What Does Short Term Disability Cover?
Short term disability in Minnesota allows you to receive benefits if you miss work due to a covered medical condition.
Covered medical conditions that qualify for benefits vary by plan. However, there are some conditions that short term disability never covers.
Pre-Existing Conditions
If you had a medical condition before you purchased your short term disability plan, you cannot receive benefits for wages or salary lost due to that pre-existing condition.
Only injuries, illnesses, and conditions that arise once you already have a plan in place make you eligible for benefits.
If you miss work during a pregnancy, you must have a short term disability insurance plan in place before conception, or the pregnancy will be considered a pre-existing condition.
Occupational Illnesses and Injuries
Injuries and illness that occur on the job are called occupational injuries and illnesses. You cannot receive short term disability benefits for occupational illnesses and injuries.
For example, if you strained your back doing heavy lifting that is a regular part of your job, and you are unable to work while your back heals, you cannot receive short term disability benefits for the injury.
However, if you strain your back doing yard work and are unable to do your job until your back heals, you may be eligible for benefits. If you were injured on the job, you may be eligible for workers’ compensation benefits.
Nevertheless, occupational injuries and illnesses are covered by workers’ compensation. So if you are injured on the job, you can seek wage-replacement benefits by filing a workers’ comp claim rather than an STD claim.
Mental Health Conditions
Many short term disability insurance plans have extra restrictions regarding mental health conditions. If a mental health condition causes you to miss work, an individual plan is unlikely to pay you benefits. A group plan offered by an employer is more likely to cover mental health issues.
Read Your Policy’s Disability Definition
Your short term disability policy will state which disabilities qualify you for benefits. Some policies will pay benefits only if you are completely unable to work. Others will pay benefits even if you are able to work part-time while recovering from your disability.
Usually, your short term disability policy will require you to provide the insurer or your employer with certain medical documentation of your disability.
This documentation may include an estimated time during which your disability will prevent you from working.
A short term disability lawyer can help you read and understand your policy before you apply for benefits. Your attorney will also ensure that all of the paperwork is filled out correctly and submitted within the strict deadlines.
What Is the Minimum Time Off for Short Term Disability?
The amount of work you must miss to receive short term disability benefits also depends on your policy.
There is usually a waiting period of a few days to a month between the time that you make a claim with your insurer and the time you begin to receive benefits.
Some policies only pay disability benefits after you have used all of your paid sick days. You will probably get a benefits check about a month after the waiting period has ended.
The period of time between when you become disabled and when you receive your benefits check is sometimes called the elimination period.
Why Was My Claim Denied?
Insurance companies sometimes deny short term disability claims because they believe that the insured has not submitted enough documentation of their disability. Paperwork such as doctor’s notes, medical records, and treatment plans can provide support for your disability claim.
An insurer may also deny your claim if they believe that your injury or illness occurred on the job or was the result of a pre-existing condition. Or your claim may be denied if you miss a filing deadline.
Just because the insurance company denied your claim does not mean that you are not eligible for benefits. Your insurer may be in error, or may just need more documentation of your condition. Speak to a short term disability lawyer as soon as possible if your claim has been denied.
How Do You Fight Short Term Disability Denial?
If your insurer denies your STD benefits claim, you may submit an administrative appeal to the insurance company. There are strict deadlines for filing an administrative appeal.
Your appeal can include new information about your disability, such as additional documentation from medical providers. The insurance company will then review the appeal and either uphold or reverse its original decision.
After the insurance company makes a decision about your appeal, you may be able to sue the insurance company if you think they are wrongfully denying you benefits. It is advisable to speak to a short term disability lawyer when filing an administrative appeal.
An attorney will be able to help you submit proper documentation of your medical condition and can help you weigh the pros and cons of a lawsuit if necessary. The dedicated attorneys at Arechigo & Stokka, P.A., are ready to fight for you if your short term disability claim has been denied.
Helping You File Your Short-Term Disability Claim
There are a number of reasons why claims are denied.
Perhaps the application didn’t have a properly documented work history with it or the medical records were missing important information.
Ensuring that all of the necessary information is included is why it is important to employ the services of an experienced work comp attorney. All of the proper documentation can be provided from the very start and the paperwork filled out properly.
If the claim is still denied, then an appeal can be filed.
It is not unusual for a claim to be denied at first, even if a lot of information is provided.
The insurance company may find that there is something else that they want to know.
If that is the case, then your attorney can ensure that the information they want is provided so that the claim can be approved.
Experienced MN Short-Term Disability Litigators
If needed, legal action can be taken against the insurance company if they continue to deny the claim after everything they have asked for has been provided.
There have been cases where claims have been erroneously denied or they have been denied in bad faith.
Your Minnesota work comp attorney will quickly take legal action in order to secure the compensation that you need so you can pay your bills and receive the medical care that you need.
Contact a Minnesota Short Term Disability Work Comp Lawyer
Short-term disability in MN through workers’ comp, is received when the injuries only warrant short-term support and medical care due to an inability to work.
The injury may keep a worker out of their job for a short period of time or they can be rehabilitated to work another position within a specific period of time. To learn more about how Arechigo and Stokka can help you with your workers’ comp claim, call today at 651-222-6603 or contact us online for a free consultation.