What Is the Process When Appealing Short-Term Disability Insurance’s Denial of Request?

A female attorney and her client discuss an upcoming case. The client has their back turned towards the camera. They are wearing a neck brace and holding crutches. The lawyer has a serious gaze as she looks at the client through her black-framed glasses.

If you’ve been injured and unable to work for pay, then you can submit a short-term disability claim to your insurance company to receive financial aid. They’ll have around 45 days or so to review your forms and make a decision — however, no matter how legitimate your injury is, there’s no guarantee it will be approved. Many injury claims are unfortunately denied, leaving individuals without the money they need to support themselves and their families.

Thankfully, it is possible to challenge the insurance company’s decision if you know how to fight short-term disability denial. Here’s an overview of the steps in the short-term disability appeal process and how to get started.

Start Appeal Preparations Soon

When your short-term disability claim is denied, it’s important to start the appeal process as soon as possible. Appeals can only be submitted within a designated time frame, which can be around 60 days or more, depending on the insurance plan. You’ll lose the opportunity to challenge the denial if you miss the deadline, so starting as soon as possible is in your best interests.

One of the first things you should do is find and schedule a consultation with an attorney. They’ll know how to fight short-term disability denials and can be a valuable asset throughout the process. A legal expert can help you review your appeal application, offer advice and assistance, and much more. With a lawyer on your side, the short-term disability appeal process will become much easier.

Understand the Denial

After denying a disability claim, insurance companies will send a letter outlining their reasoning. If you didn’t receive this letter, it’s best to ask them for it. Reading through this letter carefully and understanding why they made their decision is important for knowing how to fight short-term disability denials. 

There are a number of genuine reasons why an insurance company denied your disability claim. It’s possible that you have insufficient medical records or that a particular disability is not included in your coverage. However, there are some circumstances where their denial is because of their own errors — incorrect evaluations and information, to name a few. Some insurance companies might try to deliberately dismiss your claim by finding inconsistencies and other complications. A seasoned lawyer can help you navigate the legal complexities of a denial letter to make understanding your insurance company easier.

Gather Appropriate Evidence

Now that you know the causes of your denial, it’s time to collect evidence from disproving it. The evidence you can gather can take many forms and may require several days or weeks to collect, which is another reason to begin the appeal process early. Here are some of the records and documents that can help you combat a denial:

  • Diagnostic medical reports
  • Mental health records
  • Documentation or opinion written by your doctor
  • Observations of your condition from coworkers
  • A self-written statement about your conditions
  • Police reports, if they pertain to how you developed your injury

Because your attorney knows how to fight short-term disability denial, they’ll be familiar with the kinds of evidence that would be effective in your claim. In addition to documented proof, review all other relevant information, such as your claim application, denial letter, and other pertinent materials.

Submit Reconsideration Appeal

With evidence in place, you’re ready to submit the appeal. Your attorney can help you devise a detailed letter for your insurance company that includes information that will counter their denial. It’s essential that you closely follow the appeal process of your insurance company outlined in their denial letter — any inaccuracies might get your appeal dismissed regardless of how effective your evidence is. Once the appeal letter has been written, and your evidence has been added, it is ready to be sent to your insurance company.

If Your Appeal is Denied, Call a Short-Term Disability Attorney

Unfortunately, there is still a chance your appeal will be denied even when you know how to fight short-term disability denial. When this happens, contact your short-term disability claim lawyer. They’ll review your rights, assist you in filing a federal lawsuit, and help you pave the path forward to obtaining the short-term disability benefits you need.

For the top disability lawyers in New Jersey, Pennsylvania, and Delaware, contact Rosen Moss Snyder LLP. Our law firm has experience helping countless clients receive their short-term and long-term disability benefits and will assist with your case too. Reach out today to get started filing an appeal.

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