Short-Term Disability Insurance Claims FAQ
Short-term disability insurance serves as a replacement for income when employees are temporarily unable to work due to illness or disability.
Who Qualifies for Short-term Disability?
If you have short-term disability coverage when you become disabled, you qualify for benefits. Coverage typically includes various medical conditions, both physical and mental. Group benefits plans often incorporate short-term disability, so check your policy for confirmation.
How Much Does Short-term Disability Insurance Pay?
The amount varies based on your plan and coverage, ranging from partial to full income replacement. Short-term disability benefits generally cover 60% to 100% of your salary.
How Long Does Short-term Disability Coverage Last?
Short-term disability benefits typically last up to 6 months, but this depends on your insurance policy. Some plans extend coverage up to 52 weeks.
How Do I Apply for Short-term Disability?
To apply, request application forms from your employer or the insurer. The application includes three parts: the Employee Statement, the Attending Physician’s Statement, and the Employer Statement. Ensure all sections are completed and submitted promptly to avoid processing delays.
What Is the Claims Review Process?
After submitting your application, the insurer assigns a case manager. They may contact you for details about your symptoms, application, treatment plan, and medications. The decision, whether approval or denial, will be communicated in writing.
What If My Short-term Disability Claim is Denied?
If your claim is denied, you generally have two options:
- Appeal: You can appeal up to three times within 90 days of the decision. It is crucial to note that unless there is significantly different documentation, appealing may not be the best choice.
- Lawsuit: Consider commencing a lawsuit against the insurer for wrongful denial. Legal representation is advisable for the best outcome.
Can I Claim EI Sickness Benefits and Short-term Disability at the Same Time?
While you may be eligible for Employment Insurance (EI) sickness benefits, you cannot receive both EI and short-term disability benefits simultaneously. If your short-term disability benefits end, you may apply for EI sickness benefits.
What If I Am Fired While on Short-term Disability?
Terminating an employee due to disability, even during leave, is discriminatory under human rights legislation. If terminated while on disability leave, seek advice from a Short-Term Disability Lawyer for guidance on potential discrimination claims.
Contact Achkar Law Today
If you find yourself facing challenges with your short-term disability claim, do not navigate this journey alone. Our team at Achkar Law focuses in disability law and is here to assist you every step of the way. Schedule a confidential consultation with our experienced disability lawyers today. Let us advocate for your rights and ensure you receive the support you deserve. Contact us now to take control of your short-term disability claim and secure a brighter, more secure future.