Answering FAQ Surrounding The Denial of Short-Term Disability Claims

If you have ever been sick enough that it forced you to leave work for a significant period of time, then you may have some experience with the application process for short-term disability insurance benefits. And additionally, you may also have experience with having that very claim denied. Thus, what do you do when that happens?

Firstly, it may be comforting to hear that you are not the only one to have made that experience. Many people in similar situations come to us with all kinds of questions, like…

How can I increase my chances of winning the appeal?

After your short-term disability claim has been denied, you may want to file an appeal so your case will be re-assessed. For this, you will need to gather additional evidence to prove the severity of your condition. The best way to do this is by visiting a supportive doctor and ensuring that your treatment is of a high standard. From there, you will continue to follow all of your doctor’s recommendations for as long as they are reasonable. Failure to do so will lead to a declined claim, since it could be proof of you failing to mitigate your condition. However, if you feel uncomfortable or unsupported by your doctor’s treatment, you will need to push for a referral to another doctor specialized in your condition. This referral will then need to be communicated to your insurer. Additionally, having a Personal Injury Lawyer in Vaughan represent you helps.

What about Employment Insurance Sickness Payments?

You can apply for these payments if your claim has been denied or if you are certain that the approval of your claim has been delayed. If the latter is true, immediate application is vital. In either case, you will need your doctor’s recommendation for your application to be successful. EI sickness payments sit at little over half of your weekly income and last for fifteen weeks. Later, approval of your short-term disability will obligate you to return these payments.

Can I be fired if my claim is denied?

Not because of your condition, no, but you can be fired during sick leave if it is due to unrelated matters. However, after your claim has been denied, you will need to prove to your employer that you are still sick, despite the denial, otherwise they may count is as absenteeism.

Can my insurer force me back to work after the denial?

No, they cannot. They can use financial pressure by terminating your benefits, but they cannot force you back into work. However, returning and failing to stay for no more than a few days due to your condition can be a powerful tool to win your appeal.

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