Short term disability insurance coverage is designed to provide income in the event that a worker becomes injured or sick. The vast majority of workers who are insured for short term disabilities receive coverage as a fringe benefit from their employer. Common examples of short term disability events include surgeries, child births, and accidental injuries.
The length of short term disability coverage varies, but most policies are written to cover 90 days or 180 days of disability. Although these benefits are only payable for a limited amount of time, short term disability benefits may bridge the gap until a disabled worker qualifies for long term disability insurance coverage.
Filing Your Claim for Short Term Disability Benefits
When an individual becomes disabled, they need to file an application in order to receive short term disability benefits. This application can usually be obtained directly from the employer, but may also be found on the insurance company’s website. Typically, the application includes a statement from the employee, a statement from a treating physician, and a statement from the employer.
After receiving the necessary paperwork, the short term disability insurance company will likely request medical records to confirm that the employee is disabled. The insurance company may have a medical professional review the claim to determine if the applicant is disabled and how long their disability is expected to last. The insurance company will then send a letter to the applicant notifying them whether or not disability benefits will be paid.
Common Reasons for Denial of Short Term Disability Benefits
The most common reason for denial of a short term disability claim is the insurance company’s finding that the applicant does not meet the definition of “disability”. To qualify for short term disability benefits, the applicant must prove that their injury or sickness prevents them from working the main duties of their occupation. The insurance company’s medical reviewers may claim that the employee’s medical records do not prove they are restricted from performing their job duties. There may be other policy provisions that affect the eligibility for a disability applicant, although the “definition of disability” is most often cited.
Procedural issues may also prevent an individual from receiving disability benefits. For example, if the individual failed to provide the insurance company with necessary forms to process the disability claim, then their claim may be denied. In addition, if a person becomes disabled while working and receives workers compensation benefits, then they not be eligible to receive short term disability benefits. Other tactics used by disability insurance companies are detailed in the article “7 Ways Insurance Companies Try to Terminate Your Benefits.”
Contact a Disability Attorney at Keller & Keller Today for Help Securing Your Short Term Disability Benefits
If you have become disabled and your claim for short term disability or long term disability benefits has been denied, contact Keller & Keller immediately. We can provide a free consultation to determine if we can assist with your disability claim. Appeals to insurance denials must be timely filed, so don’t delay in contacting Keller & Keller.
