This is not an uncommon scenario: an illness or injury prevents you from being able to go to work for more days than your sick time allows. Even with an understanding employer who accepts that you need more time off, you are worried about how you will make ends meet.
If you have a short-term disability insurance policy, you should be able to file a claim and collect a portion of your salary for up to several months. Being approved for benefits is not a given, so you must understand how your policy works and when you may need the help of an experienced short-term disability attorney.
What Is Short-Term Disability Insurance?
This kind of policy provides income replacement when the subscriber is unable to work due to a non-work-related injury or illness. Because work-related injuries are covered by workers’ compensation, a different kind of wage-replacement insurance program, short-term disability does not apply to an on-the-job accident or occupational disease.
Most short-term policies will pay 50-60 percent of the insured’s salary for a limited amount of time. How long you can collect short-term disability also depends on the specifics of your policy, but is generally no longer than one year. If you are still disabled at that point, you could be covered by a long-term disability policy, if you have one.
Who Has Short-Term Disability Insurance?
The majority of people with short-term disability insurance policies have coverage through their employer. It may be a group policy that you opted into or part of your benefits package. Every short-term disability policy is different, so you will have to be familiar with the specifics of your policy to determine how much coverage you have and for how long. Your benefits coordinator should be able to help you understand your policy.
Some people do have policies they have purchased privately. In that case, you should reach out to your insurance agent with questions. However, if you are struggling to get help, or your claim has been denied, it might be time to talk to a short-term disability attorney.
How to File a Claim
The first step in filing a claim is understanding your policy, what it covers, and how you should submit a claim. You do not want to waste your time filing a claim if you will just be immediately denied. Once you have determined that you have a legitimate claim, you want to be sure to do the following:
- Understand the standard of disability. How does your policy define disability? These terms will be key to filing a successful claim. If your condition does not meet the definition of disabled according to your insurer, you will not qualify for coverage. Does your policy differentiate between not being able to do your specific job and not being able to do any job? This is also a key term to understand.
- Gather appropriate evidence. You will need to submit medical records that document your illness or injury and spell out your physical limitations. Scans and lab test results will be important, as will your doctor’s recommendations.
- Meet all deadlines. Many claims are denied simply because the claimant did not file within the deadline. Because you are dealing with a temporary condition and the amount of time you can collect benefits is, by definition, short, you will need to take prompt action when filing a claim.
- Follow your doctor’s orders and be honest. Insurers can go to great lengths to catch people trying to scam the system and sometimes they wrongly accuse honest people of filing false claims. Adjusters may spy on you and monitor your social media to catch you. For example, if your doctor says you are incapable of lifting heavy objects, you should not be out bowling with friends. If you are caught doing so, you could lose your benefits.
Can I receive short-term disability if I’m pregnant?
In many cases, a woman can receive short-term disability for pregnancy; however, it depends on the insurance policy. To ensure that you qualify for benefits while pregnant, it’s important that you read your insurance contract, as well as any fine print about pre-existing conditions. If pregnancy is not included in the policy, you may need to purchase additional coverage during this time.
Eligibility Factors
Most policies cite certain eligibility factors for collecting short-term disability benefits, including limitations on pregnancy. These factors may include:
- The date you became pregnant. Some policies may not pay for pregnancy short-term disability if you were already pregnant when you applied for insurance.
- The length of time you’ve had your policy. Some policies cite a specific amount of time a woman must have had insurance before the onset of pregnancy.
Because disability insurance is meant to provide financial support if you’re unable to work due to an injury, medical condition, or illness, many insurance companies don’t include a healthy pregnancy in with these medical issues. However, most policies cover the last four weeks of a woman’s pregnancy and the first six weeks after childbirth.
Other potential reasons for pregnancy-related disability benefits include:
- If your doctor provides a medical reason for your inability to work, insurance companies may pay disability if you’re put on bed rest or in the hospital.
- You may be eligible for benefits if you suffer complications while pregnant or during childbirth.
- If you develop a critical medical condition while pregnant or must recover from a cesarean section, your disability benefits may be extended.
Contact Marcus Vaden Law
If you’re pregnant and need help getting short-term disability benefits, contact Marcus Vaden Law. We have years of experience fighting to help women and their families get the financial support they need and deserve. If you’ve been denied benefits or need assistance collecting on your policy, contact our office for a free consultation.
Our experienced short-term disability team can help you build a strong initial application for benefits to save you the time and frustration of doing it yourself. If you have filed and been denied, do not hesitate to contact us to start on an appeal. If you made mistakes in your first application, we might be able to help you file a successful appeal. Contact our office to learn more about our services today.