny claim coverage. 

6. Missed Deadlines 

Filing deadlines for both initial claims and appeals of denied claims must be met. Failure to meet deadlines can jeopardize your right to a claim or forfeit your right to an appeal. 

Additionally, prompt response to document requests and early production of evidence is vital. Failure to include evidentiary documents in the administrative record will bar them from being introduced into court proceedings. 

Having an experienced long term disability attorney on your side is essential. It is an unfortunate truth that some insurance companies are more concerned with profits than the well-being of the disabled.

Contact a Phoenix, AZ Long-Term Disability Lawyer Today

Navigating disability insurance is a daunting task. Long-term disability lawyers are best suited to work on your behalf during the claims process, fighting against big insurance and bad-faith practices. 

If you are an Arizona resident preparing an initial LTD claim, have already filed your claim, or have been denied coverage, our Phoenix, AZ long-term disability attorneys can help. Our legal team is skilled in all aspects of long-term disability claims and appeals and will get you the compensation you deserve.  Contact one of our disability attorneys today

The plastic straw ban can negatively impact the disabled.

Plastic Straw Ban Impacts Disabled

Is a ban on plastic straws unfair to the disabled?

Anti-plastic legislation, including bans on single-use plastic bags typically used for grocery shopping and plastic drinking straws, are being enacted across the country and beyond. Many supporters feel such legislation with respect to banning plastic straws is a no-brainer or a win-win. Merchants save money on straws, environmental waste in the oceans and landfills is reduced, and sea turtles are saved from death by plastic ingestion. 

But there is a cost and it comes at the hands of the disabled community. 

The government’s definition of disabled

Disability attorneys of Arizona help those who are disabled through illness, injury, or accident to secure the government benefits to which they are entitled. 

Qualifying for disability benefits requires meeting the government’s definition of “disabled”. There is an extensive list of recognized physical and mental impairments, and sufferers of some of these conditions require flexible drinking straws for nourishment. For that reason, disability advocates oppose a flat-out ban. 

Laws differ not only from state to state but from city to city. Some of these laws ban plastic straws entirely, but most carve-out some form of exception for disabled people. Paper straws or straws made from other biodegradable materials, or reusable metal straws, may not be suitable for disabled people who need the flexibility and strength of a lightweight plastic bendable straw. 

In some places, patrons are required to ask for a plastic straw rather than being given one with their orders automatically. This approach requires patrons to pause and really consider whether they need a straw or not, which has resulted in a large reduction of the number of straws used according to restaurant and bar owners.

Still, requiring disabled people to request a plastic straw may not only be difficult for some who are verbally- or intellectually-challenged, but could make them vulnerable to a social backlash similar to what is often encountered when disabled people who “don’t look disabled” are harassed for parking in handicapped parking spots. This leads many to ask if plastic straw ban laws discriminate against or unfairly burden the disabled community.

Applying for social security disability benefits

If you need assistance applying for Social Security disability benefits, or appealing a denial of benefits, Roeschke Law can help you. Contact us today for a free consultation. 

From our offices in Tempe, Phoenix, and Tucson, we help disabled people and their families throughout Arizona in all aspects of disability law.

LTD Recipients May Be Shortchanging Themselves

Q: Should I file for SSDI if I have LTD benefits?

If you’re already receiving long-term disability (“LTD”) benefits, you may feel fortunate, but you may not be taking full advantage of your situation. And that can cost you. That’s why seeking advice from a skilled disability benefits attorney is wise as soon as you become disabled.

Most long-term disability insurance policies require claimants to file for Social Security disability benefits as well in order to collect under their LTD policy. But even if it isn’t required by your plan, there are several reasons why applying for Social Security disability benefits (“SSDI”) could be advantageous to those with LTD insurance benefits.

Social Security disability benefits are periodically adjusted based on inflation so SSDI recipients can expect to receive periodic cost-of-living adjustments in their benefits checks. But long-term disability benefits are generally not adjusted for inflation, so LTD recipients will receive the same monthly amount 10 years from now as they are receiving today—so it will not go as far in the future as it may today.

Social Security retirement and survivor’s benefits are based on the worker’s average earnings over a long period of time. SSDI entitlement “freezes a person’s Social Security earnings record”, so the time period during which they receive SSDI benefits “is not counted as the time the person is employed” and therefore does not negatively impact their lifetime average earnings for their retirement computation. But this isn’t the case for employer or insurance company LTD benefit payments where the chunk of time–months or years– in which there are no earnings due to the disability is included in the retirement calculation and will have a corresponding negative impact on their retirement computation.

Hiring a disability benefits expert is also helpful in determining tax implications which are contingent upon how the long-term disability benefits policy premium was paid – – by the person or another source and whether through pre-tax or post tax dollars.

