How to Appeal a Short-Term Disability Denial

Many public and private programs exist to provide short-term disability benefits to injured and ill workers in Ohio. These include

• Ohio Workers’ Compensation
• Personal and company insurance
• Funds like the Ohio Public Employees Retirement System (OPERS) and the State Teachers Retirement System of Ohio.

Consulting with an experienced and knowledgeable Cleveland disability attorney before completing any applications and submitting supporting documents represents an important step toward reducing the likelihood of a claim denial. Being ineligible for the program applied to is the number one cause of short-term disability denials. Closely following that reason for short-term disability denial is filing incomplete paperwork. A dedicated disability lawyer in Cleveland will also be able to assist with collecting and submitting all the required forms, reports, and medical records.

Sadly, a large percentage of correctly filed and properly completed first-time applications for short-term disability receive rejections. When an injury or illness results from an incident at work, the applicant’s employee can contest a workers’ comp claim. The usual contention is that the claimant inflicted the harm on themselves by disregarding safety rules.

Insurance companies will often attempt to challenge a claimant’s inability work while recovering. Programs like OPERS have broad latitude for arguing that settling a short-term disability claim is the responsibility of some other program.

The good news in such situations is that disability benefit applicants have undeniable rights to appeal claim denials. The exact processes for appealing differ from program to program, but taking four actions is always necessary:

• Respond quickly to a notice of disability benefits denial. The deadline to file a notice of appeal can be as short as two weeks from the date on the denial letter. Missing a deadline once a claim is in process can do more than kill that particular claim; it may leave a person ineligible to submit a new application at a later date.
• Take the denial notice letter to your Cleveland disability attorney for interpretation and advice on next steps. The reason a claim was denied may not be immediately clear, and each type of denial requires a unique response. Your legal ally should also be able to refer to other forms of financial assistance and health services while you await disability payments.
• Collect, organize, and submit more evidence to support the claim. Additional evidence usually includes more-detailed diagnoses and documentation of compliance with treatment and physical rehabilitation plans. Submitting financial records that further substantiate loss of wages, medical bills, and financial hardship can also help, as can presenting statements from co-workers, family members, and therapists who speak about the difficulties the claimant experienced while he or she was temporarily disabled.
• Do not take no for an answer. Each short-term disability benefits program permits multiple rounds of appeals. Should each of those fail, a claimant can go to court to try to secure benefits.

The Cleveland short-term disability lawyers with Agee Clymer, Mitchell and Portman welcome opportunities to advise and assist hurt and sick workers. For help with your case, call us at (800) 678-3318 or reach out to us online. An initial consultation will cost you nothing.