Glossary of Terms

An accident such as a slip and fall or a motor vehicle accident may cause a persisting injury that can force you to miss work for a long period. A debilitating illness like cancer can also cause you to miss work. Your insurance policy has specific definitions for accidents and illnesses and what conditions from them will be covered.

A test to determine that due to your condition you are unable to work in any occupation. This doesn’t mean that you wouldn’t qualify if you could still wait tables, but instead this assessment only looks at jobs you might normally be qualified for with your specific training, experience, and education.

A written argument submitted to your insurance company notifying them that you are pursuing an internal appeal in response to your long-term disability claim being denied.

A statement from your doctor who likely diagnosed you with your condition and has probably recommended a treatment plan. This statement will detail your injury or illness and explain how it prevents you from working.

A claim for benefits that only asks for standard benefits payments, not asking for punitive damages or additional expenses.

A formula to calculate the benefits amount you will be entitled to receive through your long-term disability insurance policy.

The date when your insurance company’s definition of “total disability” changes. Before this date, you must prove that you are not able to work in your current job. After this date, you must demonstrate you cannot work in any occupation.

A formal request to your insurance company to provide coverage while you are unable to work due to an injury or illness. The claim will include evidence of your condition and information about your occupation. Your insurer will need to assess and validate the claim, deciding whether you meet their definition of “totally disabled.”

A letter notifying your insurance company that you plan to appeal the denial of your claim.

A written statement explaining your argument for why your long-term disability claim should not have been denied.