A disability benefits attorney can also help with healthcare issues like COBRA medical coverage and Medicare eligibility. They can also explain the vocational rehabilitation and return to work incentives available to SSDI benefits recipients.

Regardless of whether you have LTD benefits or qualify for SSDI, you are still facing life with less money than you were previously earning. A disability benefits expert can help maximize your overall compensation and benefits.

If you need assistance filing for disability benefits or have questions regarding LTD benefits, the disability experts at Roeschke Law can help. Contact us today for a free consultation.

From our offices in Phoenix, Tempe, and Tucson, we help disabled people and their families throughout Arizona in all aspects of disability law.


Pitfalls of Accessing Long Term Disability Insurance

Can a disability attorney help me access LTD benefits?

If you’re fortunate enough to have long-term disability benefits (“LTD”), either through your employer or a private insurance policy, you might assume accessing those benefits in your time of need would be as simple is filing a few papers—sort of like a health insurance claim. Unfortunately, many people applying for LTD benefits submit incomplete applications, miss important deadlines, or fail to file specific requirements and find their claims denied.

Hiring a Long-term disability benefits attorney can make the difference between having an initial application approved or denied, or having success on appealing the denial of LTD benefits. In addition, LTD attorneys can ensure that applicants avoid other common pitfalls that would negatively impact their claim or the amount of benefits they receive.

Further, there are also many time-sensitive deadlines that are easy for laypeople to miss—especially when juggling all the other physical, emotional and financial pressures of living with a disability.

It may be advisable for a worker who becomes disabled to apply for Social Security Disability (“SSDI”) benefits prior to collecting on their long-term disability insurance benefits. In fact, some policies require that they file for SSDI first– and failure to do so can result in a denial, reduction and/or delay of LTD benefits.

Not unlike the complicated process of applying for LTD benefits, the SSDI application and appeals process is also daunting for the layperson. With approximately 2/3 of initial SSDI applications being denied and with SSDI appeals hearings experiencing a nearly two-year average delay, some disabled people are depleting their savings, losing their homes, and even dying while waiting for benefits that were initially denied. This is why many people get a disability benefits attorney on their side early on—especially since there is no out-of-pocket cost to do so.

If you or a loved one has questions regarding long-term disability insurance benefits and/or Social Security disability benefits, the disability attorneys of Arizona at Roeschke Law can help you. Contact us today for a free consultation.

With offices in Phoenix, Tucson, and Tempe, we help disabled clients throughout Arizona access the benefits they need and deserve.

Lessons About Disability from A Prominent Physicists Death

Q: Does every disabled person dream of escaping their disability?

As disability attorneys of Arizona, we fill our days helping the disabled obtain benefits. Sometimes people are born with disabilities and other times the onset of the disability happens gradually or suddenly at some point later in life.

Applying for disability benefits can be a stressful and time-consuming process. For that reason, many people choose to hire a skilled disability benefits law firm to handle the initial application.

While it is possible to appeal the denial of disability benefits, the appeals process is so backlogged and has an average waiting time of over two years. People are literally becoming homeless and even dying waiting to have their disability benefits approved.

For many who are disabled or who are caretakers for loved ones suffering from a disability, there are very real financial burdens in obtaining available government benefits necessary for survival. Even in the best-case scenario, when hard to come by benefits have been approved on the initial application, it can be difficult to survive or lead a minimalistic lifestyle on disability benefits alone. That’s one of the reasons why many disabled people, if they are able to do so, work or return to work.

We’ve previously discussed on this blog the social stigma that those who stopped working due to a disability are just lazy freeloaders who would rather collect benefits than return to work.

But the recent death of a prominent physicist forces us to reflect on other possible social stigmas or improper assumptions–that all disabled people wish they could shed their disability and that all disabilities are a burden. The man is arguably the most famous face of the disabled of our time. Nearly everyone has seen this brilliant mind trapped in an ALS-ridden, progressively deteriorating body. He used the most sophisticated and supportive wheelchair and spoke with a robotic voice through the use of modern technological devices. He reportedly was stricken with ALS at the age of 20 but had a brilliant career and the world has benefited through his scientific contributions over the past 50 years.

Since his recent death, however, images and comments on social media and elsewhere depicting him “walking among the stars” and finally “free of the burden” of both his wheelchair and physical disability sparked an unintended backlash from the disabled community nationwide. Disability advocates argue that society needs to stop assuming a disability is negative or undesirable and needs to embrace the disabled, accept them as able, and provide them the tools they need for inclusion so they can reach their full potential.

If you or a loved one is suffering from a disability and needs assistance applying for benefits or appealing a denial of benefits, the disability attorneys at Roeschke Law can help you. Contact us today for a free consultation.

From our offices in Phoenix, Tempe, and Tucson, we help the disabled and their families in all aspects of disability law throughout Arizona and nationwide.

