An injury or illness can suddenly make it impossible to do your job. Short-term disability (STD) benefits can help during this period, giving you a portion of your income while you recover.
These benefits are meant to be a temporary solution, typically lasting for a few months. However, some medical conditions last longer than a short-term policy can cover. When a condition keeps you from working past the end date of your short-term disability, you may need to apply for long-term disability (LTD) benefits.
Going from short-term disability to long-term disability involves moving from one insurance program to another, which can be confusing. So, knowing what to expect when you are going from short-term disability to long-term disability can help you avoid common mistakes. Our experienced Richmond disability lawyers can help walk you through the process.
When Short-Term Disability Ends and Long-Term Begins
Short-term disability policies are designed to cover a person for a short time, usually three to six months. The length of time is set out in your policy. As the end of your short-term disability benefits gets closer, you may need to apply for LTD if you are still unable to work.
LTD benefits typically start after a waiting period, which often lines up with the end of your short-term disability benefits. The waiting period is usually around 90 or 180 days after you first become disabled. Because of this overlap, it’s wise to start the LTD application process while you are still receiving short-term disability benefits. This helps prevent a gap in your income.
Unfortunately, receiving short-term disability benefits does not guarantee you will get LTD benefits. You will need to file a new claim and provide updated medical information to show that you continue to meet the definition of disability under the LTD policy.
How to Apply for Long-Term Disability Benefits
The process of applying for long-term disability is similar to your short-term disability application, but it is often more detailed. You will need to:
- Fill out a claim form.
- Provide a statement from your doctor.
- Give a lot of information about your medical condition, including your medical records.
The insurance company will review your medical records closely to determine if your condition meets the definition of “disability” as outlined in your policy. You should make sure your doctor’s reports clearly explain:
- Your diagnosis.
- How does your condition affect your daily life and your ability to work?
- How long is your condition expected to last?
You must submit your completed application and all supporting documents by the deadline. It’s a good idea to keep a copy of everything you send. Your insurance company may contact you or your doctors for more information, so be ready to provide additional details if they ask. The more complete and clear your initial application is, the better your chances of approval.
What Insurance Companies Look for in LTD Transitions
Insurance companies look for specific things during the transition from short-term disability to long-term disability, including:
1. Medical Evidence
This is the most important part of the review. The insurance company requires updated medical records that clearly demonstrate your continued inability to work. They look for detailed reports from your doctors explaining your diagnosis, how it limits you, and what your ongoing treatment plan is. They want to see consistent medical care with no gaps.
2. Disabilities That Fit Their Definition
Long-term disability policies have a specific and often stricter definition of “disability” than short-term disability policies. For the first 24 months, the policy might consider you disabled if you cannot perform your “own occupation.” After that period, the definition can change to “any occupation,” which means the insurance company will assess whether you can do any job that fits your education, training, and experience.
3. Consistency
The insurance company will compare the information in your long-term disability application with what you provided for your short-term disability claim. They will look for any differences in your symptoms or how they affect your ability to work. Inconsistent information can be a reason for denial.
4. Whether You Meet Policy Requirements
Insurance companies will check that you have met all the specific requirements of your LTD policy. This includes applying on time, providing all the needed paperwork, and following your doctor’s treatment plan.
Common Pitfalls When Switching to Long-Term Disability
When going from short-term to LTD, people often make mistakes that can lead to a denial. Some of these are:
- Not Applying on Time: Missing the application deadline can cause a delay in benefits or even a denial.
- Incomplete Paperwork: Failing to provide sufficient medical evidence or omitting essential information can hinder the progress of your claim.
- Lack of Medical Support: If your doctors’ reports are not clear about how your condition affects your ability to work, the insurance company may deny your claim.
When to Talk to an Experienced Richmond Social Security Disability Lawyer About Your Benefits
If you are worried about your application, your claim has been denied, or the insurance company is giving you a hard time, it may be time to speak with a lawyer. Here are some specific times to talk with an experienced Richmond Social Security Disability lawyer:
1. Before You Apply
A lawyer can assist you in preparing your initial application. They can make sure you include all the needed medical evidence and that your forms are filled out correctly. This can help you avoid common mistakes that lead to delays or denials.
2. If You Get a Denial
Most disability claims are denied at the first application stage. This denial is not the end of your case. A lawyer can review the denial notice to understand why your claim was not approved. They can then prepare an appeal and help you gather more information to make your case stronger.
3. If Your Condition Is Complex
If your medical condition is difficult to diagnose or involves multiple issues, an attorney can help explain the full effect of your disability to the insurance company. They know what the insurance company’s definitions of disability are and can present your case in a way that meets those rules.
4. When You Are Preparing for a Hearing
If your claim goes to a hearing, a lawyer can prepare you for the questions you will be asked. They can also question witnesses and present your medical evidence to the judge. Having a lawyer on your side at a hearing can make a big difference in the outcome.
Contact Our Richmond Social Security Disability Lawyer
If you have questions about short-term to long-term disability or need help with your application, contact the law office of Hunter | Everage at 704-377-9157 to request a consultation. We can help you understand your options and work to get the benefits you need.