Short term disability (STD) benefits play a crucial role in supporting individuals who are temporarily unable to work due to an illness or injury. However, navigating the complexities of these benefits in Canada can often feel overwhelming, particularly when claims are denied. At Kotak Law, we understand the challenges individuals face and specialize in helping clients overcome claim denials for the support they are entitled to.
This blog will guide you through the essentials of short-term disability in Canada, shed light on common denial reasons, and explain what steps to take if your claim has been denied. If you’re struggling with a denied STD claim, Kotak Law is here to help.
What Are Short Term Disability Benefits?
Short term disability benefits provide a safety net for employees who are temporarily unable to perform their job due to medical reasons. These benefits typically cover a percentage of your salary—commonly between 50% to 70%—for a predetermined period, often up to six months.
Employers may offer STD benefits through private insurance plans, or employees might purchase their own coverage. To qualify, individuals must meet the specific eligibility criteria outlined in their plan, which usually includes medical documentation confirming the inability to work.
Common Reasons Short Term Disability Claims Are Denied
Unfortunately, claim denials are not uncommon, even when individuals feel they have a valid case. Here are some of the most frequent reasons claims are denied:
- Insufficient Medical Evidence
Insurance providers often require substantial documentation proving your condition prevents you from working. A lack of detailed doctor’s notes, diagnostic tests, or treatment plans can lead to a denial.
- Missed Deadlines
The process of applying for STD benefits comes with strict deadlines. Delayed submissions or incomplete paperwork could jeopardize your claim.
- Discrepancies in the Application
Any inconsistencies between the information you provide and what is documented by your employer or physician might raise red flags with the insurer.
- Pre-Existing Conditions
Many insurance policies have clauses excluding pre-existing medical conditions, which insurers might use as grounds to deny claims, even if your current condition is unrelated or worsened after the policy went into effect.
- Failure to Follow Treatment Recommendations
If you haven’t followed your doctor’s prescribed treatment or failed to attend follow-up appointments, insurers may argue that you are not taking necessary steps to recover.
Steps to Take if Your Short Term Disability Claim Is Denied
If your claim for short-term disability benefits has been denied, it’s important to remember that you have options. Here’s what you can do to move forward:
- Request a Full Explanation of the Denial
Ask your insurance provider for a detailed account of why your claim was denied. This information will help you understand the specific reasons and prepare for the next steps.
- Gather Additional Documentation
Review your application and provide any missing medical evidence or clarification. This could include updated doctor’s notes, additional test results, or records proving your condition’s impact on your ability to work.
- Contact Kotak Law for Help With Your Denied Claim
Instead of navigating the often complicated and biased internal appeal process offered by insurance companies, reach out to Kotak Law. Our experienced legal team can review your denial, provide clear advice on your next steps, and advocate strongly on your behalf to help secure the benefits you deserve. Getting in touch with us early can improve your chances of a successful outcome and ensure your rights are protected throughout the process.
Navigating a denied claim can be daunting. Seeking legal assistance can make a significant difference in your chances of obtaining the benefits you deserve.
Why Choose Kotak Law for Your Short Term Disability Case?
At Kotak Law, we specialize in disability claims and are dedicated to standing up for individuals against insurance companies. Here’s why countless clients across Canada trust us to handle their cases:
- Expertise in Disability Denials
We have extensive experience in disability law and know the tactics insurers use to deny claims. This allows us to anticipate challenges and create strong counterarguments on your behalf.
- A Proven Track Record of Success
Our knowledgeable team has helped numerous clients overturn claim denials, securing the short-term disability benefits they need to recover and move forward.
- Compassionate, Client-Focused Service
We prioritize understanding your individual circumstances and providing personalized support throughout the legal process.
- No Upfront Legal Fees
Our team works on a contingency fee basis, meaning you don’t pay unless we win your case.
Take Action Today
Don’t face your denied short-term disability claim alone. Kotak Law is here to help you take back control and secure the support you need to focus on your recovery. Contact us today for a free consultation and discover how we can assist you in fighting for your rights.
Closing Thoughts
Short term disability benefits are an essential lifeline when you’re unable to work due to illness or injury. If your claim has been denied, knowing your rights and taking swift action can make all the difference. With Kotak Law in your corner, you can feel confident that your case is in the hands of experienced professionals dedicated to achieving the best possible outcome.
Remember, an initial denial isn’t the end of the road. Contact Kotak Law today, and let us fight for the short-term disability benefits you’re entitled to. Your recovery is important, and you don’t have to face this challenge alone.
