Short-Term vs. Long-Term Disability: Understanding the Difference

Sep 23, 2014

If medical conditions have rendered you disabled for any period of time, you need to understand the types of disability benefits available and how to access them. A Columbus, Ohio short-term/long-term disability insurance attorney can help you understand what options you have to make it through a period of not working.

Short-Term vs. Long-Term Disability

If you are disabled it means that you cannot work. The designation of short-term or long-term depends on the length of your disability period. A short-term disability generally persists for less than one year. A long-term disability lasts longer than one year.

Disability Insurance

Both short-term and long-term disability insurance describe private insurance benefits. That means you or your employer purchase short-term and long-term disability insurance from a private insurance company. Some employers provide group disability insurance policies as part of their benefits packages. If your employer does not offer short-term or long-term disability benefits, or if you want additional coverage, you can buy an individual policy from an insurance agent. Private insurance is different from a government benefit like workers’ compensation or Social Security disability.

Short-Term Disability Insurance

Short-term disability insurance replaces some of your income for a period of a year or less when you cannot work at all or can only work part-time because of a disability. Short-term disability benefits start after you run out of leave or sick days. To obtain coverage, you or your employer must pay a monthly premium. When an illness or injury prevents you from working, you apply for benefits through your human resources representative or your insurance agent.

If your insurance grants benefits, under a typical policy you will receive around 60% of your previous income. For instance, if you earned $1,000 per week, short-term disability insurance would pay you $600 per week while receiving benefits.

Long-Term Disability Insurance

Long-term disability insurance helps replace some of your income when you cannot work at all or can only work part-time because of a disability for an extended period of over one year. You apply for benefits by speaking with your human resources representative or your insurance agent.

Long-term disability requires a waiting period between the date you leave work and the date you actually get your benefits. Depending on your plan, you may wait anywhere between 90 days and a year before benefits are paid. Like short-term disability, long-term disability insurance usually pays a percentage of your income—usually 80% for the first few weeks then a lower percentage in the weeks that follow.

Many people choose to apply for Social Security Disability and or Supplemental Security Income benefits from the government while receiving long-term disability insurance benefits.

Denial of Benefits

Applications for short-term and long-term disability insurance require the submission of medical records. Often times, insurance companies deny disability benefits applications based on the medical records you submitted.

If your insurance company denies benefits, it might be time to hire an Ohio short-term/long-term disability insurance lawyer. A disability attorney can help your through the appeals process. Generally, an appeal requires building a record and submitting additional medical documents to your insurance provider. In order to build a record you should ask your doctors for written opinions, get any objective testing that reveals the extent of your disability, request letters or expert testimony, and track down any missing records. A short-term/long-term disability insurance lawyer can help build the record and can communicate and negotiate with insurance companies.

Appealing an insurance company’s decision may not always result in granting of benefits. If an insurance company sends a final letter of denial, this ends what lawyers call the administrative process. You could still get benefits, even after an insurance company denies your appeal.

The next step is to file a lawsuit against the company. Claims for denial of benefits arise under a statute called the Employee Retirement Income Security Act of 1974, or simply ERISA. If you file an ERISA lawsuit, a federal judge will review the administrative record to decide whether the insurance company violated its own policy or any part of ERISA.

The short-term/long-term disability insurance attorneys at Agee, Clymer, Mitchell & Portman have significant experience representing clients with disabilities throughout Ohio. We know exactly how to handle short-term and long-term disability insurance matters. In addition, our experience in all areas of disability law allows us to ensure clients avail themselves of all possible avenues to receive benefits. Our highly sophisticated team has the capability to file and represent clients in multiple overlapping claims. With offices in Columbus, Circleville, Jackson, Chillicothe, Cincinnati, Dayton, Delaware, and Galion, we are among Ohio’s premiere disability law firms.

If you are experiencing problems getting short-term or long-term disability insurance benefits, contact Agee, Clymer, Mitchell & Portman today online or call at 1-800-678-3318.

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Worker’s Comp Lawyers Columbus, Ohio - Agee Clymer

140 E. Town St. #1100
Columbus, OH 43215