Workers dealing with significant medical issues often worry about their long-term financial challenges. It is only natural for someone facing a significant, potentially permanent reduction in their earning potential to prioritize long-term benefits.
Many employers provide employee benefits packages that include short-term and long-term disability benefits. The focus when a worker discovers they have significant medical challenges is often on long-term disability benefits. However, short-term disability benefits can be equally important for someone who is facing a long-term leave of absence from work.
When do short-term disability benefits apply?
Every disability insurance package is slightly different. The policy documents directly influence when a worker receives short-term benefits and when they become eligible for long-term disability benefits. In most cases, short-term disability benefits specifically apply to the first three to six months when a worker is unable to return to their employment. Eventually, based on policy details, their claim converts to a long-term disability claim.
Why are short-term benefits valuable?
The Employee Retirement Income Security Act (ERISA) governs employer-sponsored disability benefits for a reason. When a worker can no longer continue supporting themselves, they depend on employer sponsored benefits for economic security. Every week of pay matters when someone is no longer able to work in their chosen profession. The short-term disability benefits someone may have accrued in the first three or six months after their diagnosis can make a major difference in their ability to cover their financial obligations. Particularly when a worker is unlikely to ever return to full-time gainful employment, maximizing the benefits received through an employer policy can be crucial to their long-term financial stability.
How can ERISA help?
Workers who have insurance policies governed by ERISA have more protection than those making claims on policies that they hold privately. The insurance company should approach the claim differently because it has a fiduciary duty to the policyholder. The claimant also has protection because they have the right to file an internal appeal. If the appeal seems to result in an unfair outcome, the policyholder might be eligible to file a lawsuit under ERISA. The process can take longer, but the outcome may ultimately be more favorable for the policyholder.
Securing short-term disability benefits can be difficult for workers already coping with disabling medical conditions. Those who have the right support and guidance when filing ERISA disability claims have the best chance of maximizing the benefits to which they are entitled.