A sudden injury can temporarily put your life on hold and make it impossible to work. Short-term disability is a safety net that can protect workers when they have a temporary setback from an injury. However, insurance companies might deny your short-term disability claim.
If you are making a short-term disability claim or have received a claim denial, you need a Fort Worth insurance claims lawyer on your side. At ERISA Insurance Claim Attorneys, founder Price McNamara has over three decades of experience managing short-term disability and bad-faith insurance lawsuits.
We can hold insurance companies accountable to their payment obligations and help you recover the compensation you need for financial stability while in recovery. Contact our offices today to speak to a short-term disability lawyer in Fort Worth.
How Does Short-Term Disability Insurance Work?
Short-term disability is a type of insurance coverage that protects you if you are unable to work due to an injury or illness. Short-term disability in Fort Worth will replace a percentage of your regular work income for a set period, typically up to six months. Employers usually offer short-term and long-term disability insurance as employee benefits.
What counts as a disability depends on the specific policy. However, the typical definition is any illness or injury that renders you partially or fully unable to fulfill normal work duties. Common conditions that may qualify for disability include:
- Injuries from physical trauma
- Chronic disease (e.g., heart failure)
- Musculoskeletal issues (e.g., arthritis)
- Neurological disorders (e.g., epilepsy)
- Mental illness (e.g., depression, PTSD, etc.)
- Autoimmune conditions (e.g., lupus)
Note that short-term disability is specifically for non-work injuries. If you sustain an injury at work, you would typically take workers’ compensation benefits instead.
For a free legal consultation with a short-term disability lawyer serving Fort Worth, call (225) 201-8311
How Much Does Short-Term Disability Pay?
Short-term disability in Texas will usually replace anywhere between 50% and 70% of your average weekly earnings, up to a maximum weekly amount.
For example, say your plan replaces 60% of your income up to a maximum of $850 a week. If your average earnings are $1,000 per week, you’d receive $600 weekly. If your average weekly earnings are $1,600, 60% would be $960, but you’d instead only receive the maximum amount of $850.
Fort Worth Short-Term Disability Lawyer Near Me (225) 201-8311
How Long Does Short-Term Disability Last?
How long short-term disability lasts depends on the specific policy, but most will offer benefits for a maximum of six months. In most cases, you have to use any available sick time and wait through an exclusion period before you can start receiving benefits.
If you expect your disability to last for more than six months, you would instead file a claim through long-term disability coverage. Long-term disability coverage will pay benefits for a set period as defined in the policy—typically two to ten years or until retirement age.
Click to contact our Fort Worth Insurance Claims Lawyers today
Common Reasons for Short-Term Disability Denials
When denying claims, insurance companies must provide written notification explaining their justification for the decision. Below are some of the most common reasons why insurance companies deny short-term disability claims:
- Condition doesn’t meet disability definition. Your medical conditions may not meet the policy’s definition for disability or may not sufficiently impact your ability to work.
- Insufficient medical documentation. To make a short-term disability claim, you must have exhaustive medical documentation of your diagnosis and treatment efforts.
- Injury is a pre-existing condition. Short-term disability typically won’t cover disability from pre-existing conditions or illnesses that you had before getting the policy.
- Ineligible for coverage. You typically need to work for a specific period (four to six months) before you are eligible for coverage under an employer-sponsored disability plan.
- Filing deadline has expired. Most insurance policies require you to make a claim within a specific time limit after the onset of your disability, usually ten to 30 days.
If your short-term disability claim has been denied, it’s imperative that you meet with a Fort Worth short-term disability lawyer to discuss options for appealing the decision.
Complete a Free Case Evaluation form now
Short-Term Disability Plans and ERISA Laws
Employer-sponsored disability insurance plans are governed by the federal Employee Retirement Income Security Act (ERISA). ERISA lays out minimum standards for employee-provided retirement and health plans. It requires them to provide certain plan information and establish an appeals process for claim denials.
ERISA also gives employees the right to sue insurers for breach of fiduciary duty or a failure to pay for due benefits. If your employer-sponsored disability insurance has denied your claim, we can help you file an appeal under ERISA laws to coerce them into paying. We can also take your case to formal litigation if necessary to recover your payments.
Contact a Fort Worth Short-Term Disability Lawyer Today
For many workers, short-term disability is a critical buffer to protect their finances and stability, which means a denial can cause significant complications. The team at ERISA Insurance Claim Attorneys can assess your situation and offer help with appealing a denied short-term disability claim.
Contact our offices online or call today to schedule a consultation with a short-term disability lawyer in Fort Worth. Case evaluations are free, so you have nothing to lose by getting in touch.
Call or text (225) 201-8311 or complete a Free Case Evaluation form