Short-Term Disability Claim Denials
Short-Term disability policies were originally conceived as a benefit to workers - these policies were meant to cover the gap after paid time-off was exhausted but before long-term disability insurance began making payments. In their original form, these policies provided real benefits to workers. But with the passage of time, the trend has become that the industry makes billions of dollars by peddling these policies to innocent consumers and then actively seeking to deny almost every claim. Even when claims are paid, fine-print contractual provisions often dramatically reduce disability payouts based on a policyholder’s other sources of income, Social Security benefits or the settlement of a personal injury lawsuit.
Short-term disability claims are usually denied for one of these reasons:
The condition isn't covered.The policies can be written to cover specific illness and may provide exclusionary statements, such as if the disability was caused by self-harm or during the course of work for pay.
You didn't provide adequate medical evidence. Even though your disability is only expected to be temporary, you still have to provide medical proof that you're unable to work. If the insurer doesn't think the evidence is sufficient, it will deny the claim.
The insurer thinks you're lying. Insurance adjusters check out your social media, follow you around, and even talk to your friends and co-workers, searching for a reason to deny your claim. If they think your behavior contradicts your application for disability, they could deny it.
If you’ve received a letter denying a Short-Term disability claim, contact us today. Most of these policies are ERISA policies, and therefore the claim appeal process has specific and limited remedies which make it important to hire an attorney who is qualified to handle your case.