What happens after a 'third level' of appeal if turned down for STD? Is it final?


#1

I have a deadline for new medical evidence for third appeal of January 19th for short term disability.

What can be done after this?


#2

You sue–do you expect to go on Long term–because even if you are denied for short term you need to file for LTD on or before the deadline to do so.

If you have no new medical then send them journal articles on your condition. Also send pages from Mayo Clinic website. Send in your job duties and requirements and explain why you are unable to do the duties. Put in the dates of your next medical appts. Ask for rehabilitation help. Ask your employer to send in your job duties too.


#3

Does a person need to sue to get LTD before they can sue to get LTD?


#4

Your options depend on your situation, including if you are in a union. If you are already back to work full time and are just looking for payment of the past STD claim period, then you can do a small claims court actions (Judge-Judy Style). However, if you are not back to work full time and your problems continue, then it is important that you NOT do a small claims court action. You would need to apply for LTD and if they deny that (which they most certainly will if STD has been denied), then you can sue for both LTD and STD benefits at the same time. We do this all the time. The most important thing is you actually have to get a denial of the LTD claim either by them denying the claim or refusing to give you the app forms etc.

If you are unionized there may be a mandatory grievance and hearing procedure that would mean you cannot sue your employer for the STD or possibly the insurer for the LTD.


David Brannen

Disability Lawyer with Resolute Legal

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