Expert Disability Lawyers For The Standard Company Disability Serving New York
Disability insurance is a critical safety net for employees who find themselves unable to work due to illness or injury. In New York, state law mandates certain employers to provide short-term disability insurance (DBL), ensuring that workers have some financial protection if they are temporarily unable to perform their job duties. If you are struggling with your disability insurance, The Standard Disability Company Attorney in New York is ready to assist you.
New York’s Disability Benefits Law (DBL)
The Disability Benefits Law (DBL) in New York requires most private employers to provide disability insurance for their employees. This insurance offers temporary cash benefits to eligible workers who are unable to work due to non-work-related injuries or illnesses. Unlike workers’ compensation, which covers job-related injuries, DBL is designed to assist employees who are injured or become ill outside of work.
The DBL program provides short-term benefits that are meant to replace a portion of lost wages during the time an employee is unable to work. The benefit period can last up to 26 weeks in any 52-week period, providing a crucial financial cushion for employees who may be dealing with temporary health challenges.
Overview of The Standard
Founded in 1906, The Standard, officially known as Standard Insurance Company, is headquartered in Portland, Oregon. It provides a wide range of insurance products, including disability, life, and retirement plans. The company is known for its commitment to helping individuals and businesses achieve financial security, particularly through its disability insurance offerings.
While The Standard is a nationwide company, it has a strong presence in Portland, Oregon and offers policies that comply with the state’s specific disability insurance requirements. Employers in New York can work with The Standard to fulfill their obligations under the DBL, ensuring that their employees have access to necessary financial protection if they become temporarily disabled. The Standard Company Disability Attorney in New York is able to help you and your family if you are struggling with your insurance benefits.
Eligibility Criteria
To qualify for benefits under New York’s DBL, employees must meet certain requirements. Full-time and part-time workers who are employed by private employers that fall under the law’s scope are generally eligible for coverage. Public employees, such as government workers, are typically not covered under the DBL, though some municipalities or government entities may opt to provide similar benefits voluntarily.
An employee must have worked for at least four weeks for the current employer to be eligible for disability benefits. If they switch jobs, they will be eligible for benefits after four consecutive weeks of employment with the new employer. Additionally, employees who have worked for multiple employers may combine their employment periods to qualify for benefits.
Benefit Amounts
The amount of disability benefits an employee receives is based on their average weekly wage before the disability occurred. In New York, DBL typically pays 50% of the employee’s average weekly wage, up to a maximum benefit of $170 per week. This amount has not been adjusted in several years and remains one of the lowest maximum disability benefits among states with mandated disability insurance programs.
While $170 per week may seem minimal, it is meant to serve as a supplement to other sources of income or savings, offering some financial relief while the employee recovers. Employers may choose to offer enhanced benefits through private insurance carriers, which would allow for higher benefit amounts or longer benefit periods.
Filing a Claim with The Standard Insurance Company
1. Understand the Policy Coverage
Before filing a claim, ensure that you fully understand your short-term or long-term disability policy with The Standard. This includes:
- The waiting period before benefits begin (e.g., 7 days for short-term disability).
- The benefit amount and duration.
- Any exclusions or limitations on coverage.
For New York employees, short-term disability (compliant with the state’s Disability Benefits Law) typically pays 50% of your average weekly wage, up to a maximum of $170 per week for up to 26 weeks. Employers may have enhanced coverage through The Standard, which can alter these limits.
2. Notify Your Employer
If you are unable to work due to illness or injury, inform your employer immediately. Notification should be in writing if possible. Your employer plays a role in the claims process by providing necessary employment information to The Standard.
The sooner you report your disability, the quicker your claim can be processed. Most policies require notice within a specific time frame (e.g., 30 days from the date of disability).
3. Obtain the Necessary Claim Forms
The Standard provides specific claim forms for both short-term and long-term disability claims. You can obtain these forms in the following ways:
- Online: You may access claim forms through The Standard’s online portal by logging into your account.
- From Your Employer: Employers typically have access to these forms through their group insurance plan administrator.
- Customer Service: You can contact The Standard directly to request forms.
4. Complete the Claim Forms
There are generally two parts to the disability claim form:
- Employee’s Statement: This section is where you (the claimant) provide personal and employment information, the nature of your disability, and your healthcare provider’s details.
- Attending Physician’s Statement: Your physician will need to complete this part of the form, verifying the medical condition that is causing your disability, treatment details, and their prognosis.
Both the employee’s and the physician’s statements must be submitted together to ensure timely processing of your claim.
5. Submit the Claim
Once the forms are completed, they should be submitted to The Standard for review. You can do this by:
- Online Submission: Upload the completed forms through The Standard’s secure online claims portal.
- Mail: Send the completed forms via postal mail to the address listed on the claim form.
- Fax: The Standard often provides a fax number for claims submissions.
It’s recommended to keep a copy of all forms and communications for your personal records.
6. Claims Review Process
Once The Standard receives your claim, it will undergo a review. The claims team will assess:
- The validity of the disability as certified by your physician.
- Whether your condition meets the policy’s definition of a qualifying disability.
- Any additional information or documentation that might be required.
During this review process, The Standard may request further medical records, employment details, or other evidence to substantiate your claim.
7. Waiting Period
Most disability policies have a waiting period (also known as the elimination period) before benefits begin. For short-term disability, this is usually seven days. Benefits are not paid during this time. If your claim is approved, benefits will begin after the waiting period ends.
8. Receiving Your Benefits
If your claim is approved, The Standard will begin issuing benefit payments according to the terms of your policy. These payments may be sent via:
- Direct Deposit: If you have provided your banking information, benefits will be deposited directly into your account.
- Check: Alternatively, The Standard may issue paper checks.
Benefits will continue until either you recover and return to work, reach the maximum benefit period (typically 26 weeks for short-term disability), or the medical evidence no longer supports your disability.
9. Follow-Up and Status Updates
The Standard’s claims management system allows you to check the status of your claim online. It’s essential to stay in touch with your claims manager, especially if your condition changes, or if you have concerns about delays in benefit payments.
- Periodic Updates: The Standard may request periodic updates from you or your physician to confirm that your disability is still ongoing.
- Return to Work: If you are able to return to work, inform The Standard and your employer immediately. Your benefits will stop once you resume employment.
Common Reasons for Delays or Denials
While The Standard Insurance Company is known for efficient claims management, there are some common reasons why a disability claim might be delayed or denied:
- Incomplete or Missing Information: If your claim form is incomplete or missing critical information, it can delay the review process.
- Medical Insufficiency: If the medical evidence does not clearly support a disabling condition, the claim may be denied.
- Eligibility Issues: If you have not worked long enough to qualify for benefits or your condition falls under an exclusion (e.g., a pre-existing condition), the claim may be denied.
If your claim is denied, The Standard will provide the specific reason for the denial and offer instructions on how to appeal the decision if you believe it was made in error.
Contact The Standard Company Disability Attorney In New York Today
New York’s standard disability insurance, while limited in scope and benefit amounts, plays a vital role in providing financial protection for employees who experience temporary disabilities. By ensuring that workers have access to short-term disability benefits, the state helps mitigate the financial burden that can accompany an unexpected illness or injury. Contact our team today to speak with The Standard Company Disability Attorney in New York.
