Disability insurance can be purchased as an individual policy or it may be available through an employer’s group plan.
Short-term disability insurance will, for a short period of time, replace a percentage of lost income due to a disability. The policy/plan will state the maximum length of time that benefits are payable, the maximum benefit amount, and the terms of eligibility for benefits. While there may be certain exclusions, generally, an employee will be eligible for short-term disability benefits if the employee has medical restrictions which prohibit the employee from performing his/her job, submits a timely claim for benefits, and continues to be under the regular care of a doctor for treatment related to the disability.
Long-term disability insurance is a separate policy/plan from short-term disability. Long-term disability insurance typically provides coverage to a presumed retirement age as long as the employee continues to meet the terms of the policy/plan, including submitting regular proof of disability and receiving continued medical treatment. While the terms of long-term disability insurance vary, most policies/plans will consider an employee disabled during the first two years if the employee is unable to perform their occupation, and in subsequent years if the employee is unable to perform any occupation for which the employee is reasonably qualified by education, training and experience. Most long-term disability policies/plans will require the employee to apply for Social Security disability benefits, and some policies/plans will require the employee to participate in a rehabilitation program.
If your doctor restricted you from work due to a disability, you have submitted a claim form to your insurance company, you continue to treat with your doctor for the disability, but your short-term or long-term disability insurance carrier just denied or discontinued benefits you should contact Andrea B. Niesen at Bird, Jacobsen & Stevens, P.C. for a consultation.
Disability policies/plans will have a specific procedure and timeline for an internal appeal which must be followed. It is also necessary to submit all evidence of your disability during that internal appeal process. Prompt review of your claim by Andrea B. Niesen at Bird, Jacobsen & Stevens, P.C. will ensure that your disability insurance appeal is properly considered.