If a claim for short-term disability has been denied, or benefits have been terminated before the end of the policy maximum period, an insured person can appeal this decision.
Toronto, ON (PRWEB) August 27, 2014
A person who makes an application for short-term disability benefits wants his or her claim to run smoothly as he or she is in need or income replacement as a result of a disability that renders him or her unable to work.
Some employers provide employees with access to short-term disability benefits and/or long-term disability benefits through their group insurance plans.
What are short-term disability benefits?
Short-term disability benefits are benefits that are meant to provide income replacement for employees experiencing an illness or injury who are unable to work for a specified period of time. This type of benefit pay employees a percentage of their weekly salary while they are unable to perform the essential duties of their job.
As with long-term disability benefits, there is an initial waiting period until benefits begin, however the waiting period is much shorter and can be as short as one week.
Some common questions people have when applying for any type of disability benefit are:
1. What type of information is the insurance company looking for?
2. How long are short-term disability benefits paid for?
3. What can I do if my benefits are denied?
Aaron Waxman, of Aaron Waxman and Associates is a lawyer who practices disability law in Ontario.
Mr. Waxman advised that a person who is making an application for disability benefits should take the following into consideration when submitting an application:
Insurance companies are looking for complete applications. Be sure to submit all requested forms. This includes the Plan Member’s Statement (your statement), the Plan Sponsor’s Statement (employer’s statement) and the Attending Physician’s Statement (doctor’s statement). Without the complete set of forms, the insurance company cannot properly assess your claim. If any form is incomplete or missing, it will cause a delay in your claim. Your insurance company is looking for complete forms.
In terms of what type of information your insurance company is seeking, they want information that speaks to your diagnosis and how your injury/illness affects your ability to perform the duties of your job.
Mr. Waxman also stressed the importance of making sure all sections of the forms are complete.
Short-term disability benefits are subject to a policy maximum. Some policies may pay short-term disability benefits for anywhere from 17 weeks to 26 weeks. If a group insurance policy provides long-term disability benefits as well, often times short-term disability benefits are meant to bridge the gap between the waiting period and the commencement of long-term disability benefits.
If a claim for short-term disability has been denied, or benefits have been terminated before the end of the policy maximum period, an insured person can appeal this decision. It is important for those applying benefits and receiving benefits to know that a denial of benefits from the insurance company can be appealed and it is possible to file a lawsuit against your insurance company.
Mr. Waxman advises, “This is why it is so important to seek legal advice as soon as you receive a denial of benefits. A lawyer can explain to you what your rights are and what the next steps should be”.
If you or someone you know has applied for short-term disability benefits or long-term disability benefits and your application was denied at the outset, or your benefits have been terminated, consult an experienced disability lawyer as soon as possible.
About us:
Aaron Waxman and Associates is a Toronto law firm whose practice is focused on long- term disability claims, short term disability claims, psychological illness claims, critical illness claims, life insurance claims, slip & fall claims, occupier’s liability claims, automobile accident claims, traumatic brain injury claims, and other types of personal injury claims.
We only help injured persons; we do not work for insurance companies.
We offer a free, no obligation initial consultation.
We can help you get your life back on track.
Contact us:
t: 416 661-4878
tf: 1-888-955-5342
e: awaxman9at)awaxmanlaw.ca
Twitter: @InjuryLegalFirm
Facebook: Facebook.com/TorontoDisabilityFirm or Facebook.com/DisabilityLegalFirm
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