Are you preparing to submit a claim but not sure what you’ll need? Answer a few questions with this tool and we can let you know exactly what you need!
- What are my short term disability benefits?
You can check your benefits by visiting your short term benefits page.
- When should a claim be submitted?
A claim should be submitted after the disability has begun, and when it has been determined that the disability will be long enough in duration to qualify for STD benefits. Each STD plan has an elimination period which must be satisfied before benefits commence.
A claim can be filed up to 14 calendar days in advance or submitted after the disability has begun and when it has been determined that the disability will be long enough in duration to qualify for benefits. Each short-term disability plan has an elimination period which must be satisfied before benefits commence.
- What is an elimination period?
The unpaid period of time (specific to each plan) that must be satisfied prior to the commencement of benefits.
- How long does it take to reach a decision on a claim?
Each claim is evaluated based on its own merit, and as a result, timeframes for reaching a decision could vary depending on the quality of the information supplied. Most claim decisions are made within 10 business days, provided all information is supplied timely and we are successful in obtaining any information that might be lacking. Assuming the claim is approved, and a benefit check is issued, mail delivery could vary depending upon where a claimant is located. We ask that claimants allow for ample mail delivery time.
- How are disability benefits extended?
If an individual’s disability lasts longer than expected, additional medical information may be needed. As each claim is unique, the medical information needed would vary from claim to claim. A physician simply stating that an individual is disabled may not be sufficient to extend benefits.
- What is a pre-existing condition and how does it affect eligibility for benefits?
Some STD plans include a pre-existing condition provision. If applicable, disabilities for a condition(s) that is treated within a specified timeframe prior to an individual’s STD coverage effective date may be considered pre-existing. We may limit or exclude benefits for disabilities caused by a pre-existing condition(s) unless the individual was insured for 12 (typically) consecutive months.
- When does the individual’s disability and/or benefits end?
Benefits may end when we determine the individual is able to perform the major duties of his/her regular job, even if the individual chooses not to. Benefit payments may also end if the individual returns to work; the end of the maximum payment period; the individual fails to provide continued proof of loss; the individual is no longer under a doctor’s regular care; or the individual passes away.
- How are benefits paid for maternity claims?
Maternity claims are handled the same as claims for any other illness. Benefits commence after the elimination period has been satisfied. Following delivery, continued benefits would depend on the type of delivery and taking into consideration reasonable recovery periods. The American Medical Association (AMA) has determined that 6 weeks is a reasonable recovery period following an uncomplicated vaginal delivery, and 8 weeks following an uncomplicated cesarean section. However, benefits can only be considered for the period of time for which we have medically supported limitations and restrictions preventing the individual from performing his/her job duties. If the individual experiences complications before or after delivery, we may require additional medical documentation to substantiate any excessive periods of disability. As indicated previously, benefits may be issued in a lump sum payment.
- Are there any benefit exclusions under this plan?
Yes. These would be specific to the plan in question.
Here is the full list of documents that you may need to submit as part of your short term disability claim: