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Should I Apply For Long Term Disability Benefits If Denied Short Term Benefits?

Tucker Law Group
May 1, 2017

Listen as John V. Tucker explains why you want to apply for long term disability benefits if your short term disability benefits have been denied.

Insurance companies all say different things about long term disability, but they will not always tell you to do what is best for you. If your short term disability benefits have been denied, it is almost always the best idea to send a letter to your insurance company explaining you want to claim long term disability benefits. It is also a good idea to send the letter to your employer’s group long term disability administrator. If the adjuster tells you that they will take care of that because the plans are connected, ignore them. In most cases, these are two different plans when you have insurance through an employer. That means the claim systems will be different for long term and short term disability benefits.

Sometimes the short term claim will not affect the long term claim. If it does affect the long term plan, then the letter you wrote won’t matter. However, if it doesn’t then you’re taking care of two things at once. With your letter, you’re giving a notice of claim, which lets the insurance company know you want to file a claim. You have thirty days from the day you become disabled to file a claim. The second thing you need to cover is your Proof of Loss. This includes medical records, expert reports, and witness statements; it’s essentially evidence of disability. This is important because the long term disability adjuster probably won’t talk to your short term disability adjuster or look at your short term disability file. Remember, if you are late in submitting your claim documents, they may deny your claim. Watch the video to learn more.

If you have questions about claiming long term disability after your short term benefits have been denied, then I want you to call me at (866) 233-5044. I welcome your call.

Video Transcript
Do you need to apply for long term disability benefits if your short term disability benefits were denied? I’m John Tucker. I’m a disability attorney and I handle both short and long term disability claims all over the country for people just like you. I’ve handled cases against all of the major disability insurance companies. Aetna, Cigna, Unum, Standard, Lincoln, Prudential -  you name it, I’m sure we’ve handled a case against them. 

Insurance companies tell people different things about what they need to do with long term disability. Let me tell you the best practice for you in terms of your long term disability claim if your short term disability benefits were denied. No matter what the insurance company has told you it is always the best thing for you to send them a letter explaining that you want to apply for long term disability benefits. Don’t just send that to the insurance company, send it to your employers group plan administrator too. The insurance adjuster may tell you “oh, these two plans are connected. You don’t need to do that. We’ll take care of that.” Don’t listen to them. That’s not the best thing for you. 

The short term disability plan and the long term disability plan usually are two different plans through your employer. That means there are two different claim systems. What happens in the short term claim doesn’t impact what happens in the long term claim under most plans. If it does, that letter you wrote won’t matter but if it doesn’t there are two key policy provisions in the long term disability plan you are taking care of. The first is called Notice of Claim. That is a legal term for just telling the insurance company you want to make a claim. Your letter will take care of that. Under most long term disability plans through employers you have thirty days to tell them you want to make a long term disability claim. That thirty days starts the day you became disabled.

The second policy term is called “Proof of Loss”. “Proof of Loss” is just your evidence, it’s your medical records, expert reports, witness statements, other things like that that prove you’re disabled. Why is that important? Because the long term disability adjusters not going to look at your short term disability file. In fact, there may be two adjusters who never even talk. You’ll need to resend all of that evidence to the long term disability adjuster. 

Remember, if you’re too late, if you don’t give them notice on time, the long term disability company may even deny your case saying “Sorry you were too late. You didn’t tell us about your claim in time.”

And then you’re done, you’re not going anywhere with that claim. If you have a long term disability claim, call me at the number on your screen. I handle cases like yours everyday. I’m John Tucker. Thanks for watching.