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ERISA • Employment Law

How Long Do You Have to Be Out of Work to Apply for Disability Benefits?

26 Jul 2022

Suppose you sustain a disabling illness or injury that keeps you from performing your occupational duties. In that case, you might rest easier with the knowledge that you have employer-sponsored disability insurance coverage. What you might not be aware of is that the process of applying for and receiving benefits under an employer governed group disability insurance plan might be substantially more complicated than you would imagine.

Many individuals aren’t familiar with this type of insurance process. As such, they don’t grasp how many questionable tactics insurance companies use against policyholders to withhold payments unfairly. These insurance companies attempt to decrease or avoid payments on claims whenever possible, resulting in many disabled claimants experiencing unnecessary delays or denials. Often, this is devastating, considering that you’ve already lost your ability to earn a wage because of your disability. The good news is that you could get the payments you need by turning to an experienced Philadelphia disability benefits lawyer for help.

What is ERISA?

The Employee Retirement Income Security Act of 1974 (ERISA) safeguards your disability benefits. It also sets rules for those who administer your plan. Some of which include the:

  • Requirements for processing benefit claims
  • The timeline for a decision on your claim
  • Your rights if your claim is denied

Applying for Short-Term Disability

Short-term disability coverage is more common than long-term disability. Although, many employers do provide both for their workers. Short-term disability provides benefits for employees who are temporarily ill or become injured. Short-term disability coverage usually provides up to three to six months of payments. However, there might also be a waiting period before your benefits begin.

Before you apply for short-term disability, study your plan policies to ensure your illness or injury is covered. Some policies exclude specific causes of short-term disability from coverage, such as recovery from cosmetic surgery or any self-inflicted injuries.

When Can You Apply for Disability Benefits?

You can apply for disability benefits as soon as you believe you might qualify for them. You don’t have to wait to apply, although it’s a good idea to hire a skilled Philadelphia disability benefits attorney who can help you ensure your application is complete.

Under ERISA, disability claims must be decided within a reasonable period of time. For most cases, if you submit a disability claim, the insurance company must make a decision within 45 days of receiving it. However, some circumstances could extend the timeline. Applicants who are denied should file an appeal within 180 days of the denial.  Appeals can be complex and require extensive medical evidence to substantiate your benefits request. As such, you should have a Philadelphia disability benefits lawyer assist you in this process.

Call a Knowledgeable Philadelphia Disability Benefits Lawyer

If you’re searching for a knowledgeable Philadelphia disability benefits attorney or simply have questions about how and when to get the claims process started for your illness or injury, look no further than The Garner Firm, Ltd. Contact us today to schedule your complimentary disability claim consultation.

Experienced Counsel

Mr. Garner is an ERISA employee benefits and employment attorney with over a decade of experience. The laws governing employee benefits, the employment relationship, and the workplace are complex.

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