What are my rights if i am cut off of short term disabilaty and am still under a doctors care and unable to perform my job dutie

Asked about 2 years ago - Philadelphia, PA

i am on short term disabilaty and am still under the 26 week s and i havnt been paid in over 2 months and i am still unable to perform my job duties at work plus i am still under my doctors care but i dont no my rights in this matter

Additional information

I was paid for the first 2.5 months and not paid for the last 2.5 months. Insurance co keeps giving me the run around. They said they need documatations from doctors and when they recieve them they say it can take up to 5 days to review. I call back in 5 days to check the status and they say they need more notes. So the doctors provided them and this process has been repeeted for the last 2.5 months in which I've not been paid. HR called this week to tell me that I have 15 days to apply for FMLA because my 1 year anneversary had passed while I was out. Should I apply for FMLA while I still have an open claim with STD? What rights do I have for me not being paid?

Attorney answers (1)

  1. