Income can be a major concern for people injured in a car crash. Short-term disability may be an option to replace some of your lost wages.
Questions About Short-Term Disability Benefits?
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As you may remember, FMLA and ADA do not provide any income benefits. Those are only job protection laws. STD, short-term disability, long-term disability, and social security disability are all income benefits.
Short-Term Disability & Income Benefits
In this video, I’m going to talk about STD, short-term disability. This is income replacement. It is usually 60%-66% of your pre-disability earnings.
All of these are defined terms. And all of this is specific to your policy through your employer or to your individual policy that you’ve purchased separately. Just go back to the policy and look at what your benefits are.
When Benefits Kick In
Note that there’s an elimination period, which means your benefits generally don’t start until the eighth day of disability. The insurance company or third party administrator determines whether or not you are disabled.
Determining Your Benefits
A lot of people think that it’s their employer making this decision and it’s their big, bad HR person denying them disability. And it’s not. It’s a big, bad insurance company denying you disability.
So, your employer doesn’t really have any say other than providing your job duties, your job description, and things like that for the insurance company.
The Insurance Company Review
The insurance company will then look at your medical records and your restrictions and limitations and line that up with your job description and your job requirements.
They’re looking to see if there are restrictions and limitations due to your medical conditions that would preclude full ability to fulfill your job duties.
FMLA is Separate from Short-Term Disability
Just because your FMLA leave is approved does not mean that your short-term disability income benefits are going to be approved. They’re completely separate. There’s a higher burden to get income benefits rather than just job protection under FMLA.
How Long Benefits Last
And if your benefits are awarded, they will continue to be paid as long as the insurance company is satisfied that you continue to meet the definition of disability that is in your insurance policy.
So go back to your policy and read the definitions. And that is what is going to govern whether or not you get your benefits.
Delay in a Benefits Decision is Common
The insurance policy is a contract between you and the insurance company. And judges look at the contract. When you’re hurt and you can’t work, you feel the financial burden immediately. But the decision-making process is not usually an immediate process.
I have had several people come to me and say, “The insurance company just isn’t making a decision. They keep asking for more stuff.”
Unfortunately, that is what happens. It’s not you. It’s them. Don’t take it personally. This is what they do. Unfortunately, there is not a lot that we can do to make them do anything. But we can try.
You Must Advocate for Yourself
You have to be proactive. You have to call your claims adjuster, your claims representative all the time. “I sent this in. Did you get it? My doctor sent this in. Did you get it? My doctor sent it in again. Did you get it now? What forms did you send my doctor? Can you send them to me too so that I can get them from my doctor?”
I know that it’s very hard for you to manage this process. Unfortunately, for your own benefit, you do need to take control and do this or have somebody help you make sure that all the paperwork gets taken care of. Also make sure that your doctors are indeed filling out the forms and sending in your medical records.
Your Doctors’ Role
Your doctors have to note your restrictions and limitations. Again, your medical records have to show what your cognitive limitations are, what your physical limitations are, and what kinds of restrictions your doctor has placed on you as far as returning to work is concerned.
If your doctor says you can’t return to work right now or you can only return to work part-time or under specific conditions, those are restrictions. Your doctor has to outline those. And your insurance company is going to take a look at both.
Doctors don’t typically do this though. Doctors treat you. They don’t write medical records for the purpose of helping you win a disability income benefit claim. Sometimes, you have to do extra work. The insurance company is not going to do it for you. They’re not going to help you find a way that they to pay benefits to you. That’s very frustrating.
How Long You Can Expect Payments
Usually, short-term disability is short-term. It’s generally for six months. And if you have a long-term disability policy to cover you after that, that’s great.
And I’m going to talk about that in my next video. And if you don’t have an LTD policy, your benefits are only going to be for the term under your policy, which may be for six months, 12 months, or sometimes 24 months.
And usually, that’s about it for a short-term disability policy. Generally, for short-term disability, there are very few exclusions or limitations.
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