Disability insurance policies can come with unfamiliar jargon, confusing timelines, and fine print that’s difficult to navigate. You may be wondering about the differences between short-term and long-term disability insurance and how each type works.
In most cases, people have both types of coverage if they have disability insurance at all. The key distinction lies in the duration and purpose of each: short-term disability insurance typically covers temporary setbacks, offering support for a few weeks or months, while long-term disability insurance provides coverage for extended periods, helping with income replacement during prolonged illness or life-changing injuries. What you have depends on your individual needs, job, financial situation, and long-term goals, so it’s important to understand what each policy offers and how they work together.
At Kantor & Kantor, we understand how important it is to get disability insurance right. Whether you are choosing a policy, filing a claim, or facing a denial, our experienced attorneys are here to guide you. We have seen firsthand how the right coverage can make all the difference in someone’s life—and how frustrating it can be when insurers do not uphold their promises.
What Is Short-Term Disability Insurance?
Short-term disability insurance, often referred to as STD, is a type of coverage that provides financial support if you are temporarily unable to work due to an illness, injury, or other disabling condition. It helps replace a portion of your income so you can cover essential expenses and medical bills while you recover.
This type of insurance is designed for situations where your condition is expected to improve within a relatively short period—usually a few weeks to several months. Common reasons for filing a short-term disability claim include recovery from surgery, pregnancy and childbirth, or acute illnesses or injuries like a broken bone.
How Does Short-Term Disability Insurance Work?
Short-term disability benefits typically begin shortly after you become unable to work. Most policies have a waiting period, also called an elimination period, which is the time between your injury or illness and when the benefits kick in. This waiting period can range from one to 14 days.
The duration of coverage varies by policy but generally lasts anywhere from three to six months. Some policies may extend benefits up to a year, depending on the terms.
What Is Long-Term Disability Insurance?
Long-term disability insurance, often called LTD, is a type of insurance that provides financial support when you are unable to work due to a serious illness or injury that lasts for an extended period.
Unlike short-term disability insurance, which typically covers temporary conditions, LTD is designed to help you maintain your income for months, years, or even decades if you are unable to return to work.
How Does Long-Term Disability Insurance Work?
When you become disabled and unable to work, long-term disability insurance kicks in after a waiting period, also known as the elimination period. This period usually lasts anywhere from 90 to 180 days. During this time, many people rely on short-term disability insurance.
Once the waiting period is over and your claim is approved, long-term disability benefits will provide a percentage of your income depending on your policy. These benefits can continue for a set number of years or until you reach retirement age, depending on the terms of your plan.
What Does Long-Term Disability Insurance Cover?
While specific coverage details depend on the terms of your policy, most long-term disability insurance plans cover a wide range of conditions, including:
- Chronic Illnesses: Chronic conditions like multiple sclerosis, lupus, or rheumatoid arthritis can make it difficult or impossible to maintain regular work duties.
- Serious Injuries: Accidents or injuries that result in long recovery periods or permanent impairments, such as spinal injuries, traumatic brain injuries, or loss of limbs, are typically covered under long-term disability plans.
- Mental Health Disorders: Severe mental health conditions, such as major depression, bipolar disorder, or post-traumatic stress disorder (PTSD), may qualify for benefits if they significantly impact your ability to work.
- Cancer: Individuals undergoing treatment for cancer, dealing with its long-term effects, or experiencing complications may be eligible for long-term disability benefits.
- Progressive Diseases: Conditions like Parkinson’s disease, ALS (amyotrophic lateral sclerosis), or Alzheimer’s disease, which worsen over time and limit your ability to work, are commonly covered.
- Cardiovascular and Respiratory Conditions: Serious heart conditions, chronic obstructive pulmonary disease (COPD), and other illnesses that impair physical stamina or cognitive abilities often qualify for long-term disability benefits.
- Autoimmune Diseases: Disorders such as Crohn’s disease, fibromyalgia, and chronic fatigue syndrome may be covered if they substantially impact your work capacity.
Why Are Long- and Short-Term Disability Claims Denied?
Both long-term and short-term disability insurance claims can be denied for a variety of reasons. Here are some reasons for denial:
1. Insufficient Medical Evidence
Insurance companies require detailed medical documentation to prove that your condition prevents you from working. If your records are incomplete, unclear, or fail to show the severity of your disability, your claim may be denied.
2. Missed Deadlines
Disability claims often have strict deadlines for filing paperwork, submitting evidence, and responding to requests. Missing these deadlines can result in an automatic denial.
3. Non-Compliance With Treatment
If you fail to follow prescribed treatments or medical advice, insurers might argue that you are not doing everything possible to recover, leading to a denial of your claim. This can include skipping treatments, not taking prescribed medications, or failing to attend follow-up appointments with your healthcare provider.
4. Duration of Condition
For short-term disability claims, if the insurer believes your condition will not last beyond the policy’s minimum duration requirement, they might deny the claim. Similarly, for long-term disability, if they determine the condition is temporary, not chronic, they may deny it.
What Can You Do if Your Claim Is Denied?
Here are steps you can take if your claim has been denied:
- Review the Denial Letter: Understand the reasons for denial. This letter should provide specific explanations as to why your claim was denied.
- Gather More Information: Collect additional medical evidence, doctors’ statements, and any other documentation that supports your claim.
- Appeal the Decision: Most insurance policies offer a process for appealing a denial. This is a critical opportunity to present additional evidence and arguments.
- Get Legal Help: Contacting our disability insurance lawyer can provide you with guidance and increase your chances of overturning the denial.
How Kantor & Kantor Can Help
Often, when you are making your case for short- or long-term disability insurance, it helps to have a professional on your side to support you, ensure all deadlines are met, and navigate the disability insurance system. Here is how we, at Kantor & Kantor, can help you:
Policy Review and Guidance
Disability insurance policies are often full of confusing legal jargon and fine print. We will review your policy in detail, explain what it covers, and help you understand your rights and responsibilities. This way, you will know exactly what to expect if you need to file a claim.
Filing a Claim
Submitting a long-term or short-term disability claim can be complicated. Insurance companies often require extensive documentation and precise details about your medical condition and ability to work. We can assist you in gathering the necessary evidence, completing the paperwork, and presenting your claim in a way that strengthens your case.
Appealing Denied Claims
Insurance companies frequently deny claims for various reasons. We have experience appealing claim denials and holding insurance companies accountable. We will build a strong case on your behalf and fight for the benefits you are entitled to.
Litigation Support
If your insurer refuses to pay even after an appeal, we are prepared to take legal action. Our attorneys have a proven track record of successfully litigating disability insurance cases. We will advocate for your rights and work tirelessly to achieve a fair resolution, whether through negotiation or in court.
We are people helping people, and we are here to help you secure the benefits you deserve.
Contact a Disability Insurance Lawyer Today
Having the right type of coverage—whether short-term, long-term, or both—can make all the difference in maintaining your financial stability and focusing on your recovery without unnecessary stress.
But insurance policies are not perfect, and too often, legitimate claims are delayed, reduced, or denied outright. When this happens, it can feel like the system is working against you during a time when you are most vulnerable.
Our team has years of experience holding insurance companies accountable and fighting for your rights. We will ensure you are treated fairly and that the promises in your policy are upheld. Disability insurance should offer peace of mind – not frustration.
Contact us today at 818-886-2525 for a free consultation and let us help you secure the benefits you have earned.
