Frequently Asked Questions

Yes, if you’ve exhausted your short-term disability benefits, you may be able to apply for long-term disability benefits. Usually this happens after you’ve had an extension of your short-term disability benefits.

To go from short-term to long-term disability, you will need to meet the stricter eligibility requirements of the long-term disability coverage and provide medical evidence that you are unable to work long-term. It may also be possible to apply for Social Security Disability Insurance (SSDI) depending on your work history.

The answer varies. This usually depends on who pays the premiums and when they are paid.

• If you pay for the premiums with your after-tax dollars, your short-term disability benefits are not taxed.
• If your employer pays for all of the premiums, your short-term disability benefits are taxed.
• If you split premium payments with your employer and your share is deducted from your paycheck, your short-term disability benefits are taxed.
• If you split premium payments with your employer and your share is paid with after-tax dollars, half of your short-term disability benefits are taxed.

Maybe. This depends on your short-term disability policy, the nature of your part-time work, the number of hours worked, and how much income you’d earn. Double-check your short-term disability policy before considering any part-time employment.

If you are permitted part-time work, you will likely need to report all work activities to your insurance provider and your employer.

Potentially yes, though this depends on your short-term disability policy and your workplace. It also depends on how pregnancy and/or childbirth have affected your ability to work and what medical evidence can be provided with your claim.

Yes, you can apply for short-term disability if you experience behavioral and mental issues such as depression, anxiety, and post-traumatic stress disorder (PTSD). However, the claim approval process for mental health crises can be more challenging.

Yes, though that is not always the case. This is dependent on your employer and whether they allow retirees to maintain their life insurance benefits after they’ve finished working.

If you or your spouse has retired and you have concerns about your ERISA life insurance coverage from your old company, reach out to your plan advisor or old employer for more information.

If your ERISA life insurance benefits are denied, you’ll be asked to gather specific documents to help support your appeal. This may include:

• Death certificate
• Medical or employment records
• Plan documents
• Relevant communications with the employer or insurer

When you reach out to Sinclair Law Firm, we can give you a full list of what you’ll need. Tom and his team will discuss what other supporting evidence we’ll include to make sure you have a strong legal foundation in your appeal.

Under ERISA rules, a married person is required to list their spouse as the primary beneficiary of a life insurance policy unless the spouse provides written consent otherwise. Other possible beneficiaries include children, close family members, and other designated dependents.

Some of the most common reasons a person’s ERISA life insurance gets denied include:

• An alleged lapse in coverage
• Loss of benefits from termination
• Failure to convert coverage after leaving a job
• Alleged mistakes or misrepresentations on forms
• Failure to provide “proof of insurability”
• Disputes over beneficiary designation

Your denial letter will include the reason(s) for your claim denial as well as instructions on how to appeal. Your attorney can build a strong appeal based on the reason(s) your claim was denied, and look for strong supporting effort that helps demonstrate the abuse of discretion standard.

Any time you feel an insurer acted in bad faith, we recommend that you review your insurance policy, gather the denial letter and any other documents from the insurer, and request a free claim review at our Birmingham law office. We can determine if you have a viable bad faith claim and begin the process of holding the insurer accountable.

No, your existing insurance coverage should not be impacted by filing a lawsuit as long as you continue to meet the terms in your policy. However, some insurers may retaliate against you because of the bad faith claim. Let Sinclair Law Firm know if you notice that your premiums have gone up or if your insurance policy is not renewed.

Yes. Just because you were paid does not mean the insurer acted in good faith. Any delays or misconduct that causes you to wait for payments or experience a financial loss are grounds for a bad faith claim. In fact, the insurance company may have been lowballed you with their initial offer, and that can also be grounds for a bad faith claim.