Estimated reading time: 9 minutes
If you’re filing for short-term disability and wondering “how long does it take to get a short-term disability claim approved?”, you’re asking a question that many of our clients ask. Approval times can vary significantly but typically range from a few days to a few weeks after filing. This article will outline the essential steps of the claim process, discuss the waiting period, and explore the various factors that influence how quickly your claim is resolved. The bottom line is this: you want to make the claims adjuster’s job easy.
Key Takeaways
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Act fast and be thorough when filing a short-term disability claim by notifying your employer, collecting your medical pertinent medical records and consulting with the right medical professional.
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Understand the waiting period before benefits start. Typically, there’s a seven to 30-day period, but if you are out of work due to an accident you may receive immediate benefits.
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Keep good records of all of your communications with the insurance company and understand and meet all deadlines.
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The Initial Steps in Filing a Short-Term Disability Claim
Filing a short-term disability claim can often feel like a daunting task. But with the right preparations and understanding, you can map out your path and navigate this terrain with confidence. The process starts with notifying your employer (usually through H.R.) and insurer, collecting the necessary medical evidence, and seeking advice from a medical professional. Having short-term disability insurance can provide you with financial support during this challenging time.
Notifying Your Employer and Insurer
Just as you would inform relevant parties before a long journey, you need to do the same when filing a short-term disability claim. You’ll need to contact your HR department or manager to access the required claim forms.
Filing your claim within the prescribed time frames, such as within nine days of disability onset, is crucial to prevent any processing delays. This is akin to keeping a schedule, ensuring everything proceeds smoothly without delays. That being said, insurance company’s understand that often claims can be delayed when you have been involved in a serious accidental injury.
Gathering and Reviewing Required Medical Evidence
In the process of filing a disability claim, consider your medical records as a guiding light. They chart your medical history, pointing out the landmarks of your condition and how it affects your work capabilities. Providing tangible proof of loss, like x-rays and blood tests, can speed up your claim approvals. Read your records for accuracy before sending them to the insurance company.
Consulting with a Medical Professional
Your doctors plays a crucial role in this process. They validate your illness or injury by providing a professional diagnosis, outlining a treatment plan, and estimating the duration of time off work required for recovery. The support from your doctor must align with their medical judgment and accurately reflect your medical records. Importantly, the records should make it clear why you cannot work.
Understanding the Waiting Period
After starting the claim, there is typically a short waiting period, or elimination period. This is the gap between when your disability begins and when your benefit payments start.
Definition and Purpose of the Waiting Period
The waiting period serves a dual purpose. On one hand, it helps insurance providers avoid the administrative burden associated with very short-term absences, such as those not covered by the medical leave act. On the other hand, it ensures that only claimants with more serious conditions, which warrant longer-term financial support, receive benefits. The waiting period also help make short term disability benefits affordable for employers.
Typical Duration of Waiting Periods
How long is this runway? Common waiting periods for short-term disability claims are typically seven, 14, or 30 days. But there’s an exception. For injuries due to accidents, some policies may distribute benefits immediately, effectively eliminating the standard waiting period.
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Navigating Through the Approval Process
With the claim initiated, it’s time to tackle the approval process. It involves submitting your claim, having it thoroughly reviewed by the insurance company, and then receiving a decision on approval or denial.
Submission of the Claim
Submitting your claim sets the process in motion. Ensure you accurately complete the claim form with all required details and obtain the necessary signatures. Then submit it to the insurance company or state agency for review while retaining a copy for your records.
Insurance Company’s Review
The process doesn’t end once you’ve submitted your claim. The insurance company reviews your claim, medical records, and work history, and may conduct additional investigations such as a telephone interview. They may request additional documents or (rarely) conduct surveillance to confirm the validity of reported limitations.
Communication and Decision
The concluding phase of the process is the reception of the decision. You will be informed about the approval or denial of your claim through written communications from the insurance company.
In case of denial, don’t lose hope. You’ll receive a detailed denial letter outlining the reasons and the steps to appeal. At BenGlassLaw, we’ll look at your short term disability denial letter for free and give you a personal review for next steps that we suggest.
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Factors That Can Affect Claim Approval Time
You might ponder: “What factors can affect the duration of my approval process?” Well, several elements can impact the duration of your approval process.
We’ll delve into these factors further.
Complexity of the Medical Condition
Just as a complex path can slow progress, intricate or rare medical conditions can extend the approval process. Detailed medical evaluations and assessments of non-exertional limitations can require extended periods for accurate evaluation. In some cases, this may be due to insufficient medical evidence, making it difficult to reach a conclusive decision.
Responsiveness of All Parties Involved
The speed of the process is dictated by the responsiveness of all parties involved. Timely submissions of additional medical documentation by the claimant can facilitate a quicker approval process.
Policy-Specific Guidelines
Lastly, the specifics of your long term disability insurance policy guidelines can also influence the duration of the process. Adhering to the specific time frames allocated by the insurer is crucial to maintain eligibility for short-term disability benefits, as well as long term disability benefits.
What to Do If Your Claim Is Taking Longer Than Expected
What happens if the process takes longer than anticipated? Fear not, there are measures you can adopt. It’s all about staying proactive and navigating the course with patience and persistence.
Following Up with the Insurance Company
Just as you would check your flight status, you can follow up with the insurance company. Ask for an estimated timeline for response and when to expect the first payment upon claim approval.
Enrolling in text alerts with the insurance company, if available, can provide claim status updates directly to your mobile device.
Seeking Legal Advice
When faced with delays or denials, don’t hesitate to seek legal advice. Consider hiring a disability lawyer to guide you through the process, assess your options for an appeal, and navigate through litigation if necessary.
Reach Out to An Experienced ERISA Disability Attorney
If you are unsure of how to approach the disability claims process, then it’s vital to reach out to an experienced disability lawyer for guidance.
We often see people make the big mistake of leaving their job position and then calling us for help in filing a short-term disability claim. Here is the problem with that. As much as we would love to help those people, the reality is that once you leave your job, your coverage under your policy ends. It becomes harder to prove that you were disabled while you were working and covered by your policy if you stopped working and waited to make a claim for disability benefits.
Sometimes disability claims are clear – we call these the “hit by a bus” claims. But often, disability comes on gradually. You could work with your condition then, but you can’t now. That’s complicated to explain. If this is you, the best time to call an experienced attorney is while you are still working. That way, we can guide you in the right direction and help you apply for short-term disability benefits. The last thing you want to do is ruin your short-term disability claim without fully understanding the process.
Tips for a Smoother Approval Journey
As we approach the end, let’s review some tips to ensure a smoother approval process. They include keeping detailed records, meeting deadlines and requirements, and seeking help from HR or medical professionals.
Keeping Detailed Records
Keeping a record of all interactions with the insurance company’s customer service center, including inquiries and updates to contact information, is key for organization.
Meeting Deadlines and Requirements
Ensure to meet all the deadlines and requirements set by federal law. Compliance with the specific time frames set by the insurer or certain state programs is vital to keep your eligibility for short-term disability benefits.
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