Are You Entitled to Lifetime Disability Benefits from Ohio National?

I recently spoke with a claimant regarding a letter he received from Ohio National that indicated he was not eligible to receive lifetime disability benefits as he was not totally disabled before the age of 60 and continuously so through the age of 65. During our initial call I advised him that although each disability carrier and/or policy can differ in language, as a general rule it is very common that lifetime benefit provisions in individual disability policies require an insured to be totally disabled (not partially/residually disabled) prior to a certain age in order to qualify for a lifetime benefit. As he had continued to work, albeit in a greatly reduced capacity after the age of 60, it would seem his claim would fall into this scenario. Regardless, I wanted to review the letter he received as from experience I know that things are not as clear cut as Ohio National would have him believe.

Prior to our follow up free consultation the claimant sent me copies of two disability polices he had with Ohio National. Upon review of one of the policies it was clear that his benefit under same would in fact end at age 65. However, his other policy contained a unique definition of total disability that led me to believe he may have a way to collect lifetime benefits:

Total Disability or Totally Disabled: You are Totally Disabled or have a Total Disability if (a) you are not able to do the substantial and material tasks of your own job due to Injury or Sickness; and (b) you are under a Physician’s Care. . . You are not Totally Disabled if you are working at your own job and are earning more than 25% of your Monthly Earnings Before Disability. [Emphasis added]

It is this last sentence that raises the potential for a strong argument that despite his working past the age of 60 he could qualify for Lifetime Benefits. Whereas Ohio National was evaluating his claim as a Partial Disability claim due to the fact he was working, from the above definition it was my opinion that if his earnings were less than 25% he would be deemed Totally Disabled- a qualifier for receiving lifetime benefits under the policy.

Traditionally, if you are working in your occupation but are suffering a loss of income- typically a 20% loss- your claim would be considered a Residual or Partial Disability claim. The claimant’s policy did have a Partial Disability provision, which as noted above Ohio National had been issuing his monthly benefits under. Normally, if you are being paid under a Partial/Residual disability and suffer a 75% loss of earnings the carrier will issue 100% of your monthly benefit, and in doing so the insurance company will still categorize you as Partially Disabled and not Totally Disabled under the policy provisions. This distinction is very important as Lifetime Benefit Riders do not typically allow for, or contemplate, Partial Disability- you must be Totally Disabled in order to qualify. 

The letter the claimant received did not even mention the above definition of Total Disability, and was frankly a lazily written letter to explain to an insured why his claim was being closed. In speaking with the claimant and reviewing information sent I advised him that if he could show that his earnings were less than 25% of his pre-disability earnings from the age of 60 through 65 then there would be an argument that Ohio National was misapplying the appropriate definition/standard of disability and had miscategorized his claim for benefits, which could result in hundreds of thousands owed over the course of his lifetime.

Are you eligible for Lifetime benefits with Ohio National?

If your policy contains the same definition of disability and you have worked and earned less than 25% of your pre-disability earnings before the age of 60 through the age of 65 you could be entitled to lifetime benefits. Based on the above referenced policy provisions it could be possible that Ohio National has miscategorized your claim as a Partial Disability claim and in doing so deprived you of a lifetime benefit. As was the case with the gentleman I spoke to, each claim would require a detailed investigation on its specific merits to determine the applicability of the lifetime benefit. Time will tell for him if the financial information will support the required loss of earnings over the five year period to make a strong argument to Ohio National as to his entitlement to lifetime benefits.

If you have questions regarding your claim with Ohio National or want to know if this plan provision can be used to maximize your earning potential while on disability and still qualify for a lifetime benefit please contact our office and ask to speak to Attorney Jessup or one of our other disability attorneys.

We have a detailed page about Ohio National claims where you can read more about this topic.

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Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Reviews

Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Jeff P. (Oklahoma)

After a very long and frustrating ordeal to keep my LTD payments coming I decided to seek assistance from and attorney. After much research and asking those in the legal profession Dell & Schaefer seemed to be the top choice. I reached out and Alex Palamara was the attorney assigned to my case. All I can say is the experience was outstanding. Both Alex and his Paralegal, Danielle Lauria were excellent to work with. They were very kind, concerned, understanding of my frustrations and treated me with the utmost respect. Communication was excellent with regular updates and telling me what I could expect in each stage of the process.

Alex was also very straight forward with what to expect and no pie in the sky promises or expectations were made. In the end we won our case and I believe it was solely due to their experience and knowledge of not only the laws but the insurance companies as a whole. I would highly recommend them and am very grateful for the help they afforded to me.

Chad B. (Illinois)

I originally spoke with 3 other long term disability lawyers about my case before contacting Dell and Schaefer. None of those law firms would take it. They said the chances of me winning was not good. After finding Dell and Schaefer online I spoke with one of the attorneys that has since left. He did take my case but later it was picked up by Rachel Alters. Rachel is amazing and a very intelligent attorney. She not only won my case but also was able to get my back pay for 6 months.

I also cannot say enough about Sonia Nogueira. Sonia was always quick to answer any of my questions. I would usually hear back from her within hours of sending her a email. I do not know where I would be if I hadn’t contacted them. My family and I cannot thank them enough. Don’t let an insurance company tell you they are not responsible for paying you. I paid them for 20 years monthly and they looked for any reason they could not to have to pay me when I needed my benefit. Thank you Rachel and Sonia for all you guys do.

Paul L. (New York)

Words can only scratch the surface regarding my experience working with Attorneys Dell & Schaefer. It’s a very emotional experience making the decision to utilize disability insurance. The unknowns were/are scary. From the very first phone call, the support staff was/are very professional and reassuring. I have been working with Attorney Steven Dell for approximately 10 years. He is confident, reassuring, listens to and addresses all my concern, and is extremely dilligent in understanding my specific policies for how they impact me. It is very reassuring that Steven handles and deals with the insurance company on my behalf. Attorney Dell’s team, and specifically Merlin, Attorney Dell’s assistant, is simply fantastic. Her professionalism and attention to detail have made all my communications with the office seamless.

Simply put, my experience with Dell & Schaefer made the emotional rollercoaster experience of my neck surgery seem like a walk in the park.

Thank You, Thank You, Thank You, to both Attorney Steven Dell and to Merlin for how you have helped me over these past 10 years.

Dilligence, Reassurance, Professionalism at every step, Confidence, Results.

With 10 years experience with working with Dell & Schaefer, taking that step to call Attorneys Dell & Schaefer was one of the best professional and personal decisions I have ever made.

You want to know what you can do – the below comment about posting your first name and last name initial on our website. Put up my full name, phone number, and email address. I will gladly speak to anyone about your office and tell them my story and how instrumental Steven and Merlin have been in my life over the past 10 years.

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