Short-term disability insurance is an employer-sponsored policy that provides income in the event you are disabled from working. It is meant to provide income replacement for a short period. Short-term disability insurance policies normally provide coverage from 3 to 6 months, depending on the terms of the policy. The income replacement level varies from 60% to 80% or more of your pre-disability salary depending on the terms of your policy.
Many employers offer both short-term and long-term disability insurance policies. If you are disabled for an extended period, short-term disability insurance benefits will pay until your long-term disability insurance policy takes effect.
Short-term disability insurance applies to most disabling conditions, with a few exceptions that will be listed in the policy (normally, self-inflicted injuries, or those caused by war, are among the conditions excluded from coverage). Common disabling conditions include cancer, chronic migraines, fibromyalgia, back injuries, heart disease, and other injuries and illnesses. In many policies, work-related injuries are often excluded from short-term disability coverage. Work related injuries are typically covered by Worker’s Compensation.
Many short-term disability denials occur when the disabling condition is either not covered by the policy or there is a dispute about the diagnosis. Disputed diagnoses frequently occur with conditions such as chronic migraines or fibromyalgia, and the insurance companies will even deny legitimate claims for a lack of “objective evidence.”
If your short-term disability claim has been denied, your long-term disability claim is in trouble. The insurance companies will use any disability insurance denial (including social security disability and short-term disability) as a reason to deny long-term disability. This is particularly troubling if you have a permanent disabling condition. Short-term disability insurance is meant to cover your income for a limited period, and a short-term disability denial will most likely lead to a denial of long-term disability insurance benefits which should pay you benefits until retirement age.
Your employer or short-term disability insurance company may tell you that because you were denied for short-term disability, you are not eligible to apply for long-term disability. In most cases, that’s not true. You CAN be approved for long-term disability benefits even as you appeal your short-term disability denial. It sounds crazy, but it has happened.
Some short-term disability policies are governed by ERISA or the Employee Retirement Income Security Act. If your short-term disability insurance policy is governed by ERISA, you should hire an attorney with experience in this complex area of disability insurance claims. If you are not sure if your policy is governed by ERISA, call us and we will review your denial letter and/or short-term disability insurance policy for free.
