Private disability insurance benefits -from your private policy do not follow the same criteria as disability benefits from the Social Security Administration. Being approved for Social Security Disability Insurance (“SSDI”) benefits can help your claim with your private insurance company. But it does not automatically mean you will get disability insurance benefits from a private insurance company.
Private disability insurance benefits provided through your insurance company are governed by your policy and each policy is unique. SSDI benefits are awarded according to one standard definition of disability.
The Social Security Administration (“SSA”) oversees the approval of SSDI benefits. They determine if you meet their criteria for SSDI benefits. The definition of disability in your insurance policy may be different than the definition of disability the SSA uses.
Insurance companies sometimes try to use a denial of SSDI benefits against you. But then they will ignore an SSDI approval for benefits. Disability insurance law requires insurance companies to consider the award of SSDI benefits when reviewing a claim for disability insurance benefits.
It is important to use this to your advantage when dealing with your disability insurance company. But disability insurance law does not require an insurance company approve your claim because you receive SSDI.
Many policies require that you pursue SSDI benefits. This is especially true if the policy allows any amounts received from SSDI to be offset.
For example, your insurance company owes you $2,000 in monthly disability benefits. You are receiving $1,200 in SSDI benefits. The insurance company will offset the $1,200 from SSDI and only pay the difference – in this case, $800.
It is important to read your policy closely to determine what is required to succeed in a claim for disability benefits with your insurer and what is required in regard to SSDI benefits. An ERISA attorney can help navigate the policy requirements for your specific case. Usually you will need a separate SSDI attorney in order to file a claim or appeal for SSDI benefits. Not all ERISA attorney’s handle SSDI issues.
