What You Should Know Before You Read:
- The transition from short term to long term disability is a critical point in your claim and when insurers conduct a more intrusive review.
- Careful documentation, timing, and medical support are essential to getting long term disability benefits approved.
- Understanding what type of evidence to give the insurer greatly improves your chances of approval.
- Dabdoub Law Firm focuses exclusively on disability insurance claims, representing clients nationwide with a proven record of success in federal court.
Understanding the Transition from Short Term to Long Term Disability
Most disability insurance policies provide short term disability (STD) coverage for the first few months after you stop working. This period of time is usually the first 180 days starting with the first day absent from work. When that period of time is up, you may need to apply for long term disability (LTD) benefits under a separate insurance policy or provision.
While this may seem like a routine rollover, insurance companies treat the LTD stage as a new claim, meaning the entire basis for disability is reassess, including whether you are still disabled. Many claimants experience delays or denials at this stage because of avoidable mistakes, missing documentation, or not knowing how to respond to tactics by insurance companies designed to delay or deny a claim.
These five do’s and don’ts will help you prepare for the transition and protect your benefits.
1. Do Start the Claim Early
Insurance companies will tell claimants that the long term disability claim review process does not begin until all short-term disability benefits have been paid. This is usually false.If you wait too long, you may go weeks or months before getting paid benefits..
Do:
- Confirm the exact date your short term disability coverage will end and when your long term disability claim must be submitted.
- Begin gathering updated medical records and documentation before your STD period expires.
- Plan to submit your LTD claim about 2 to 3 months before the STD period expires.
Do Not:
- Assume the insurer will automatically roll over your short term disability claim into long term disability. Even if the same company handles both, LTD claims typically require new paperwork and additional review.
- Do not take advice from the insurance company that you must wait to begin the LTD claim until all STD benefits have been paid.
2. Do Keep Consistent Medical Treatment and Documentation
Continuity of care is one of the most important factors in determining whether your LTD claim is approved. Consistent and appropriate medical treatment demonstrates that your disability persists beyond the short-term period.
Do:
- Continue regular appointments with your doctors and follow all recommended treatment.
- Make sure your providers’ notes reflect that your symptoms remain disabling and that you cannot return to work.
Do Not:
- Let your treatment lapse or skip follow-ups because your STD claim was approved. Gaps in medical care may be interpreted as evidence of improvement.
3. Do Review the Long Term Disability Policy Carefully
The long term disability policy may have different definitions, waiting periods, or evidence requirements compared to the short term policy. Understanding these differences can help you anticipate what the insurer will scrutinize.
Do:
- Review the LTD policy language, especially how it defines “disability.”
- Confirm whether the policy shifts from an “own occupation” to an “any occupation” standard after a certain period.
Do Not:
- Assume that the approval for short term disability guarantees approval for long term disability. The insurance company will undertake a stricter medical and occupational review.
4. Do Communicate Clearly with Your Doctors About Work Limitations
Your treating physicians’ opinions carry significant weight in determining whether you qualify for long term disability benefits. Insurance companies are required, by law, to give significant weight to your doctors’statements about your ability to work.
Do:
- Ask your doctors to clearly describe how your medical condition prevents you from performing your job duties.
- Make sure restrictions and limitations resulting from your medical conditions are properly documented in your medical records.
Do Not:
- Assume that your doctor’s treatment notes automatically explain your disability. Medical records often focus on diagnosis and treatment, not functional limitations. Diagnosis alone does not get disability claims approved.
5. Do Consult Dabdoub Law Firm Early in the Process
The transition from short term to long term disability can be complex, and early legal guidance significantly increases chances of approval. Our team of expert disability attorneys can help you prepare your documentation, meet all deadlines, and handle every aspect of your long term disability claim.
Do:
- Call Dabdoub Law Firm before your short term disability benefits end to ensure a smooth transition.
- Have your attorney review your LTD policy and claim forms before submission.
Do Not:
- Wait until your claim is denied to seek help. Early involvement gives your attorney time to build a strong record and address potential issues before they become obstacles.
How Dabdoub Law Firm Can Help
Preparation is key. Dabdoub Law Firm helps clients across the country navigate this process with expertise and experience. We stand in the shoes of our clients so that insurance companies never contact them and can only engage with our disability attorneys.
We assist clients with:
- Filing a disability insurance claim when the insurer questions ongoing eligibility.
- Appealing a wrongful denial or termination of benefits during or after the transition period.
- Negotiating a lump-sum settlement when a final resolution is in your best interest.
- Litigating claims in federal court when the insurer fails to act in good faith or follow the law.