How Do You Transition from Short-Term to Long-Term Disability Benefits?
Navigating disability benefits through your workplace can be overwhelming, especially when you’re trying to understand the difference between short term and long-term disability benefits. These benefits are part of most extended group insurance policies, yet many employees are unsure how to transition from one to the other or what to do if their LTD claim is denied.
Learn about the process of moving from short term disability (STD) to long term disability (LTD), what to expect during the qualifying period, and how to prepare a strong long term disability application.
As an employee, you’ll have access to an extended group benefits policy provided by your employer. Within your benefit booklet, you’ll see a section for disability benefits labelled “short term” and “long term” disability (“STD” and “LTD”). You might wonder, what’s the difference?
Short term disability benefits are intended to provide income support if you need to go off work due to an illness or injury – for a “short” time. The short term disability coverage usually ranges between three to six months and is intended to be a bridge to get you to long term disability (should you need it). The idea is, there will not be a break in income support if you need to go off work from the short-term period to when the long term disability periods kicks in.
What should you do if your short term disability benefits are coming to an end?
If you find yourself suffering from a condition that has not gotten better or is not expected to get better within the short term disability period, you should apply for long term disability benefits.
How To Apply for Long Term Disability?
If your short-term disability provider is the same as your long term disability provider, the insurer should automatically transition you from STD to LTD. A new application is only required if the STD provider is different from the LTD provider*. If that is the case, you would need to file a new application with the forms.
An long term disability application requires three forms:
- A Plan Member Statement, filled out by you
- A Plan Sponsor Statement – filled out by your employer
- An Attending Physician Statement – filled out by your doctor
My STD Application was Approved but My LTD Application was Denied
Not all policies are created equal, and this stands true for STD and LTD policies.
An application for short term disability benefits is treated differently than an application submitted for long term disability benefits. Why is that?
Well, the STD coverage is of limited and finite duration. If your STD coverage maxes out at 16 weeks, the potential money the insurer must pay for income replacement is limited as well. This does not mean the process “easier”, but the eligibility test for STD benefits is generally different and less stringent on applicants due to the finite nature of the coverage.
In contrast, the long term disability benefits policy may look similar or have some similar wording, but operates very differently. If you remain unable to work due to injury or illness, most LTD coverage is intended to provide you benefits until the age of 65. The age factor alone makes the potential benefit period for LTD much longer than any STD coverage.
Second, the LTD policies have different definitions that are more stringent on applicants as compared to STD policies. For LTD policies, there are two definitions at play:
- Own occupation – when you initially make an application for LTD, the insurer takes your medical information and determines whether the totality of your medical evidence restricts you from performing the essential duties and responsibilities of your own occupation. The insurer evaluates your claim based on your own occupation for the first two years.
- Any occupation – after the two-year period, a Change of Definition occurs and the test for ongoing benefits gets harder for a claimant. The insurer no longer determines whether your condition prevents you from doing the duties of your own occupation but evaluates whether your medical restrictions and limitations prevent you from performing the essential duties of any occupation that you may be suited for [or become suited for] by training, education and experience.
That is why it is common t be approved for STD benefits but denied long term disability benefits benefits.
How Can I Prepare for My LTD Claim While On STD?
What is the Qualifying Period?
The Qualifying Period for LTD is a period of time which usually spans the short term disability period. During this time, the LTD insurer will evaluate if your medical symptoms support an inability to do your job. For example, if your STD benefits last for four months, the LTD Qualifying Period will match this and be four months as well (or indicate “120 days”).
When you submit an LTD application, the LTD insurer will look at your medical information through the Qualifying Period and determine if it supports approval of LTD benefits.
During this time, it’s important to be consistent. You should:
- Continue to see your doctors, keeping all medical appointments and documenting symptoms etc.
- Listen to reasonable treatment recommendations
- Inform your insurer if you have any specialist referrals or medical assessments coming up.
[i]It’s important to work with your doctors and ensure you have their support for your claimed disability.
What Should I Do If My LTD Application Was Denied?
You need to speak with an experienced disability benefits lawyer. Lawyers can help you understand the difference between short term and long term disability benefits, evaluate your claim, advise you of your rights and guide you in the right direction to obtain the LTD benefits you deserve.
At Whitten & Lublin, our dedicated disability law team offers free consultations for short- and long-term disability claims.
Get the benefits you deserve by taking control with us in your corner. Contact us online or call us 416 640 2667.
*There may be an exception to a new application if there is an agreement between the short term and long term disability provider where a new application would not be required, in which case a transition would occur
Author – Aman Chaggar