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Understanding short-term disability denials in Missouri

On Behalf of | Jun 25, 2024 | Personal Injury

Serious injuries in an accident can have far-reaching consequences for victims. One such consequence could be being unable to work and earn a living temporarily. In such situations, understanding the types of disability benefits available is crucial for workers in Missouri.

Two key forms of support are Temporary Partial Disability (TPD) and Temporary Total Disability (TTD) benefits.

  • TPD benefits apply if you can still perform some work despite your injury. These benefits are about two-thirds of the difference between your average earnings before the injury and what you could earn in your current condition, subject to the maximum TTD rate.
  • TTD benefits apply when you’re completely unable to work due to your injury. The amount is about two-thirds of your gross average weekly wage, again subject to a maximum amount. You collect these benefits until you can go back to working or reach “maximum medical improvement” as determined by a doctor.

These benefits can be a lifeline, but they are not guaranteed. Knowing why insurance denies claims can help you avoid common pitfalls.

Common reasons for denial

Insurance may deny your short-term disability claim for several reasons:

  • Incomplete information: Missing or inaccurate details can trigger a denial or delay claims.
  • Discrepancies in documentation: Any inconsistency between your claim and medical records can lead to denial.
  • Pre-existing conditions: Some policies exclude coverage for conditions you had before obtaining insurance.
  • Delayed filing: Companies might view unnecessary delays in filing as a sign that the injury is not disabling.
  • Insufficient medical evidence: You must support your claim with medical evidence confirming your inability to work.

These common missteps can be avoidable with careful preparation and honesty. Understanding how the system works and getting help from professionals, including attorneys familiar with this complicated process, can also help you sidestep costly mistakes.

Impact on life and livelihood

A serious accident injury can turn your life upside down. Suddenly, you’re facing doctor appointments, recovery time and the stress of lost wages. Short-term disability benefits can help you through this tough time, providing financial support while you focus on getting better.

By understanding the common reasons for denial, you can take steps to ensure your claim is strong and clear, improving the likelihood of approval.