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A Short Term Disability Denial or Determination Delay Does Not Preclude a Claim for Long Term Disability Benefits

On Behalf of | Feb 17, 2017 | Appealing A Claim Denial |

Many insureds are discouraged from pursuing a claim for long term disability benefits prior to receiving an approval of short term disability benefits or after receiving a submitting an appeal of short term disability benefits. A potential problem with simply waiting for the approval of short term disability benefits, especially where the insurance company is dragging out the review process, is that information pertinent to both the short term and long term disability claims is not being submitted and considered by the insurance company and the likelihood of a denial of both claims increases. In the case where short term disability benefits have been denied, submitting an appeal along with a claim for long term disability benefits could very well result in the approval of both.

Many clients come to our firm very upset because they have become financially strapped while their insurance company takes its time reviewing their claim. They are also quite worried that there will be a significant gap between the time short term benefits end (if approved) and their claim for long term disability benefits is processed. Our advice is to become aggressive in getting the short term claim approved while simultaneously pursing long term disability benefits. The information required for both is basically the same; but carriers often treat the claims separately so that they can delay approval and avoid the payment of benefits. Very few policies require an approval of the short term disability claim in order to qualify for long term disability benefits. Even where the insurance company or administrator of the short term claim is different from that of the long term claim, there is no reason not to pursue long term benefits during the administration of a short term disability claim and prior to the date they are payable, as this will avoid further delays and a period of nonpayment.

Insureds that have been denied short term disability benefits should not delay their application for long term disability benefits and should submit it simultaneously with their short term disability appeal. As noted above, very few polices (although some do exist) require an approval of short term disability benefits as a requisite for long term disability benefit approval. When a client seeks assistance from our firm after being denied short term benefits, we prepare an extensive appeal with the information and details necessary for the long term disability carrier or administrator to fully evaluate their LTD claim and make a determination quickly. In many instances our client receives all retroactive benefits due and owing under the STD claim and is also issued an approval on their LTD claim, thereby avoiding additional time without any income.

At Disability Insurance Law Group, our attorneys work closely with our clients and their physicians to obtain the proof required for benefit approval. We have extensive experience with the majority of short term disability and long term disability insurance companies and administrators and are familiar with the delay and denial tactics of each. If you are considering filing a claim for disability benefits, have filed a claim and are waiting for approval, need to appeal a denial of benefits, or are considering litigation, please feel free to contact us for a free consultation. We are happy to discuss your claim and your options.