Short-Term Disability Claim Lawyer in Birmingham, AL
Secure income replacement so you can make a full recovery
When people get seriously hurt or suffer a health setback, it can affect their ability to do their job. That’s why there’s short-term disability coverage comes in. Short-term disability provides temporary financial relief as someone heals so they can get back to earning a living. Unfortunately, insurance companies may deny your benefits even when you qualify for them.
Denied short-term disability benefits can mean the difference between making ends meet and losing your ability to recover with dignity. Alabama insurance lawyer Tom Sinclair doesn’t think that’s fair. He’s here to make sure you get those benefits and can make a full recovery.
It’s an uphill battle taking on insurance companies, but Sinclair Law Firm is up to the challenge. To request a free claim review with an Alabama short-term disability claim lawyer, contact our Birmingham law firm today. You can also reach our law office by phone at (877) 249-0091.
Understanding Short-Term Disability Insurance
Short-term disability benefits provide workers with temporary income replacement if an injury, illness, or medical condition prevents them from performing their usual job duties. This covers a wide range of conditions, including serious bodily injuries, major illnesses, and recovery from a medically necessary surgery or treatment.
Most people have group short-term disability coverage through their workplace/employer, though it’s possible to purchase individual short-term disability plans as well.
Eligibility for Short-Term Disability Coverage
To qualify for short-term disability coverage:
- You need to have a temporary medical condition that prevents you from doing job-related activities
- You need a medical certification from a doctor that verifies you are unable to work
- You need to have been employed long enough to be eligible for short-term disability coverage
If your injury, illness, or medical condition was caused by an on-the-job accident or performing your workplace duties, you would apply for workers’ compensation benefits instead of short-term disability.
How Much Beneficiaries Receive While on Short-Term Disability
The amount paid through short-term disability ranges from 40% to 70% of your weekly pay. This can vary, however, based on the type of policy you have. If you’re curious about how much you’ll receive, check your policy or discuss this with your plan advisor.
The Duration of Short-Term Disability Benefits
Short-term disability benefits typically last from three to six months. Depending on the nature of your condition, you may be able to extend your short-term disability up to 12 months.
By comparison, long-term disability benefits typically last anywhere from two years to retirement age, depending on the policy and the nature of the injury or illness.
Short-Term Disability and ERISA: The Risk of a Denied Claim
Many employer-provided workplace benefits are subject to regulations under the Employee Retirement Income Security Act of 1974 (ERISA). Most of our clients had never heard about ERISA until their employer-provided benefits got denied.
This federal law was originally intended to protect group plans and employee retirement benefits. However, insurance companies have figured out how to turn the law against workers. Under ERISA, you need to go through a specific set of procedures to appeal for your denied disability benefits.
You Need an Attorney as Soon as You Get a Denial Letter
If your ERISA claim was denied, you have a tight deadline to seek those benefits. For many short-term disability claims, you have just 180 days to file an appeal. Once that time is up, you’ve lost those benefits for good.
Once you get that denial letter, it’s best to contact our Birmingham law office about your short-term disability claim. Even if your plan isn’t governed by ERISA, it’s worth seeking legal help as soon as possible. Attorney Tom Sinclair and his team are ready to help.
Why Choose Sinclair Law Firm for Your Short-Term Disability Case
Attorney Tom Sinclair started his legal career representing the insurance industry and automakers. He realized his true calling was helping normal Alabamians who’ve been wrongfully denied access to coverage, such as short-term disability benefits. Our Birmingham legal team is driven to help everyone in need.
We Handle ERISA and Non-ERISA Claims
Tom and his team can work on ERISA and non-ERISA short-term disability disputes. Each type of case has separate processes and challenges, but you can trust our experienced legal team to diligently work on appeals and litigation. Don’t go it alone against the insurance company. You can count on our firm.
We Work with Our Own Team of Experts
Insurance companies have a team of experts who justify the denial of disability claims. Sinclair Law Firm also works with experts who will dispute the insurer’s decision. Our team will connect you with reputable doctors who can conduct independent medical exams and functional capacity evaluations.
We Represent Alabamians from All Walks of Life
Tom and his team believe in helping all Alabamians in need. It doesn’t matter where you come from or your politics. When the system lets people down, we want to right wrongs and level the playing field for honest people who just need a little help while they heal.
