Understanding Backdating a Long-Term Disability Claim: What It Means and When It’s Appropriate
When you’re applying for long-term disability (LTD) benefits, the timing of your claim can significantly impact the outcome. One tactic sometimes used is “backdating” a claim.
While backdating may sound like a somewhat nefarious concept, you’ll understand its potential advantages and risks once you know what it does and how it works. However, it should be noted that backdating a claim is something you shouldn’t attempt without the help of an experienced LTD attorney. Doing it by yourself without understanding all of the nuances could put a claim at risk, as outlined in the long-term disability claims and appeals process.
What Is Backdating in the Context of Long-Term Disability Claims?
Backdating a long-term disability claim essentially means requesting that the effective date of disability benefits start earlier than the date you actually submitted your application, or sometimes even before you stopped work altogether. This can result in retroactive benefits, sometimes covering a period during which you were unable to work but had not yet filed your claim, or for when there was a compensable loss that was not previously presented.
For example, if your claim is filed in March, but your disability began in December of the previous year, backdating could mean your benefits would start in December, not March. This sounds simple, but as previously mentioned, there are important nuances.
Success Story – Backdated Residual Disability Claim
Retained by our client to pursue benefits for her claim, we investigated her issues thoroughly, exploring her medicals and how she had altered the manner in which she practiced. We were able to succeed in developing a claim for benefits going back over three years and securing a six-figure recovery for the client beyond her ongoing benefits.
When Does Backdating a Claim Make Sense?
Backdating is typically considered in two scenarios:
- Waiting Period or Elimination Period: Most LTD policies have a waiting period (also called an elimination period) that must pass before benefits are paid. This can range from a few weeks to several months. In some cases, backdating a claim allows LTD benefits to cover the time spent waiting for the elimination period to be completed, meaning you might get benefits retroactively.
- Delayed Filing of the Claim: Sometimes, a claimant becomes disabled and is unable to work for a significant period, but delays filing their claim. This delay could be due to a variety of factors, such as not fully understanding the process, personal issues, or thinking they’d recover and return to work. Backdating in this scenario might allow the policyholder to receive benefits for a period during which they were disabled but hadn’t yet filed the claim.
Is Backdating an Appropriate Tactic in Long-Term Disability Claims?
There is no one answer to this question. Each case has different circumstances, each policy is different, and every insurance company has its own idea of what is allowable.
Here are some examples where backdating could be a worthwhile strategy:
- When the Elimination Period Has Been Satisfied: If you have already met the elimination period but simply haven’t filed the claim yet, backdating may be an option. For instance, if you experienced a disability in October but didn’t file your claim until March, backdating could allow your benefits to begin as of October, potentially covering several months of lost income.
- If Your Disability Was Diagnosed After a Delayed Filing: A disability may have been present for months before you were formally diagnosed or aware of the full extent of the condition. For example, a chronic illness that develops over time might not have been recognized as disabling until later. If this is the case, and you’ve been unable to work due to the disability, backdating your claim could help recover those lost months of income, assuming the policy allows for retroactive benefits.
- As a Strategy to Align with Social Security Disability Benefits: Many LTD policies require you to apply for Social Security Disability Insurance (SSDI) in parallel with your LTD claim. Backdating the LTD claim might align with the SSDI approval process, especially if the disability date for SSDI and the LTD policy coincide. (Note Newfield Law Group does not represent SSI claims).
When Backdating Might Not Be Appropriate
Here are scenarios where it may not be appropriate:
- If the Policy Has Specific Filing Deadlines: Many LTD policies impose strict filing deadlines, often requiring claims to be submitted within a certain period after the disability begins, typically within 60 to 180 days. Backdating is not an option in these cases if the claim is filed after the deadline.
- If the Policy Has Clear Exclusions on Retroactive Benefits: Some insurance policies prohibit backdating or retroactive benefits. Even if there is a legitimate reason to request backdating, it might not be an option due to the policy’s terms.
- If There Is Insufficient Documentation to Support Backdating: Even if your long-term disability insurance attorney believes your policy permits backdating and it is appropriate, you’ll need to be able to present documentation. Your medical records will need to reflect the onset of your disability and prove you were unable to work.
- If the Insurance Company Contesting Your Disability: If the insurance company disputes the existence or severity of your disability, backdating may be a more difficult argument to make. Insurers will typically require substantive proof that your disability existed prior to the claim being filed, and if that evidence is lacking, the insurance company may deny a retroactive start date.
The Role of an Attorney in Backdating Long-Term Disability Claims
Navigating the backdating process can be complex, and it’s crucial to understand both the legal and insurance-related implications of such a tactic. Newfield Law Group helps clients in the following ways:
- Reviewing Policy Language: Jason Newfield will review the terms and conditions of your LTD policy to determine if backdating is allowed or feasible.
- Gathering Evidence: If backdating is appropriate, Newfield Law Group will assist in gathering medical records, employment records, and other documentation to support the start date of your disability.
- Negotiating with the Insurance Company: Insurers are often reluctant to pay benefits retroactively, especially in long-term disability claims appeals. Newfield Law Group advocates on the client’s behalf, negotiating with the insurance company to get the best possible outcome.
- Handling Disputes: If your insurance company denies your backdating request or delays the claim, we assist you in appealing the decision or pursuing legal action.
Next Steps to Consider About Backdating a Claim
If there has been a delay in filing or if you’re trying to align with the completion of the elimination period, then backdating a long-term disability claim may be a valuable tactic. Jason Newfield offers a free review of policies and can discuss your situation in a telephone call.
There is simply too much at risk to try to manage backdating a claim on your own. You’ll benefit from the help of a skilled LTD attorney, ensuring that you make informed decisions and take the appropriate steps to maximize your chances of receiving the benefits you deserve.
