This is not an uncommon scenario: an illness or injury prevents you from being able to go to work for more days than your sick time allows. Even with an understanding employer who accepts that you need more time off, you are worried about how you will make ends meet.
If you have a short-term disability insurance policy, you should be able to file a claim and collect a portion of your salary for up to several months. Being approved for benefits is not a given, so you must understand how your policy works and when you may need the help of an experienced short-term disability attorney.
What Is Short-Term Disability Insurance?
This kind of policy provides income replacement when the subscriber is unable to work due to a non-work-related injury or illness. Because work-related injuries are covered by workers’ compensation, a different kind of wage-replacement insurance program, short-term disability does not apply to an on-the-job accident or occupational disease.
Most short-term policies will pay 50-60 percent of the insured’s salary for a limited amount of time. How long you can collect short-term disability also depends on the specifics of your policy, but is generally no longer than one year. If you are still disabled at that point, you could be covered by a long-term disability policy, if you have one.
Who Has Short-Term Disability Insurance?
The majority of people with short-term disability insurance policies have coverage through their employer. It may be a group policy that you opted into or part of your benefits package. Every short-term disability policy is different, so you will have to be familiar with the specifics of your policy to determine how much coverage you have and for how long. Your benefits coordinator should be able to help you understand your policy.
Some people do have policies they have purchased privately. In that case, you should reach out to your insurance agent with questions. However, if you are struggling to get help, or your claim has been denied, it might be time to talk to a short-term disability attorney.
How to File a Claim
The first step in filing a claim is understanding your policy, what it covers, and how you should submit a claim. You do not want to waste your time filing a claim if you will just be immediately denied. Once you have determined that you have a legitimate claim, you want to be sure to do the following:
- Understand the standard of disability. How does your policy define disability? These terms will be key to filing a successful claim. If your condition does not meet the definition of disabled according to your insurer, you will not qualify for coverage. Does your policy differentiate between not being able to do your specific job and not being able to do any job? This is also a key term to understand.
- Gather appropriate evidence. You will need to submit medical records that document your illness or injury and spell out your physical limitations. Scans and lab test results will be important, as will your doctor’s recommendations.
- Meet all deadlines. Many claims are denied simply because the claimant did not file within the deadline. Because you are dealing with a temporary condition and the amount of time you can collect benefits is, by definition, short, you will need to take prompt action when filing a claim.
- Follow your doctor’s orders and be honest. Insurers can go to great lengths to catch people trying to scam the system and sometimes they wrongly accuse honest people of filing false claims. Adjusters may spy on you and monitor your social media to catch you. For example, if your doctor says you are incapable of lifting heavy objects, you should not be out bowling with friends. If you are caught doing so, you could lose your benefits.
Our experienced short-term disability team can help you build a strong initial application for benefits to save you the time and frustration of doing it yourself. If you have filed and been denied, do not hesitate to contact us to start on an appeal. If you made mistakes in your first application, we might be able to help you file a successful appeal. Contact our office to learn more about our services today.