Private Short-Term and Long-Term Disability Insurance in Pennsylvania
Employment, Family Law, Individual, Unemployment | February 13, 2014
Many times, people will not think about their private, short-term or long-term disability plan until after something happens to them. Only then, do they find out whether the plan they’ve been paying for all those years is any good or not.
Disability Benefits
The first thing a person who is applying for short-term or long-term disability benefits quickly learns from their private disability insurance company is that getting paid is not always going to happen as easily or as quickly as they thought. For one thing, Pennsylvania disability plans usually require that a person be “disabled” (whatever that means – see discussion below) for a period of time before short-term or long-term disability benefits are actually paid. This is generally known as the “elimination” or “waiting” period. Typically, short-term or long-term disability plans require a person to be disabled for 30, 60 or even 90 days before they can collect a dime under their private short-term or long-term disability plan. For Pennsylvania residents, this often comes as a shock.
Defining Disability
The next thing a person learns is that all policies do not define disability the same way. Some disability plans define disability as the inability to perform the job at which you were working at the time you became disabled. This is sometimes referred to as “own occupation” disability insurance. Other plans, however, require that the person be unable to work any job for which they are otherwise suited based on their education and work experience. It does not take a rocket scientist to figure out that proving you cannot do the job at which you were working when your disability started, is not nearly as tough as showing you cannot do any other kind of work activity.
Claim Approval
Finally, a person seeking short-term or long-term disability benefits quickly learns that their disability insurance company is not nearly as eager to approve their private disability insurance benefits as they are to receive them. Indeed, the disability insurance company will routinely require substantial documentation including an application and related forms, medical records and statements from your physicians. If and when they have all of that, if the insurance company is not satisfied with what they get, they will pay a doctor to review the medical records and other relevant documents. As you might imagine, the insurance company’s paid physician will often declare that the applicant seeking disability benefits is not disabled, thus giving the insurance company a valid basis to deny the claim.
All of this, then, usually leaves a person completely flabbergasted because, after all, they have been paying the disability insurance company for years for just such a time as this – and yet, now that same company who gladly took their premium payments is not paying their benefits and is giving them a hard time.
If you find yourself in this situation and if you are a Pennsylvania resident who applied for short-term or long-term disability benefits and you are getting the run around, contact the disability insurance lawyers at Trinity Law. The private disability insurance lawyers at Trinity Law help Pennsylvania residents whether in York County, Adams County, Lancaster County, Cumberland County, or Dauphin County. Contact us as soon as you notice that you are not getting satisfaction in the private disability insurance claim’s process. And, by all means, be aware the if you receive a denial from your short-term or long-term disability insurance company, you generally have a limited time to respond to the denial, or you could very well lose important rights.