Why Do Insurance Companies Deny Short Term Disability Benefits or Cut Off Benefits During The Short Term Disability Period?
Unfortunately, it’s not uncommon for disability insurance carriers to deny a short term disability claim, or cut off a policy holder during a short term disability period. Why? Most of these policy holders also have long term disability insurance and that creates a significant exposure to the long term disability insurance carrier. The disability carrier is hoping that you get discouraged and don’t file an appeal and/or fail to even apply for your long term disability benefits.
Why Do Disability Insurance Carriers Deny Short Term Disability Claims
I believe that disability insurance companies set up short term disability denials to make it harder for policy holders to get the disability benefits they deserve.
Unfortunately, inexperienced disability attorneys may make the mistake of only appealing the short term disability claim and, if the claim is not approved, only suing for short term disability benefits. This is a huge malpractice issue.
Worse yet, the issue can be complicated by the specific terms of the short term disability plan or policy. Some long term disability policies require the policy holder to be eligible for and be paid for all of their short term disability benefits before they can qualify for long term disability benefits. However, many short and long term disability plans aren’t coordinated.
The Elimination Period Game
The long term disability policy has a separate requirement that the policyholder be disabled during the elimination period and most policies don’t require that the policyholder actually be paid short term disability benefits to be paid for long term disability benefits.
The disability carrier won’t tell you that hoping to discourage you from appealing your short term disability denial, hoping that you’ll find an inexperienced ERISA attorney who will only take the short term disability claim and that you will let the time run for filing a long term disability claim.
What Should A Short Term Disability Plan/Policy Holder Do If Their Claim Has Been Denied?
At Cavey Law, we not only appeal the short term disability claim we:
1. Write a letter to the long term disability carrier advising them that our client will be applying for long term disability benefits and request that the long term disability carrier send us a copy of the application and/or
2. that our letter be considered an application for long term disability benefits.
Disability insurance carriers may flat out refuse to send out an application for benefits, refuse to accept our letter as the application for benefits or, worse yet, they ignore it.
What Happens If They Say No Or Ignore Our Request
There are two ways to go, depending on the policy language. If the plan language explicitly requires you to be eligible for or paid all of your short term disability benefits, then, technically we need to win the short term disability claim or exhaust the claim first.
But the reality is, we want to be able to sue them for both the short and long term disability benefits. We send the disability carrier a reminder that if the short term disability benefits were paid, that the claim would rollover into long term disability benefits. We want them to consider the case on that basis. Alternatively, we remind them that anything and everything we submit is considered both a part of the short term disability appeal and the long term disability claim.
Better yet, we’ll submit a long term disability claim and let them deny the same. That let’s us take an appeal and, ultimately, file a suit on both the short and long term disability claims.
We don’t let a disability carrier say no! If your short term disabilty claim has been denied, you owe it to yourself to contact disabiltiy insurance attorney Nancy Cavey who can help you get the disability benefits you deserve regardless of where you are in the United States. Call today at 727-894-3188 for your complimentary consultation.