Legal Question in Employment Law in California

Re: Am I eligible for Long Term Disability Benefits from my employer?

First, you need to understand that most employers don't pay disability benefits. The premiums you are paying are for disability insurance that is most likely administered and paid through an insurance company. This insurance company underwrites the policy which contains the qualifying conditions to receive long term disability. No one can tell you if you qualify for benefits without reading the policy. You can obtain information about the policy by asking your employer for the name of the plan administrator and writing to the plan administrator for the "summay plan description."

Secondly, many of these insurance companies have made it very difficult to obtain long term benefits. They have tended to deny benefits for the most technical of reasons. This practice has resulted in many lawsuits against the insurance companies under a law called ERISA. Your employer is probably not liable for any decision the insurance company makes, unless it is self-insured.

If you are going to make a claim, you will have to show that you became permanently disabled while you were employed and while you were covered under the policy. You will also have to show that you are unable to perform any work. You must work closely with your health care providers to document your medical condition and limitations.

I do not handle ERISA or insurance cases, as I only handle disputes between employees and employers, but you would be best advised to seek advise from an attorney that specializes in that area to help you.