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Can I File for Long-Term Disability Benefits Even if My Claim for Short-Term Disability Benefits is Denied?

Can I File for Long-Term Disability Benefits Even if My Claim for Short-Term Disability Benefits is Denied?

Short-term disability benefits can be useful for employees who need to be off work due to a medical condition for a limited period. In the state of California, most workers are entitled to State Disability Insurance (SDI), although some employers can provide comparable short-term disability plans.

Nonetheless, in some situations, you may not be eligible for short-term disability benefits, particularly if you are seeking benefits through an employer-sponsored private plan. However, being denied short-term disability benefits does not automatically disqualify you from seeking long-term disability benefits, particularly if injury or medical condition has worsened over time.

Some of the reasons that you might receive a denial of short-term disability benefits have little to do with the fact that you are temporarily disabled due to an injury or illness. For instance, some private short-term disability plans might require you to be employed for six months or another period before you’re eligible for benefits. Likewise, you may have to exhaust all available sick leave time before you qualify for short-term disability benefits.

In the case of SDI benefits, you must have earned a specific amount of money during your base period, which is typically 15 to 17 months before you apply for benefits to qualify. You also may have to attend at least one doctor’s appointment that the Employment Development Department (EDD) sets up for you to get SDI benefits. However, if you don’t keep that appointment as scheduled, you might disqualify yourself from coverage. You might still be disabled and unable to work, but you might not be able to get SDI benefits.

Although insurance companies tend to approve more short-term disability benefit claims than long-term disability benefit claims, denials of short-term disability claims still occur. As a result, even as you appeal a denial of short-term disability benefits, however, you may still want to move forward with a long-term disability claim.

Long-term disability claims are complex matters that require intensive knowledge of ERISA laws and regulations. As a result, you will need experienced legal representation and advice to pursue an ERISA-governed disability claim. Bonnici Law Group is a law firm focusing on ERISA long-term disability benefits and bicycle injury cases in San Diego, CA. When you need effective legal representation, contact Bonnici Law Group at 858-261-5454 or email us at help@bonnicilawgroup.com.

2410, 2024

Understanding the Statute of Limitations for Disability Policy Denials and the ERISA Appeal Process

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One of the most common questions people have when dealing with long-term disability denials is: How long do I have to appeal, and what is the statute of limitations on filing a lawsuit?

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