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If you experience an injury or illness which requires you to remain off of work, you may be entitled to short-term disability benefits from your employer. Many short-term disability benefit plans require you to be unable to perform your usual and customary occupation. It’s important to know what benefits are available to you before you need to rely on them. You can request your short-term disability benefit plan information from your HR department or the Plan Administrator of the company’s benefit plans.
The terms of a short-term disability plan will vary from employer to employer. This is why you need to review the written plan document to find out what you need to prove eligibility for benefits. The plan document will also inform you of any exclusions and limitations that may impact your claim.
Depending on your employer’s short-term disability plan, you may be entitled to income replacement benefits ranging anywhere from 50% to 100% of your pre-disability earnings. Most short-term disability plans do not provide benefits beyond one year of disability.
It’s important to note that most short-term disability benefit plans offset, or reduce, the benefits payable to you depending on disability income you receive from other sources. For example, many employees are covered by the California Employment Development Department’s State Disability Insurance (“SDI”) benefit program, which provides a 52-week disability benefit. If your short-term disability benefit policy provides you with 60% of your pre-disability earnings, you may only receive about 10% or less of your pre-disability earnings after the offset for the California SDI benefit.
At Kantor & Kantor LLP, we can help you find exactly what information you need to know about your employer’s short-term disability plan.
When you receive the denial of short-term disability benefits letter, you should contact the team at Kantor & Kantor LLP as soon as possible. We have represented numerous clients in their appeals for short-term disability benefits. We have also helped clients with denied claims for short-term disability benefits eventually obtain long-term disability benefits. The benefit denial letter should state the deadline for submitting an appeal, which is usually 180 days. It is important that you do not wait until close to the deadline to find legal representation. Sometimes, it can take the entire appeal period to gather the necessary information to submit a successful appeal.
If you receive a short-term disability benefit claim denial, you must submit an appeal in order to further pursue your claim. If you miss the deadline to appeal, you may completely lose your opportunity to reopen your claim or file a lawsuit in court. Sometimes, you must receive the full amount of short-term disability benefits in order to receive benefits under your employer’s long-term disability benefit plan.
The team at Kantor & Kantor LLP understands the ERISA short-term disability claims and appeals process. We have successfully represented hundreds of clients in their claims for disability benefits. The appeal of a disability benefit denial is one of the most important components of a claim, and we have the expertise to prepare a strong case for you.
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