How Does Short-Term Disability Insurance Work?
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.
- Related Article: 5 FAQs About Private Disability Insurance Claims
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.
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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.
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.
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.
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