At BenGlassLaw, our lawyers have experience dealing with the complex area of short-term disability claims, which involve group and individual short-term disability policies (often under a little-known area of the law called ERISA, or Employee Retirement Income Security Act).
Most Virginia long-term disability attorneys don't handle short-term disability insurance claims. Many lawyers, even those that work on ERISA long-term disability appeals, won’t take short-term disability cases because they’re “too small.” At BenGlassLaw, we know there is nothing small about being denied benefits.
We believe that you should never try to file a short-term disability insurance appeal without an experienced, ERISA trained, short-term disability attorney. This is a different and more arcane and complex area of law than social security or worker's compensation claims. The time limit for action after your disability insurance claim has been denied is short. The failure to file a correct appeal can be fatal to your chances of getting benefits.
If your short-term disability claim has been denied and want your case handled by a team with experience dealing with this little-known and difficult area of the law (even judges think ERISA disability claims are tough), you have come to the right place. Whether you are thinking about applying for benefits or have been denied benefits, we can help. Representation in jurisdictions where we are not already licensed is performed in conjunction with local counsel–at no additional legal fees to the client–and with permission of the court.
Here’s How BenGlassLaw Can Help You Right Now with Your Short Term Disability Claim
- Fax/email/mail us your denial letter. We will review it and give you a detailed strategy for moving forward. This service is FREE, but you must act promptly before your timeline to appeal runs out. You only have 180 days within which to file all of your arguments, witnesses, medical articles, legal citations, updated medical records, and narratives.
- Download our free book, Don’t Try This at Home. Don’t Try This at Home is our premier guide on ERISA disability claims where you will learn about why insurance companies deny claims and how you can appeal.
- Contact us about a consultation. We can review your claim and the evidence you have supporting your appeal. Additionally, we will talk to you about how this may affect your current employment and answer any other questions you may have. (There is a nominal fee for this consult, but we have saved claimants thousands of dollars just in one meeting.)
- If your benefits have been denied and you did your own appeal, we can only help you if you have a second appeal available to you. Really, you should contact an attorney before your claim gets this far - second appeals are tough, and there is often extra work to be done by untangling errors made in the first appeal if it was not prepared by an ERISA experienced attorney.
What is Short-Term Disability Insurance?
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.
What Information Should You Gather to Appeal a Short Term Disability Denial?
Before you and your attorney appeal an ERISA disability claim, you need to gather documents from:
- Your Employer
Often claims are denied because there is a dispute over whether you can perform your job duties with your disability. It is helpful to have a description of your job provided by your employer that you can review and compare to the description of your duties in your disability claim. “Sedentary” jobs are notorious for generating disability denials, but “sedentary” may not cover the full scope of your duties.
- Your Doctor
How your doctor interprets your disability and your ability to work is critical for your appeal. You probably already have your doctor’s support, but the insurance company may disregard or overlook your doctor’s input on your disabling condition.
- Your Disability Insurance Provider
Most people don’t know this, but you can and SHOULD request your claim file from your insurance company. You should know and understand why the insurance company denied you, and you will want to review their “evidence” about your claim. Bring this with you when you meet an attorney, it will help the attorney understand why you were really denied when reviewing your claim.
BenGlassLaw has Offices Throughout Virginia, Including in Fairfax, Richmond, Virginia Beach, and Many Others to Meet With You About Your Short Term Disability Claim AND We Are Fully Equipped for Virtual Meetings!
Having a Hard Time Finding a Lawyer for Your Short Term Disability Claim Denial?
Insurance companies wrongly deny millions of dollars in short term disability claims each year, knowing that they will likely get away with it.
How does this happen?
In many cases, a claimant has returned to work after suffering an illness or injury. Even though they may have a valid claim for short term disability benefits, to the insurance companies, they are simply a small math problem. The insurance companies know that:
- Many claimants will simply "go away," thinking that fighting an insurance company for short term disability benefits isn’t worth it.
- Some claimants will think that it hurts the employer to file a claim.
- It is unlikely that you will be able to find an experienced ERISA attorney who will take on the challenge of a short term disability case (because short term disability cases can be a lot of work.)
- Some attorneys will charge so much money to take on a claim that there will be little left for the client.
- While some attorneys with little or no experience in these claims may agree to represent you, the complexities of ERISA (the Employee Retirement Income Security Act), which governs most employer-sponsored disability claims, will trip them up.
Most denials of short term disability claims are the product of shoddy or even fraudulent claims handling. Have you received a letter that says “our nurse consultant has reviewed your records and finds that you are not disabled?” Having a nurse consultant review your claim and deny you your contractual benefits is wrong. You are entitled to a full and fair review of your short-term disability application, but a "nurse consultant review" is one strategy insurance companies use to deny claims.
Our office has developed a proprietary system for handling these short term disability claims that are “too small” for most attorneys and, while each case is different, we have a great track record with our systems and procedures. There are no upfront attorney fees in short term disability claims and we only get paid if we win.
To get started, you can request a FREE denial letter review from BenGlassLaw. Just send us your short-term disability denial letter and we will do the rest.
Remember, you typically only have 180 days (or less) to appeal your denial letter. After that, your claim may be extinguished. Send us your denial letter today!
If you have already had a claim denied or your benefits have been terminated and you would like to speak with an attorney, call our team of experts at (703)584-7277
When Should You Get Legal Advice Regarding Your Disability Claim?
You should absolutely consult with an attorney experienced in ERISA short-term disability claims before you file a claim. Too often we are contacted by people who have filed claims and exhausted their administrative appeal rights. If you must later file suit, a court is only going to review what is in the insurance company's file. EVERY case we have in which the client has applied for benefits and done the appeal himself/herself, the record that the court reviews lack important information and documents that could have been provided with the original claim. Remember, the insurance company KNOWS that your review in court is limited.
Do you think that the insurance company is going to fill the record with information favorable to you? We have never seen that happen!
Your attorney should be experienced in litigating disability income insurance claims and, if your insurance is through your employer, that attorney should understand how ERISA impacts the case. Ask the right questions. Attorneys cannot simply “dabble” in ERISA!
If you have been denied short-term disability benefits, we will review that denial letter at no charge and suggest an appropriate course of action. After that first step, you may want to hire us to create an appeal for you depending on your particular circumstances.
We want you to know your rights and understand the insurance company tactics.