Short-term disability insurance provides coverage for certain disabilities.It’s meant to replace a portion of your paycheck until you can return to work.You will most likely appeal if you are denied coverage.It can be simple to write an appeal letter.It should explain why you are disabled.
Step 1: You should read your denial letter.
You should get a letter from your insurer explaining why you were denied benefits.Look closely at the reasons in the letter.You might be rejected if you don’t give enough information.If the policy doesn’t cover your disability, you could be rejected.
Step 2: Do you know how to appeal?
The denial letter should tell you how to appeal.Write down deadlines on your calendar so that you don’t forget.Call the insurance company if the information is not in the letter.
Step 3: You can request a copy of your claim file.
If you get short-term disability through an employer, you have the right to request a copy of your claim file, summary plan description, and policy.You have 30 days to get these documents from the plan administrator.The administrator of the plan may be your employer or the insurance company.Hold onto the receipt if you mail the letter certified mail.
Step 4: Support documentation should be gathered.
You need to gather the supporting documentation if you were rejected because of insufficient information.Along with your appeal letter, you will want to provide this supporting documentation.If you’re injured in an accident, you might want to get medical records from your doctor, as well as an opinion from a second doctor about how the injury has affected you other records, such as police records.
Step 5: If you need a lawyer’s help, consider it.
You don’t know how to appeal.You could meet with a lawyer if that’s the case.Lawyers don’t work for free, so the expense could outweigh the amount of short-term disability benefits you are seeking.If you are low income, you might qualify for legal aid.Legal aid is available to people with incomes less than 25% of the federal poverty level.Legal aid can be found at http://www.lsc.gov.Free consultations with lawyers might be offered by your employee assistance program.You should check the details of your plan.A lawyer could give you half an hour of advice.The lawyer could give you tips on how to improve the letter.A lawyer could charge $400 an hour but only charge $200 for a half-hour of advice.Contact your local or state bar association to get a referral to a lawyer.
Step 6: The letter should be formatted.
The letter should be similar to a business letter.Set the fonts to something readable by doubling the space on the document.Times New Roman 12 point is usually accepted.
Step 7: Provide information.
The insurer should be able to tell you who you are and why you’re appealing.The insurer denied your claim if you didn’t provide the following information.
Step 8: Explain to the insurer why you need their help.
You should ask the insurer to change its mind.Mention your documentation and argue that you qualify for benefits.I broke my arm on August 15, 2016 in my enclosed medical records.I have been unable to complete a shift since August 16 because my job requires that I put books and boxes above my head.I had to leave early two times because I couldn’t complete tasks because of the enclosed letters from my coworkers.I have been out of work for a while.I want you to approve my request for short-term disability benefits.
Step 9: You should include your supporting documentation.
Make copies of all the documents you include.Do not send originals.The original denial letter and a copy of your application can be included.
Step 10: The appeal letter needs to be submitted.
Make a copy of the letter for your own records, and then send it certified mail, return receipt requested to the address provided by the insurance company.
Step 11: Wait for a response.
Your appeal letter should be reviewed by the insurance company.You should reply in writing.Other appeals should also be considered.You might be told by the letter that you can bring another appeal.If your employer sponsors your short-term disability insurance, you can appeal.You could file a lawsuit in federal court after you appeal to the administrative judge.