If you have had to stop work due to illness or injury and your short term disability claim has been denied, you should immediately consult with a lawyer.
What is a Short Term Disability Claim?
In general, to claim disability, you must provide proof of the disability.
There are many claims whereby an individual subjectively states they are
disabled, such as “it hurts when I bend over”. You must provide objective
evidence from, for instance, a doctor supporting your claim for disability.
While short-term disability insurance creates benefits that will work in the short term (usually less than a few years), long-term disability is more suited towards lengthier periods; longer than a few years and lasting towards retirement, or,
When a short-term disability claim (or any claim for that matter) has been
submitted, an individual will usually require a doctor’s note requesting leave
or a need for prolonged medical absence. This note will clarify why the individual
cannot complete the obligations of their occupation.
You may need to provide reasons for work stoppage, earnings and benefit
information, tax information, additional earnings, compensation information,
job requirements, declarations, medical information, and more. In some cases,
companies will ask you questions such as:
- When was your last day of work?
- What were your first symptoms and when did you first experience them?
- A description of why you are unable to perform your regular duties
- …and much more.
Initial Assessment Process
Any costs incurred in the completion of claim forms are usually the responsibility of the patient, however, in many cases our lawyers will be able to recoup costs towards such fees. Read our blog post on Short Term Disability Benefits to understand what you may be entitled to.
Short Term Disability Claim Denial
Denial letters from insurance companies will usually (and legally should) give reason as to why an insurance company has denied the claim. This note may accompany a statement of your short term disability policy, copies of medical reports, and any other documents that have been provided in the initial claim. Understand that most insurance companies do not return originals sent to them, therefore it is very important you keep copies for your personal files.
The right to claim insurance benefits stems from a collective agreement. Both parties; insurance and insurer, must agree that a disability may procure support from the insurer. If the insurer’s terms suggest that an employer does not have to pay salary, there may be more reason for the claim to proceed in court. In certain cases, a judge will decide the intent of the insurance company and its perceived obligations to you; the insured. Simply put, even though you may have agreed to an insurance policy, it may not exactly hold true to what the agreement represents.
It does not matter whether:
- The Insurance Company is in the right
- You do not qualify for the financial and medical security and support that you should be receiving from the Insurance Company, after filing your claim
If your short term disability claim has been denied, or you feel that you or a loved one have been wrongfully denied long-term disability, then we highly suggest you contact a Disability Claim Attorney immediately. You have rights that need to be fought for.
Appealing a Short Term Disability Claim Denial
Are you appealing a short term disability denial? We find that an overwhelming number of claims are denied on a daily basis. DO NOT hold yourself responsible. It may be a motion of bad faith on behalf of the insurance company. TSF Law, with many years of experience, will be able to help you with your claim.
There are numerous examples of insurance companies acting with poor conduct in providing insurance, after a client has appealed a short term disability denial. In some cases, insurers will reject medical evidence and make errors in a claim. In some instances, subjective evidence will be put forward for a claim (e.g. fibromyalgia). This must be objectively proven in court such that a test will be created to conclude whether the claimants disability is covered and has occurred during the timeframe of holding the benefit plan. However, this may not always hold true, and what an insurance does versus insurance laws is not often in line. The public generally just accepts the wrong-doings of insurance companies and the claim decisions, most often because the filing and appeal process are made to be exhausting and redundant. Regardless, by hiring a long-term disability lawyer, you won’t have to waste any more time or energy with dealing with your claim and the insurance company. TSF Law is your voice in this matter.
Standard Claims Processes & Precautionary Measures
Short Term Disability Denial can be a lengthy process. In many cases, an appeal may go through two or three review sessions until a satisfactory conclusion is made.
Do not despair – here at TSF Law, our disability lawyers are here to help.
If your insurance plan has a policy towards how it will be handled in court, then it is expected to be followed. This is where you should hire a lawyer. TSF Law will take the correct steps to ensure that if, for instance, a Manulife short term disability claim denied the proper legal proceedings, you may be in a better position to display their bad faith towards the claim.
In some cases, if there is a medical opinion that is mounting towards your denial, this must be made clear to your lawyer. If not, your lawyer will also recognize the mal-intent of your insurance company. Contact us for a short term disability attorney if you are appealing a short term disability denial.
The Short Term Disability Denial Process
If you would like more information on the claims process, we encourage you to read our section “Disability Claim Denied the First Time”. Many people are denied after going through a claim application and filing for a long term disability or personal injury insurance claim. This denial does not mean it is right or that you are not entitled to insurance coverage.
Handling the Appeal
A quick online search will reveal templated letters, DIY appeals kits, and large books designed to educate you on the appeal process. While these resources may be useful to understand the process, they do not replace the added benefit of legal representation from a long term disability lawyer. In short, seek legal advice immediately. Our team has years of experience working with claimants and are a valuable resource. Understand that the insurance companies will make it exceedingly difficult for you; let your legal team deal with that noise, it is you who needs to be seeking optimal wellness in this time of hardship.
Do not take your life into your own hands when appealing long term disability denial. You may end up in debt and with further physical/mental instability from the arduous process.When hiring a lawyer, expect to gain access to a platform designed to support you.
Legal management will assist in gathering pertinent information in your case, including: doctors’ notes, accident statements and reports, medical records and files, and other information. Your long term disability claim must be expertly built in order to defeat any doubt in your claim.
Insurance companies may have a backlog of appeals which will add time to the decision. You may be subjected to waiting periods and a long administrative process which will drain you financially. Many short term disability lawyers and short term disability appeal experts will be able to assist with funds depending on your case. We suggest you contact us for more information – there may be an opportunity to help.
Along with our free consultation, if your case is taken on, we may assign a personal support worker to help with your physical or mental ailments in the process. This is an important part of rehabilitation for you. The services that an expert long term disability professional may provide for you will help in the long run.
It is at this point that TSF Law suggests you retain legal council and further your claim appeal process with legal representation and guidance. We do not want anyone to give up, feel defeated, and resort to disability loans.
Further, if you have any questions or concerns regarding a filed disability claim, or how to begin the appeal process to a denied disability claim, TSF Law are here to help. Please contact us for any questions.