Short-term disability (STD) and long-term disability (LTD) are types of insurance that provide financial assistance to individuals who are unable to work due to a non-work-related illness or injury. These insurance policies are designed to replace a portion of the individual’s income, ensuring that they can continue to meet their financial obligations while recovering from a disabling condition.
 

Short-term disability (STD):

  1. Coverage period: Short-term disability insurance typically covers a period of a few weeks up to several months, with common durations being 3, 6, or 12 months. The exact coverage period depends on the specific policy and the individual’s circumstances.
     
  2. Waiting period: There is usually a waiting or elimination period before the benefits begin, which can range from a few days to a few weeks. This period is intended to ensure that the disability is severe enough to warrant the use of the insurance.
     
  3. Benefit amount: Short-term disability insurance typically replaces a percentage of the individual’s pre-disability income, often between 60% and 80%. The exact amount depends on the policy, and there may be caps on the maximum benefit payable.
     
  4. Common uses: STD policies are used for temporary disabilities that prevent an individual from working, such as injuries, surgeries, or severe illnesses. These policies can help bridge the gap in income during the recovery period.
     

Long-term disability (LTD):

  1. Coverage period: Long-term disability insurance provides coverage for an extended period, usually several years or up to a specific age (such as 65). The coverage period varies based on the policy and the individual’s circumstances.
     
  2. Waiting period: LTD policies also have a waiting or elimination period, which is typically longer than that of STD policies. This period can range from several weeks to several months and is meant to ensure that the disability is long-lasting and not a temporary condition.
     
  3. Benefit amount: Long-term disability insurance also replaces a percentage of the individual’s pre-disability income, generally between 50% and 70%. Like STD policies, there may be caps on the maximum benefit payable.
     
  4. Common uses: LTD policies are used for disabilities that are expected to last for an extended period, such as chronic illnesses or severe injuries. These policies can provide financial stability for individuals who are unable to return to work for an extended time.
     

Both short-term and long-term disability insurance can be offered by employers as part of their benefits package, or individuals can purchase policies on their own. It is essential to review the specific terms, conditions, and coverage limits of any policy to understand the protection it provides.

If your short-term or long-term disability claim is denied, you have the right to appeal the decision. The appeals process may differ depending on whether your insurance policy is provided by a private insurer or through your employer under the Employee Retirement Income Security Act (ERISA). Here’s an overview of the general process for both types of policies:

Private insurance policies:

  1. Review the denial letter: When your claim is denied, you should receive a written explanation from the insurance company. This letter will provide the reasons for the denial and information on the appeals process.
     
  2. Check the policy: Review your policy to ensure you understand the terms, conditions, and any specific requirements for filing an appeal.
     
  3. Gather additional evidence: Collect additional documentation to support your claim, such as updated medical records, doctors’ opinions, and any other relevant evidence that can help demonstrate your disability.
     
  4. Submit a written appeal: Within the time frame specified in your policy, submit a written appeal to the insurance company. This should include a detailed explanation of why you believe the denial was incorrect and should be accompanied by the additional evidence you have gathered.
     
  5. Insurance company’s response: The insurance company will review your appeal and make a decision. If they uphold the denial, you may have the option to file another appeal or pursue legal action, depending on the terms of your policy.

Employer-provided policies under ERISA*:

  1. Review the denial letter: As with private policies, you will receive a written explanation for the denial, which will also outline the appeals process and any applicable deadlines.
     
  2. Check the Summary Plan Description (SPD): Review the SPD for your employer’s disability plan, which should outline the specific requirements and procedures for filing an appeal.
     
  3. Gather additional evidence: Collect relevant documentation to support your claim, including medical records, doctors’ opinions, and any other pertinent evidence that can help establish your disability.
     
  4. Submit a written appeal: Within the time frame specified by the plan (usually 180 days), submit a written appeal to the plan administrator. Be sure to include a detailed explanation of why you believe the denial was incorrect, along with the additional evidence you have gathered.
     
  5. Plan administrator’s response: The plan administrator will review your appeal and make a decision. If they uphold the denial, you have the right to file a lawsuit under ERISA in federal court.

*Some employer policies are governed by state law instead of ERISA

Keep in mind that the specific appeals process and deadlines may vary depending on your policy and location. It’s crucial to follow the guidelines provided in your denial letter and policy documentation. Additionally, consider consulting with an attorney specializing in disability law to guide you through the process and maximize your chances of a successful appeal.

An attorney experienced in disability law can provide valuable assistance throughout the appeals process for short-term and long-term disability claims. Here are some ways an attorney can help:

  1. Review your case: An attorney can evaluate your claim and the reasons for denial, providing guidance on whether an appeal is likely to be successful and what evidence will be needed to strengthen your case.
     
  2. Interpret policy and regulations: Disability policies and regulations can be complex and difficult to understand. An attorney can help interpret your policy, the applicable laws, and any specific requirements for filing an appeal.
     
  3. Gather additional evidence: An attorney can assist in gathering and organizing the necessary documentation to support your appeal. This may include obtaining updated medical records, coordinating with medical professionals to provide written opinions, and collecting other relevant evidence to demonstrate your disability.
     
  4. Prepare the appeal: An attorney can help you draft a well-organized and persuasive appeal letter that addresses the reasons for denial and presents your case in the best light. They will ensure that your appeal meets all policy and procedural requirements, and includes the necessary supporting documentation.
     
  5. Negotiate with the insurance company: An attorney can act as an advocate on your behalf, communicating with the insurance company or plan administrator throughout the appeals process. They can help negotiate a favorable resolution or settlement, and navigate any obstacles that may arise.
     
  6. Represent you in litigation: If your appeal is unsuccessful and you decide to pursue legal action, an attorney can represent you in court. They will develop a legal strategy, file the necessary paperwork, and present your case before a judge.
     
  7. Protect your rights: An experienced disability attorney will be familiar with the applicable laws and regulations, ensuring that your rights are protected throughout the appeals process.


Hiring an attorney can increase your chances of a successful appeal by providing expert advice, guidance, and representation. While it may be an additional expense, the benefits of having an experienced professional on your side often outweigh the costs.

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