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ERISA Law

Going from Short-Term Disability to Long-Term Disability

July 12, 2020

Short-term disability (STD) insurance provides financial benefits when you become temporarily disabled and cannot work.  Long-term disability (LTD) insurance provides financial benefits if you become disabled and are unable to work for a longer period of time, but there is typically a 90 to 180-day waiting period before long-term disability benefits begin.  Short-term disability insurance also provides benefits to cover the waiting period before long-term disability benefits begin.  If you receive the maximum amount of short-term disability benefits allowed under your policy, you will then need to transition to long-term disability benefits.

Shifting from short-term disability to long-term disability can be simple in some cases but challenging in others. There are several important factors to consider as your STD benefit period is coming to an end and you plan to transition to LTD.  Among other things, you should consider changes in the definition of disability, if your benefits are going to be limited once you transition from short-term disability to long-term disability, and if your STD and LTD coverage is from the same insurance company.

Changes in Definition of Disability

Typically, the definition of disability remains the same for your entire short-term disability claim. Most short-term disability policies require you to be disabled from your regular occupation and receiving appropriate treatment for your disability.  While many long-term disability policies also require you to be disabled from your own occupation initially, after a certain amount of time, the LTD definition of disability often becomes more restricted and challenging to meet. Many LTD policies require you to be disabled from any occupation after 24—48 months of benefits.

Limitations in Long-Term Disability Policies

Unlike short-term disability policies, long-term disability policies typically have restrictions for certain kinds of conditions that limit how long you can receive LTD benefits. For example, mental health conditions are often limited to 12—24 months of benefits.  You should read your LTD policy carefully before you transition to LTD to understand any limitations that may apply to your claim.  You should contact an attorney if your disability is entirely or partly due to mental health conditions or any other condition that may be limited once you transition to LTD.

Are your Short-Term Disability and Long-Term Disability Policies From the Same Insurance Company?

Transitioning from short-term to long-term disability may be easier for those whose long-term disability coverage is provided by the same insurance company that handled their short-term disability claim.  This is because that specific insurance company already found you to be disabled.  Further, they typically will already have a substantial amount of your medical records and/or reports from your providers supporting your claim.  Often in those cases, the insurance company will evaluate your claim for long-term disability benefits before your short-term disability benefits end to eliminate the need to go through a new claim process.  However, you may still need to complete some claim paperwork.  It is important that your LTD claim is consistent with what you reported during your STD claim.  It is also important to be aware that, even though your STD and LTD policies may be from the same insurance company, the requirements to be eligible for benefits are likely different.  You should still carefully compare your short-term and long-term disability policies to ensure you understand the requirements of your long-term disability policy.

Going from short-term disability to long-term disability can be more challenging for those whose LTD coverage is provided by a different insurance company than their STD coverage.  This is because the new insurance company will not have immediate access to the medical records, reports, or other documentation that you submitted in support of your short-term disability claim.  In these cases, claimants typically must submit a completely new claim, including claim forms from both the claimant and their treating physicians, as well as medical records.  This process can be daunting.  You should make sure to have copies of your short-term disability approval letter and any other documentation that supported your short-term disability claim.  Submitting documents such as an STD approval letter can help demonstrate to a new insurance company that you meet the definition of disability.  It is very important that you understand the differences between your short and long-term disability policies, especially if you are dealing with a new insurance company for long-term disability benefits.

Contact the Long-Term Disability Legal Team at CCK

At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has helped many clients successfully transition from short-term to long-term disability.  We can help bolster your claim so that you receive the benefits to which you are entitled.  Our team is experienced with benefit limitations and can help ensure the insurance company does not incorrectly limit your benefits once you transition to long-term disability.  Contact us now at (401) 237-6412 for a FREE consultation to see if we might be able to assist you.