Going from Short-term Disability to Long-term Disability
When you file for short-term disability benefits, it’s usually with the expectation that you’ll recover quickly and return to work. For many people, this turns out to be true. But for others, the road to recovery can be longer and more complex.
Most short-term disability plans only pay monthly benefits for 90-180 days (3-6 months). If medical or life complications keep you away from work for longer, you may need to consider other options like long-term disability (LTD) insurance.
At Bryant Legal Group, we’ve guided many clients through disability coverage and policy provision transitions. In this article, we explain factors you should consider when going from short-term disability to long-term disability coverage, and why it’s essential to consult a disability insurance attorney before moving forward.
Many Disabilities Last Longer Than You Think
Life rarely follows a script, especially when it comes to health. Recovery timelines vary widely based on your diagnosis, age, job demands, and access to treatment.
For example:
- A back surgery may require a year or more of rehabilitation, and complications can prolong recovery even further.
- Stroke survivors often face long-term or permanent limitations that make daily living more difficult.
- Chronic illnesses like multiple sclerosis, long COVID, or rheumatoid arthritis can cause fluctuating symptoms that interfere with sustained work activity.
- Mental health conditions such as anxiety, PTSD, or depression can worsen over time or resist standard treatment.
What seems like a temporary setback can gradually become a long-term concern. And if your ability to work remains compromised beyond your short-term disability policy period, it’s time to consider filing for long-term disability benefits.
RELATED: How Do You Prove You Are Disabled Under a Disability Insurance Policy?
Understanding the Differences Between Short-term and Long-term Disability Policies
Your short-term and long-term disability policies may be part of the same benefits package but can be very different in scope, eligibility criteria, and benefit duration. Relying on your short-term experience to guide your LTD claim can lead to costly missteps.
Here are four key differences:
1. The Definition of “Disability” Often Changes
Most insurance policies define “disability” in one of two ways:
- Own occupation. You are disabled if you cannot perform your specific job or specialty.
- Any occupation: You’re only considered disabled if you can’t perform any work for which you’re reasonably qualified, based on your education, training, or experience.
Most short-term disability insurance policies use the less rigid “own occupation” definition. However, many group LTD plans will begin with either the “any occupation” definition or shift from “own occupation” to “any occupation” after a period. Make sure to look at the fine print of your policies.
2. LTD Policies May Include Different Exclusions or Limitations
While short-term policies may offer relatively straightforward terms, LTD policies—especially group plans governed by ERISA—often contain specific exclusions or limits such as:
- Pre-existing condition denials
- Time limits for mental health or addiction-related conditions
- Exclusions or limitations for self-reported symptoms such as chronic pain or migraines
- Exclusions for specific conditions such as cancer
Understanding these limitations is essential before you apply. Similarly, short-term disability policies often exclude coverage for occupational injuries, while many long-term disability policies do not include that same exclusion.
You don’t want to find out halfway through your claim that your condition doesn’t qualify or that your benefit period is limited to two years due to policy fine print.
RELATED: Long-term Disability Insurance and Pre-existing Conditions
3. Insurers Are More Likely to Challenge LTD Claims
Short-term claims typically involve weeks or months of benefits and are typically paid by your employer. Long-term claims can last years or even decades, costing insurers significantly more, and typically these are insured benefits paid by the insurance company. As a result, LTD claims often face heightened scrutiny.
Common insurer tactics include:
- Denying benefits based on minor inconsistencies or vague reasons
- Requesting repeated “independent” medical exams
- Arguing that you can perform other work
Even if your short-term disability claim was approved without issue, do not assume your LTD claim will receive the same treatment. Claimants may be surprised by how quickly the tone shifts once the financial stakes increase for the insurer.
4. You May Have More Flexibility in Returning to Work With LTD
There is a silver lining: many long-term disability policies—particularly private or individual policies—offer residual or partial disability benefits.
If you can return to work in a reduced capacity or in a different role that pays less than your pre-disability income, you may still qualify for partial LTD benefits. For example, a surgeon who can no longer operate due to essential tremors might still work as a medical consultant or educator. If their income is reduced, residual benefits may help bridge the gap.
Again, it’s essential to review your policy carefully. Some plans require a specific income loss percentage while others restrict benefits based on how many hours you work or whether you’re in a different profession.
RELATED: Residual Benefits in Private Disability Policies
Why You Should Consult an Attorney Before Filing Your LTD Claim
Going from short-term disability to long-term disability can be overwhelming. You must manage complex medical issues, financial stress, and policy language.
An experienced disability insurance attorney can provide the clarity and strategy you need. At Bryant Legal Group, we help clients:
- Understand their coverage. We analyze your STD and LTD policies, identify key differences, and explain what your insurer will likely require.
- Build a strong LTD claim. From medical documentation to vocational assessments, we guide you through every step of the claim process.
- Avoid critical errors. Simple mistakes such as inconsistent statements or missed deadlines can lead to denials. We help you prevent these costly pitfalls.
- Respond to denials or delays. If your claim is denied or dragged out, we can appeal on your behalf and help hold the insurer accountable.
If your employer-sponsored plan is governed by ERISA, you may also face strict deadlines and limited legal remedies. This is another good reason to get legal guidance as early as possible.
RELATED: 5 FAQs About Private Disability Insurance Claims
What to Do If You’re Nearing the End of Your Short-term Disability Benefits
If your recovery is slower than expected and you’re concerned about losing income when your short-term disability coverage runs out, here are some immediate steps to take:
- Review your LTD policy. Look at definitions of disability, waiting periods, exclusions, and deadlines.
- Consult with your doctor. You’ll need strong, consistent documentation showing why you cannot return to work.
- Request your full claim file. If you’ve already started the LTD process, ask for copies of all documents from your insurer.
- Track your symptoms and limitations. A symptom journal or daily activity log can help substantiate your claim.
- Speak with a disability insurance attorney. The earlier you consult with a lawyer, the better your chances of protecting your benefits.
RELATED: 5 Essential Questions You Should Ask a Disability Insurance Lawyer
Bryant Legal Group: Helping You Bridge the Gap to Long-Term Support
At Bryant Legal Group, we focus exclusively on disability and insurance law. Our attorneys have decades of experience helping professionals, executives, and policyholders transition from short-term to long-term disability coverage and secure the benefits they deserve.
Whether you’re just beginning the LTD process or fighting a wrongful denial, our team is ready to guide you. We’ve helped clients recover millions in unpaid benefits, and we’d be honored to do the same for you.
Schedule your free consultation with a Bryant Legal Group attorney today. Call us at 312-634-6160 or complete our online contact form.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.