Published by The Pellegrin Firm July 29, 2019

The relationship between Long-Term Disability benefits and Social Security Disability benefits creates a lot of confusion and concern among claimants. This relationship is the source of a great number of questions and frustrations.

First, people are often frustrated to learn that Long-Term Disability usually gets a set-off for benefits paid by Social Security. People are frustrated that they have to go through the tiring, time-consuming Social Security application process all so that their insurance company, who they have paid premiums to over the years, can save some money. Unfortunately, there is usually no way around this. The policies usually require the claimant to apply for Social Security. Some policies even claim to give the company a set-off for benefits which the claimant could apply for and doesn’t!

The reality of the situation is that courts tend to apply the policies as written unless there is some compelling legal reason not to. There are a few exceptions, but generally the policy governs. The unfortunate fact is that Long-Term Disability policies provide claimants much less than people generally think they do. Perhaps one day Congress will mandate certain coverages in these policies or forbid certain exclusions, so that the policies are more in line with consumer expectations of what they are paying for. Until then, we have to deal with the law as it is.

I usually advise people first filing for Long-Term Disability to get the Social Security process rolling at the same time. First, a favorable decision from Social Security can be persuasive evidence in the LTD claim. Second, Social Security benefits give security private insurance is not going to provide. In my experience, Long-Term Disability benefits are much more likely to be terminated than Social Security Disability benefits.