After a serious injury, it’s common to focus on the immediate aftermath: medical care, lost work, and possibly a personal injury claim. But what happens if the injury prevents a return to work for weeks, months, or the foreseeable future?
That’s where short- and long-term disability (S/LTD) insurance claims become essential.
If you were covered under either an individually purchased or employer-provided S/LTD policy as of the time of your injury, you may be eligible to file a disability insurance claim if you are unable to work. These benefits provide a source of monthly income when a health condition (including one caused by a third party’s negligence, such as a car crash) makes it impossible to work. These benefits can be a financial safety net while a personal injury case unfolds or while recovery takes longer than expected.
Disability insurance benefits often cover around 60% of your pre-disability income (consult your policy for the exact details) and can help with:
- Rent or mortgage payments
- Groceries and daily living expenses
- Continued medical costs
- Supporting children or dependents
Unlike a personal injury claim, which may take months or years to resolve, short- and long-term disability insurance claims are meant to process more quickly, providing income during a long recovery.
Why Coordination Matters
It’s not unusual to be navigating both a personal injury case and a disability claim at the same time. But the two don’t always work well together unless they’re carefully managed. For example, disability insurance policies may contain offset clauses, reducing benefits if a personal injury settlement is received. Settling an injury claim without understanding LTD implications may unintentionally reduce long-term financial support. Additionally, evidence used for one case could either help or hurt the other case. For example, if your doctor gives inconsistent statements about your condition across the two cases, this could be used against you. However, favorable medical or vocational evidence obtained for a personal injury case may also provide support for an S/LTD claim or vice versa.
That’s why careful coordination between the legal teams handling each matter is so important. When the personal injury attorney and the disability insurance attorney work together, it helps ensure nothing is left on the table and benefits remain protected.
What to Expect in a Disability Insurance Claim
Filing a disability insurance claim consists of initiating a claim with the disability insurance company and providing the insurer with the paperwork and medical evidence necessary to review your claim. Unfortunately, filing for disability insurance benefits isn’t always straightforward. Insurers can take excessive time to review claims and may deny benefits even when a person clearly can’t work. Common challenges include:
- Insufficient or misinterpreted medical evidence
- Denials based on surveillance or flawed third-party reports
- Confusion around policy terms, pre-existing condition clauses, or return-to-work expectations
If your claim is denied, appealing a disability insurance denial requires a deep understanding of the policy language, medical evidence, and legal standards. The appeal is also a very important point in the process, as if your claim is governed under ERISA (the Employee Retirement Income Security Act of 1974), this stage may be your last chance to get additional information in the record. New evidence generally cannot be submitted at the lawsuit stage for the judge’s consideration once the insurer makes their final decision. Acting quickly and strategically can make a significant difference.
Getting Support Early Can Make a Big Difference
Even if a personal injury case is still pending, there may be no need to wait to pursue disability insurance benefits. With the right approach, both claims can move forward without jeopardizing each other.
For those facing long-term work limitations due to injury, S/LTD benefits can be a lifeline, helping maintain financial stability while focusing on healing and recovery.
If an inability to work is affecting your life after an injury and you were covered by a Short- or Long-Term Disability policy when you got hurt, reach out to Hawks Quindel to learn more about the options and protections available.