Fort Lauderdale Short-Term Disability Insurance Attorney
Over 45+ Years of Experience Serving South Florida
Short-term disability insurance protects you in scenarios where you are unable to work due to an unforeseen injury or illness. Policy benefits cover a significant portion of missed wages so you can focus on recovery. Paying premiums on a policy can give you peace of mind in knowing your income will be largely protected no matter what, but some insurance companies will act in bad faith and wrongfully deny legitimate claims.
Our Fort Lauderdale short-term disability insurance lawyer at Martin J. Sperry, P.A. has recovered millions of dollars for clients with wrongfully denied claims. We have an extensive familiarity with short-term disability practices and policies and have over 45 years of legal experience in this field. If your insurer is refusing to honor your policy, our firm can help you explore the full extent of your legal options. We are compassionate to the uncertainty and financial difficulties injured policyholders face when their claims are improperly denied and are committed to helping our clients efficiently obtain the benefits they need.
How Does Short Term Disability Work In PA?
When you are injured or become ill and are unable to work, short-term disability insurance benefits can cover a portion of your wage for a set period of time. To be covered by a short-term disability insurance policy, you or your employer will pay a monthly premium.
These policies are generally intended to cover temporary disabilities that policyholders recover from relatively quickly. Many short-term disability policies will cover as much as 60% of your income during a benefit period. Some policies will have maximum caps, which limit the total benefits you can receive.
Our Fort Lauderdale short-term disability attorney can review your policy and help you understand what types of benefits you can expect to receive. When a qualifying event occurs, you will submit a claim explaining the injury or illness that temporarily limits or eliminates your ability to work. You will typically need a medical professional to agree that you are unable to work. Events that can warrant a short-term disability claim include:
- Pregnancy complications and childbirth
- Broken limbs
- Debilitating illness
- Intensive surgery
If your claim is approved, you will be subject to a “waiting period” before you begin to receive benefits. This waiting period, formally called the “elimination period,” varies from policy to policy but will typically last approximately 2 weeks.
Once the waiting period concludes, a portion of your paycheck will continue to be covered until you can return to work or until the benefit period expires, whichever comes first. Most benefits periods last for several months, but more expensive policies can include coverage for up to a few years.
Short-Term Disability Insurance vs. Long-Term Disability vs. Workers’ Compensation
Long-term disability insurance is similar to short-term disability insurance in that it covers a portion of your paycheck if a worker is unable to work due to injury or illness. As its name would imply, however, long-term disability policies cover situations where a policyholder’s injury or illness is so severe that they will not be able to return to work for at least 3 months. These policies also tend to cover more than short-term disability policies. In many cases, long-term disability benefits can compensate workers for up to 80% of their paychecks.
Long-term disability insurance can generally be purchased with benefit periods of 1, 2, 5, or 10 years. In some cases, policies can cover a policyholder until they turn 65 or 67. However, these policies carry a longer “waiting period.” Many policyholders will need to wait at least 90 days before they start to receive benefits. Long-term disability policies can also be substantially more expensive than short-term options, but they will sometimes be covered by your employer.
Workers’ compensation insurance specifically and exclusively covers on-the-job accidents. If the accident or complication that results in your missing work is unrelated to your job responsibilities, workers’ compensation will most likely not be able to cover any medical expenses or missed income. Only short- or long-term disability insurance can cover off-the-clock incidents.
Why Short-Term Disability Claims Are Denied
Workers rely on short-term disability benefits when an injury or illness prevents them from quickly returning to their jobs. When insurance companies unfairly deny claims, policyholders have limited means of making up income and covering expenses. Insurers will attempt to deny short-term disability claims for many reasons, including:
- Suspicions of fraud. If an insurance company believes you lied or misled them at any point during the application process, they may attempt to deny you benefits. Unscrupulous insurers will look for almost any thin excuse to justify a claim denial.
- Condition not covered by the policy. Short-term disability policies are meant to cover any situation where you are not able to perform your normal job responsibilities. However, certain injuries and conditions can be excluded from your policy. For example, certain types of pregnancy complications are often omitted from policies. Ambiguous language can sometimes be exploited to justify improper denials of benefits.
- Inadequate medical evidence. A medical professional will need to agree you cannot work in your current condition before an insurer will approve your claim. Some insurance companies will forward provided medical evidence to an examiner of their own. These professionals may provide a contradicting opinion and argue you should be able to work, facilitating a denial of benefits.
If you are unable to work as a result of a qualifying condition and have dutifully paid your premiums, there is no reason an insurance carrier should reject your claim. Our Fort Lauderdale short-term disability lawyer at Martin J. Sperry, P.A. can assist you with filing an appeal and pursuing all legal options when your benefits are being unfairly delayed or withheld. Our firm can provide you with communicative, one-on-one attention and serve as your advocate throughout the process.