Preparing for a Long-Term Disability

Q: How can I prepare for a long-term disability?

There are few things more frustrating than applying for disability benefits on your own.

And with about 60% of first time applications for Social Security disability insurance being denied, necessitating a lengthy appeals process which can take months or even years, most people seek the help of a skilled disability benefits attorney.

In order to apply for Social Security disability insurance (“SSDI”), the worker must meet the government’s definition of permanently mentally or physically “disabled”, must be between the ages of 18 and 65, and must’ve worked and paid into the Social Security system through payroll taxes for the requisite number of years and amassed the minimum number of work credits. The application process is complex and mistakes or incomplete applications will result in a denial of benefits.

Is there another alternative?

In addition to SSDI, many workers can obtain a long-term disability insurance policy (“LTD”) through their employers. Although an estimated 213,000 employers offer long-term disability insurance, only about 40% of employees sign up, presumably preferring to direct the policy premium money to more urgent household expenses.

While about 70% of people have life insurance–possibly because death is a certainty and disability is not—it may be wise to reconsider how you and your family would function for years or decades in the event a permanent disability prohibited you from earning an income. Accidents happen every day. Even unexpected intentional violence, such as the horror we witnessed in Las Vegas, happens more often lately—shattering life plans.

Whether you have LTD insurance or are applying for SSDI after you’ve suffered a permanent disability, the associated paperwork and processing time to receive benefits may range from 90 days to a year for LTD and even longer for SSDI. It is noteworthy that most LTD policies require the worker to apply for SSDI as a prerequisite to receiving LTD benefits.

So, the bottom line is to apply for disability benefits as soon as possible after the disabling event. Of course, the time you should take this action unfortunately coincides with the time you are least able to handle such a burden due to the physical, emotional, and financial consequences you have suddenly found yourself and your family facing. That’s why many people engage a skilled disability benefits attorney to handle the application and appeals process for them.

If you or a loved one is applying for or appealing a denial of Social Security disability benefits or long-term disability insurance benefits, the disability attorneys of Arizona at Roeschke Law, can help you. Contact us for a free consultation.

From our offices in Phoenix, Tempe, and Tucson, we fight for the rights of the disabled throughout Arizona so they can focus on healing.


The Consequences of a “Bad Faith” Disability Insurance Claim Denial

Q: What happens if a disability insurance claim is denied in “bad faith”?

Sometimes, karma happens.

In a perfect world, a person with long term disability insurance (“LTD”) would submit a valid claim with sufficient medical documentation in support and it would be approved. The financially-vulnerable (and now-disabled) insured would benefit from having had the good fortune and/or foresight of obtaining LTD insurance in healthier days either through an employer plan or a private policy.

While long-term disability insurance won’t undo the physical or mental disability that prompted its activation, having it can be the difference between financial security and financial ruin for the insured and their family.

With so much riding on approval, hiring a skilled Arizona disability insurance benefits attorney may help expedite the process and increase the chances of a claim being approved or appeal of a denial being successful. In addition, some long-term disability insurance policies make applying for social security disability benefits a prerequisite to getting LTD benefits.

Arizona disability insurance claims lawsuits against insurance companies that act in “bad faith” can be brought based on the improper denial of a valid claim or the unexpected and unjustified termination of a previously-approved claim.

Arizona juries have recently cracked down on insurance companies that they felt acted in “bad faith”, awarding not only substantial compensatory damages, but slapping insurers with devastatingly-large, multimillion dollar punitive damages awards designed to punish the insurance company and deter them from such reprehensible actions in the future.

One jury found an insurance company acted with an “evil mind” in its “conscious disregard of the harm” its insured would likely suffer by its wrongful termination of previously-approved disability benefits for a young man who suffered a traumatic brain injury and subsequent suicidal mental health issues stemming from severe depression that followed his accident. The blatant termination of disability insurance benefits—which the insurer should have known could cause additional harm to the insured’s fragile health and financial situation– was reportedly based on the insurer’s alleged review of the insured’s medical records. However, it was allegedly established that the records had never even been requested much less reviewed.

It is noteworthy that the same company was also reportedly sanctioned by another Arizona court in separate case for “withholding evidence, falsely asserting the attorney-client privilege, and manipulating the record to intentionally create a false narrative”. A ruling of “bad faith” was also found therein.

The motto: Fight back against insurers that act in “bad faith” by engaging a skilled attorney with the experience and resources to level the playing field and fight for your rights.

If you need help applying for long term disability insurance benefits or appealing a denial of disability benefits, the disability attorneys at Roeschke Law can help you get the benefits to which you are entitled. Contact us today to request a consultation.

From our offices in Phoenix, Tempe, and Tucson, we’ve been helping disabled people and their families from all over Arizona get the benefits they deserve.