Are you, a spouse, or a family member dealing with a disabling medical condition? You are certainly not alone. The Centers for Disease Control and Prevention (CDC) estimates that 61 million Americans are currently living with a disability. When managing a disability, you need access to all available financial support. You may be entitled to benefits through a private disability insurance policy. 

Short-term disability benefits and/or long-term disability benefits may be available. At The Law Office of Paul J. Dombeck, PLLC, we help people navigate the full range of claims. Within this article, our Phoenix disability claim attorney provides an overview of the key things to know about the difference between short-term disability and long-term disability in Arizona. 

Short-Term Disability vs. Long-Term Disability

If you are preparing to file for disability benefits, it is vital to understand the difference between short-term disability insurance and long-term disability insurance. Here is an overview of the key differences between the two types of benefits in Arizona: 

• Short-Term Disability (STD): Short-term disability policies are designed to provide wage replacement benefits to employees who are temporarily unable to work due to a medical condition. These benefits typically cover a portion of the employee’s salary and are meant to last for a pre-defined, limited period of time—from a few weeks to a few months. In Arizona, short-term disability benefits often begin after a brief waiting period. Need help with a short-term disability claim? Contact our Phoenix, AZ, disability attorney today. 
• Long-Term Disability (LTD): Long-term disability benefits kick in where short-term disability leaves off. They provide financial support to people who face longer periods of work incapacity due to more severe medical/health issues. Notably, long-term disability policies usually have a longer waiting period—often several months—before the benefits actually start. The coverage can extend for several years or even until retirement age. Long-term disability benefits are crucial for people with a chronic illness or severe injury that can permanently undermine their ability to work. Our Phoenix disability attorney has the experience to handle the full range of long-term disability claims. 

In other words, the key difference between short-term and long-term disability benefits is the timing of when they are paid. You can get short-term disability benefits faster, but they end relatively quickly. In contrast, you often cannot start receiving long-term disability benefits for several months, but they can last for many years. 

Do I Always File for Short-Term Disability First?

While disability benefits always depend on the specific terms of the policy, an applicant would indeed typically file for short-term disability benefits before considering long-term disability benefits. Short-term disability is designed to cover immediate, temporary incapacity. With most types of policies—especially those that provide coverage for both short-term disability and long-term disability—the short-term disability benefits usually exhaust before long-term disability eligibility begins. There can be a seamless transition from one to the other if your condition does not improve. Of course, it is important to review your specific policy details. The terms and waiting periods can vary. If your medical condition is expected to last beyond the coverage period of short-term disability, preparing a long-term disability claim in advance can help ensure continuous coverage. Our top-rated Phoenix disability lawyer can help you navigate the process. 

Most Private Disability Policies are Regulated By ERISA

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that regulates employer-sponsored group benefit plans, including short-term and long-term disability policies. As most people who have private disability coverage get that coverage through their employer or their spouse’s employer, these disability claims are often ERISA cases. Here are key points that claimants should understand about the ERISA disability regulations:  

• Standardized Claims and Appeals Process: ERISA requires insurance companies that offer disability plans to provide a clear process for filing claims and appeals. Among other things, the policy should include a timeline for reviewing claims and communicating decisions to claimants. A standardized claims process helps to ensure that all private disability policies meet minimum mandatory standards. 

• Comprehensive Disclosure Requirements: Under ERISA regulations, disability plan administrators must provide participants with important information about plan benefits and guidelines. Key details include eligibility and the calculation of benefits. 

• • Fiduciary Duty: Under ERISA, plan administrators are held to a fiduciary standard that requires them to act in the best interests of plan participants. Insurers must ensure a plan is managed prudently and with an exclusive purpose of providing benefits to participants.
• Right to Sue (After Exhausting Administrative Claims: If a claimant feels that their rights under the plan have been violated or their benefits were wrongfully denied, ERISA grants them the right to sue for disability benefits. However, they must exhaust the administrative process before doing so. Your first-level appeal in an ERISA disability claim is an administrative appeal—which is effectively a second look at your claim by the insurance company. You can and should submit additional evidence with your administrative appeal. 

Struggling to Get Disability Benefits? Know Your Right to Appeal

Unfortunately, some people struggle to get their disability claim paid. Whether you are filing for short-term disability benefits or long-term disability benefits, it is crucial that you know your right to challenge a denial. Disability appeals are a time-sensitive process. If you have received a denial letter from an insurance company, consult with a Phoenix, AZ, disability appeals attorney as soon as possible. Your lawyer will review your case, answer your questions, explain the implications of the denial letter, gather supporting documentation, and submit a strong, compelling appeal. 

Contact Our Phoenix, AZ ERISA Disability Attorney Today

At The Law Office of Paul J. Dombeck, PLLC, our Phoenix disability lawyer has the skills and experience to take on the full range of cases, including short-term disability claims, long-term disability claims, ERISA claims, and Social Security disability (SSD) cases. Contact our law firm today for your free, no-obligation initial case review. From our Phoenix office, we handle disability cases in Maricopa County and throughout Arizona.