We Offer Free Legal Consultations
At Sinclair Law Firm, you can get honest advice from professionals without worrying about a bill. Our team in Birmingham will analyze your short-term disability claim, your case, and your policy. We don’t make any promises of representation unless we know we can do some good for you.
We’ll Work with You and Your Financial Situation
If you’re unable to work, you’ve got a lot of financial worries on your mind. We understand. At Sinclair Law Firm, we can work with you and your financial circumstances to find a fair payment arrangement that makes the most sense.
Get a Free Claim Review from a Birmingham Short-Term Disability Attorney
As soon as you get your denial letter, you need us on your side. We’re ready to help you get those benefits you’ve earned and qualify for. To request a free consultation with an experienced Alabama attorney about your short-term disability claim, contact our Birmingham law firm today.
Reasons Short-Term Disability Coverage Gets Denied
The denial letter will state why your disability coverage has been denied or delayed. Here are a few common reasons our past clients have run into issues with their short-term disability benefits:
- Condition Doesn’t Meet the Definition of Disability: The insurer may state that your health condition is not severe enough to qualify as a disability under your policy.
- The Condition Is Excluded from the Policy: Certain types of conditions may be excluded from coverage under the policy. This includes self-inflicted injuries, conditions caused by elective procedures, or illnesses linked to a pre-existing condition.
- Policy Holder Didn’t Meet Eligibility Requirements: Insurers may claim that you do not meet basic eligibility requirements because you haven’t been employed by the company long enough to qualify. Other reasons may also be cited.
- Lack of Sufficient Medical Documentation: Insurers might say there’s not enough evidence of your condition, citing incomplete medical records, vague diagnoses, or lack of objective testing.
- Evidence That Contradicts the Disability Claim: You may be denied coverage because there is contradictory evidence of a disability. This might involve issues with your medical documentation. You may also be surveilled, and the insurer finds evidence that you are not actually disabled.
- Missed Deadlines, Errors, or Incomplete Information: Claims can also be denied if applications are filed late, forms are not completed, or there’s inaccurate or incomplete information.
How to Fight for Denied Short-Term Disability Benefits
Our Birmingham team can review your short-term disability denial and start determining the best course of action to secure your benefits. The right approach will depend on whether your policy is subject to ERISA regulations or not.
Legal Options for Non-ERISA Short-Term Disability Denials
For plans not subject to ERISA regulations, our Birmingham short-term disability attorney can demand to see your claim file. Based on what’s contained in your file, our team can start crafting an appeal so you can secure those benefits and get your bills taken care of.
Since non-ERISA plans are governed by Alabama state law, attorney Tom Sinclair and his team can also explore filing a bad faith insurance claim. These legal actions can recover damages when people have been wrongfully denied benefits that they were entitled to receive. In addition to payment of benefits, compensation can also include additional financial losses associated with the denial of benefits as well as pain and suffering.
Legal Options for ERISA Short-Term Disability Denials
For plans governed by ERISA, you will need to file an appeal within that tight deadline, which is usually 180 days for short-term disability claims. During the ERISA appeals process, Tom and his team will create an appeal that satisfies requirements and provides additional medical documentation and evidence that you are rightfully entitled to those benefits.
If your appeal is unsuccessful, Sinclair Law Firm will then help with the trial process. ERISA trials are different than bad faith trials. These federal trials involve a review of your appeal by a federal judge. There’s no jury, and no new evidence is admitted, so your appeal needs to be your legal foundation.
These strict deadlines and specific processes are why you need an ERISA lawyer on your side after a denied short-term disability claim. Our Birmingham law office is here to craft a persuasive appeal and increase your chances of getting those benefits.
Contact an Experienced Short-Term Disability Attorney in Birmingham, AL
If you’re unable to work and have been denied your short-term disability benefits, Sinclair Law Firm is ready to offer our help. Whenever the system pushes working people around, we’ll gladly push back. For a free claim review with an experienced Alabama short-term disability lawyer, contact Sinclair Law Firm today. You can also call our Birmingham law office at (877) 249-0091.
Short-Term Disability FAQs
Short-term disability coverage can be confusing, regardless of whether your policy is subject to ERISA. We get it. Our team has compiled some common questions about these claims we’ve received from Alabamians just like you. If you have additional questions about short-term disability claims, our Birmingham law office can get you the answers you’re looking for.
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.
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.
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.
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.
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.