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At Bryant Legal Group, we know how short-term disability benefits can provide much-needed peace of mind and financial security while you deal with a disabling illness, injury, or chronic condition.

However, short-term disability insurance policies have their imperfections too. If you don’t understand your plan’s shortcomings from the beginning, you may have unpleasant surprises later on.

Here, Bryant Legal Group’s team of respected short-term disability lawyers outlines the power and challenges of short-term disability coverage.

Pro: Short-Term Disability Provides Monthly Income When You’re Ill or Injured

Whether you have a self-funded or employer-sponsored short-term disability plan, the goal is the same: the plan is supposed to pay you a monthly benefit when you’re unable to work due to a medical condition or injury.

Typically, short-term disability benefits pay between 40% and 60% of your monthly income, although this varies. (Some policies will even pay 100% of your weekly wages for a period.) These benefits provide stability and peace of mind, giving you space to focus on your health and recovery.

RELATED: Disability Insurance in a Nutshell

Pro: Most Short-Term Disability Policies Are “Own Occupation” Plans

Disability insurance plans define “disability” in one of two ways:

  • Own occupation: You are disabled if you cannot do your actual job.
  • Any occupation: To get disability insurance benefits, you must prove that you cannot do any type of work.

For many professionals, it’s a lot simpler to prove you’re unable to do your actual occupation than any job. For example, suppose you’re a respected neurosurgeon who develops an essential tremor. You cannot safely operate on patients due to your health condition, so you’re eligible for short-term disability under an own occupation plan. However, under an any occupation plan, the insurance company may argue that you’re still capable of teaching, managing a medical practice, or working as a telehealth physician.

Thankfully, most short-term disability policies use the easier own occupation standard. To understand your policy’s precise definition of disability, you should review your Plan Document or Summary Plan Description (SPD). If you need help understanding these documents, contact an experienced short-term disability lawyer.

However, even if you have an “own occupation” short-term disability policy, you’re not out of the woods. Many long-term disability insurance policies use the “any occupation” definition. So, suppose your illness or injury takes a while to heal, or you are permanently disabled. In that case, the insurer may try to argue that you’re ineligible for long-term disability because you can still do other work—even though your short-term disability claim was quickly approved.

Con: Your Policy Might Not Cover All Health Conditions

Most short-term disability plans have exclusions and limitations. It’s a good idea to understand this fine print before choosing a private disability plan or applying for benefits. Look out for these common exclusions and limitations:

  • Pre-existing conditions: Many employer-funded plans have waiting periods that you must complete before the plan will cover a pre-existing condition.
  • Self-inflicted injuries: Many policies will not cover self-inflicted injuries.
  • Normal pregnancy: While many short-term disability policies will cover your recovery time after labor and delivery, some plans limit your benefits unless you’ve undergone a C-section or suffered complications.
  • Workers’ compensation: Some short-term disability policies will not cover claims involving an occupational illness or injury. Other plans have specific limitations. For example, the insurance company may offset your monthly benefits dollar-for-dollar with anything you receive in workers’ compensation benefits.

Insurance companies sometimes read these exclusions and limitations too broadly, denying valid claims. If the adjuster tries to limit your short-term disability claim or deny it completely, consult a lawyer as soon as possible.

Con: Waiting Periods Are Common in Short-Term Disability Plans

While most short-term disability exclusion periods aren’t as long as their long-term disability counterparts, you’ll still have to wait a bit before you’re eligible for a monthly benefit. For short-term disability claims, the elimination period can be between 0–90 days, although a seven-day waiting period is most common. Some policies have different elimination periods for illnesses and injuries, so make sure you review your plan’s terms and conditions carefully.

You should also pay close attention to how elimination periods and limitations interact. Many policies treat these waiting periods like a deductible—you lose out on benefits during the elimination period regardless of your claim’s length.

For example, UNUM often limits short-term disability benefits for a normal pregnancy to six weeks. Suppose you have a one-week elimination period. In this case, you may only receive five weeks of benefits, because UNUM will “deduct” your waiting period from your maximum period of disability.

RELATED: Get Your Short-Term Disability Approved: 5 Ways to Improve Your Application

 

Contact a Short-Term Disability Lawyer and Get Your Questions Answered

Every short-term disability policy has its own quirks and challenges. If you have questions about your policy’s specific terms, it’s best to consult an experienced disability insurance lawyer. That way, you’ll know you’re getting honest, reliable advice from a professional.

Our attorneys help people at every stage of the disability insurance process:

  • Identifying the best policy for their unique needs and goals
  • Deciding whether it’s time to apply for short-term disability
  • Navigating the application process
  • Appealing a wrongly denied disability insurance claim
  • Filing a state or federal lawsuit

Unlike an adjuster, who represents the insurance company, our team is committed to helping and educating professionals throughout Chicago and Illinois.

Bryant Legal Group: Chicago’s Trusted Short-Term Disability Lawyers

At Bryant Legal Group, we focus our practice on disability and other insurance claims. If you have questions about your short-term disability options, contact us today. We can help you interpret your policy’s terms and conditions and decide whether you should file or appeal your claim.

To schedule your free initial consultation with our team, call us at 312-561-3010 or complete our online form.

When you’re unable to work, due to an injury, illness, or chronic medical condition, you may be eligible for short-term disability benefits. Many people think that getting short-term disability is a simple process and are surprised when issues come up that lead to a denial or termination of benefits.

If you’re considering applying for short-term disability, you need to be prepared. To give yourself the best chance at getting benefits without an appeal, you need to provide detailed information and substantial evidence. In this article, we’ll outline the essentials of a short-term disability claim.

What Is Short-Term Disability Insurance?

Short-term disability insurance plans are available either independently through a private insurance plan or through your employer. The employee benefits from these plans serve as a limited wage replacement during a temporary disability period.

For example, suppose you are in a car accident and need cervical spine surgery. Your doctor takes you off work for six months while you heal and rebuild strength. Thankfully, your back heals, and you’re able to return to work. Under these circumstances, you may be eligible for short-term disability benefits during the six months of recovery.

Short-term disability is different from workers’ compensation. To get workers’ comp, your injury or illness must be work-related, which means you either suffered the injury on the job or it occurred directly because of your work duties. With short-term disability, you can collect benefits even if the injury or illness happened away from your workplace and had nothing to do with your work.

Also, short-term disability and workers’ compensation don’t necessarily exclude each other; in some instances, it is possible to collect both types of benefits at the same time.

Short-term disability is also not related to Social Security Disability (SSD). The Social Security Administration does not offer any type of short-term benefits.

Am I Eligible for Short-Term Disability Benefits?

Depending on your short-term disability insurance plan, you can have quite different requirements for qualification. Each plan has its own definition of what constitutes a qualifying “disability,” and there are additional requirements that can differ, too.  These requirements may include:

  • Minimum period of time working for an employer before coverage applies
  • Full-time employment
  • Minimum duration of disability (usually a minimum of 8–9 weeks)
  • Frequency of medical updates

Requirements may differ from plan to plan, but in general, short-term disability coverage requires that you have a condition that prevents you from working for a significant but temporary period, usually between two months and one year. There is often a waiting period (also called an “elimination period”) before you are entitled to receive benefits, and you may have to use sick days at work before your benefits kick in.

 

How Much Will I Receive in Short-Term Disability Benefits?

Short-term disability benefits will pay a percentage of your wages. Depending on the terms of your disability insurance plan, you may receive 40, 50, or 60 percent of your wages on a weekly, biweekly, or monthly schedule.

For example, if you were earning $3,000 per month and your short-term disability plan paid out 50 percent of your wages, you could receive $1,500 per month in biweekly payments of $750.

How Long Will My Short-Term Disability Benefits Last?

Short-term disability benefits are intended as a stopgap measure that replaces your wages following an unexpected event, like an accident or illness. Under most plans, the benefit period lasts for a year or less.

If your disabling condition continues, you may be eligible to receive long-term disability benefits. Depending on the plan, your short-term disability benefits may automatically qualify you for long-term disability benefits after a certain period of time.  Otherwise, you will have to reapply and qualify for long-term disability benefits.

RELATED: How Long Do I Have to Wait for a Disability Insurance Decision?

How Do I Apply for Short-Term Disability Benefits?

Before you apply for short-term disability benefits, it’s important to understand your plan’s exact terms and conditions. You should request a copy of your Plan Document and Summary Plan Description from your employer’s human resources department or directly from the insurance company. Then, carefully read these documents (or work with an attorney who can read them) to identify the disability definition, filing deadlines, and procedures that apply to your claim.

Because filing a disability claim is a highly technical process, we encourage short-term disability claimants to schedule a consultation with an experienced lawyer. Disability insurance claims require a detailed understanding of the law, medicine, and vocational analysis, and a single misstep can cost you the benefits you deserve.

Also, short-term disability benefits are short-lived. Sometimes, insurance companies deny or delay valid claims, hoping that you’ll simply return to work and give up. So, it’s critical that you consult an attorney early on in the process. Your attorney will challenge wrongful denials and work to make sure that your full benefits are paid promptly.

Once you understand the policies and processes that will frame your short-term benefit claim, you and your lawyer will compile evidence, including medical records and statements from your physicians. You’ll also complete a series of forms that discuss your disability, work experience, job requirements, and other issues.

RELATED: Common Reasons for Denial of Short-Term Disability Benefits

What Happens After I File for Short-Term Disability Benefits?

Once the disability insurance company receives your application for benefits, an adjuster will investigate your claim. They may ask for additional information or schedule an examination with one of their doctors. In general, the company will look for reasons to deny your claim, like a pre-existing condition. Based on its assessment, the insurance company will either approve or deny your claim.

However, you do have the right to appeal the insurance company’s decision. If you receive a written notice denying your short-term disability claim, you should contact a disability insurance attorney immediately to discuss your legal options.

Bryant Legal Group Is Here to Help With Short-Term Disability Claims in Chicago

If you’re ready to apply for short-term disability benefits, it’s time to get in touch with an experienced Chicago short-term disability attorney at Bryant Legal Group. Our attorneys have decades of experience helping people file successful short-term disability claims and challenge unreasonable denials. We are committed to our clients, and we make ourselves available to answer any questions or concerns you may have regarding the claims process.

Call 312-561-3010 or complete our online contact form to speak with one of our short-term disability attorneys today. We look forward to assisting you.