Employees who are unable to work for a short time due to illness or injury can get short-term disability insurance to cover their lost wages. Learn about your short-term disability choices in the next paragraphs.
Are there any restrictions on who can receive short-term disability benefits?
In order to qualify for short-term disability payments, an employee must be covered by short-term disability insurance at the time they get ill. Medical insurance policies cover a wide spectrum of medical issues, from physical to mental, cognitive, and emotional. Benefits for short-term disability are often included in group health insurance policies. It’s best to check your group benefits policy to see if you are covered.
How much does a short-term disability policy cover?
The amount of short-term disability compensation you receive depends on the terms of your insurance policy. Some can completely replace your income, but most simply cover a fraction of it. The short-term disability benefit might be anywhere from 60% to 100% of your earnings.
Short-term disability benefits have a time limit
Short-term disability payments are often available for up to six months of coverage, however this varies from policy to policy. Some insurance policies extend coverage for up to 52 weeks.
Can you tell me how to go about getting a short-term disability application started?
In order to apply for short-term disability, you will need to request the application forms from your employer or directly from the insurance company itself. In many cases, the forms can be found on the website of the benefit provider. In order to complete the application, you’ll need to submit three parts:
First, the employee’s statement; second, the statement of the attending physician; and third, the statement of the employer.
There are two forms you’ll need to fill out: the employee statement and the attending physician’s statement from your doctor. The employer’s statement must be completed by your employer. To ensure that your application is processed as quickly as possible, all three parts of the application must be completed and submitted.
Once the insurer has received your application, a case manager will be assigned to make a decision on your claim. Frequently, the case manager will phone you to inquire about your symptoms, any areas in your application that need clarification, your treatment plan, and any drugs you may be taking. They will make a decision on your short-term disability application once they have collected all of the necessary information. As far as I know, you can expect to receive a written explanation of their decision.
Your short-term disability claim may be rejected
Short-term disability benefits may be denied for a variety of reasons, including the insurer’s belief that the employee does not qualify as totally disabled and hence ineligible. Even if an employee has medical records and doctor notes to back up their claim for benefits, it may still be judged insufficient.
One of the two alternatives available to a worker refused short-term disability compensation is to appeal.
As an initial step, you can file an appeal with your insurance provider. Within 90 days of the ruling, you can often appeal up to three times (make sure to review the appeal deadline specified in the denial letter). It’s vital to keep in mind that appealing the judgment may not be the best option unless your doctor can give considerably different data to support your claim.
The second alternative is to file a lawsuit against the insurance company for denying disability benefits based on a lack of evidence. To get the best possible result, it is best to hire a lawyer. This will help you to concentrate on your rehabilitation and alleviate some of the stress.
Don’t waste your time arguing with the insurance company if your short-term disability application is rejected. With Monkhouse Law, you can hire an employment lawyer to help you through the Court, which is a higher authority. Consider the insurer’s internal appeal deadlines and the two-year legal limitation period while discussing with us about your options.
EI illness and short-term disability benefits are both available to me
Short-term disability benefits and employment insurance sickness benefits cannot both be received at the same time by a person who is unable to work because of a medical condition. If this is the case, you will be required to pay back the EI sickness benefits you obtained. EI sickness benefits can be applied for after your short-term disability benefits have expired.
While on short-term disability, what if I was fired?
If you terminate an employee on disability or sick leave, you must offer them with termination or severance pay, which is discriminatory under human rights regulations. Employers in Ontario are required by the Human Rights Code to make reasonable accommodations for their employees, even if doing so causes them undue hardship.
Your best bet is to get in touch with a short-term disability lawyer at Monkhouse Law as soon as possible if you are fired from your position while on disability leave.