Filing A Short Term Disability Claim
Illness and injury are facts of life. Even a short-term disability can keep us from earning a paycheck for an uncomfortable period of time.
Many large companies purchase short-term disability insurance plans as part of a group benefit package, for their employees. Individuals, who are not insured through their employer, can purchase their own. These plans are intended to provide an income to plan holders who have become temporarily injured or ill. In order to be eligible for these disability benefits, the plan holder must be disabled from doing his regular job. Problems arise when the disability payments people count on are delayed or denied by the insurance company.
Short-term disability benefits can be payable as early as a week after the injury or illness first took place. Claimants often use any accumulated sick pay to bridge them financially, until their short-term disability payments come in. The duration of payments can last for as little as 20 weeks or as long as 52 weeks. Specific start and end times for coverage range widely, depending on the company and policy you have. The exact definitions for eligible type and amount of disability vary widely among insurance companies and plans, so you must read your own policy carefully to determine what you are entitled to.
How to apply for short-term disability benefits
You will need an application form from the specific insurance company you are insured with. Usually these are available online. You can get the forms from your employer. Alternatively you can download and print these off from your home, if you are the plan member who pays for your own coverage. The wording of application forms will vary depending on the individual insurance companies. Generally, the information required is as follows:
The application form requires a signed report from each of the following:
- Your employer (if applicable)
- You, the plan member
- Your doctor
- Specific date when your injury or illness occurred
- Description of how your injury or illness occurred
- Dates of all medical reports and names of specialists
- Dated records of all doctors’ and hospital visits along with names of attending physicians
- Dates and records of x-rays, scans, MRI or other testing procedures
- Any special or alternative treatments along with therapist names and notes
- The date when you were first disabled from doing your job
Applicants must meet certain criteria
Many plan holders are disabled due to a car accident or other injury. Others are disabled due to illness. Whatever the cause of disability, the applicant must meet the level of disability as defined in the insurance contract. The application must be signed by the appropriate parties and completed fully and accurately.
Unfortunately many plan holders who apply for short-term disability benefits, are legitimately disabled from doing their job, and yet are denied.
How can they deny benefits?
Insurance companies deny claims due to:
- Lack of medical proof that you are suffering from injury or illness
- You may still be able to do part of your job, so your amount of disability is not recognized under the insurance contract
- Your illness does not meet the definitions of the insurance contract even though the amount of your disability would.
While it is common practice for insurance companies to deny benefits, you still may have a legal right to claim. In most situations we are able to help clients win disability benefits even after being wrongfully denied
It is a matter of fact that, insurance companies usually have their own hired professionals do medical and disability assessments. These assessments are often biased in favour of the insurance company. Your personal injury lawyer will work with medical and rehabilitation professionals, to make sure you are fairly assessed. In most cases when clients have experienced legal support, the dispute settles with no need for trial.
Ask the questions and get the answers you need to make your best decision at no charge.
Scott Furlong Ford lawyers will assess your case and let you know whether or not you have a claim. If you do not have a claim its better to know for sure, rather than walk away and always wonder. If you do have a claim our lawyers will guide you through the procedure step by step. No payment is due until the case has been settled and won on your behalf. In most cases, the support of an experienced personal injury lawyer will overturn the insurance company’s original decision. This makes the difference between winning and defeat. If you are entitled to insurance benefits, don’t let yourself be bullied out of them.