Best Practices for Filing a Long Term Disability Claim – Plan Sponsor

May 19, 2015

This post will highlight the best practices for plan sponsors when filing an LTD claim on behalf of their employee.

There are a few simple things that plan sponsors can do to ensure that the claim is submitted accurately and quickly. This helps to keep the disability claim process flowing smoothly and can help claimants receive a decision on their claim as early as possible.

First, plan sponsors should ensure that their form is fully completed with current information, including hire date, salary, job duties, etc. If possible, a copy of a detailed job description is a great supporting document to help the case manager or adjudicator evaluate the tasks and the functional requirements of the job. Any missing fields on the plan sponsor form will delay the assessment of the claim and ultimately income to the employee.

When providing salary, it is important to differentiate between base salary/bonus/commission depending on the definition of earnings in your group insurance policy. Some income may or may not be eligible. Since the eligible benefit amount is calculated based on the amount of salary that LTD premium is being paid for, it’s also very important to have a process for regular salary updates to the insurance carrier to prevent under (or over) insurance coverage.

Finally, it is very valuable to include general commentary on the employee’s work history, availability of modified duties, the ability to accommodate gradual return to work, etc. This helps the case manager determine if the workplace is supportive of the employee’s return to work and may have a significant impact on the outcome of the claim.

Now that I’ve explained the best practices for the plan sponsor when filing an LTD claim, my next post will focus on the best practices for the employee or plan member.

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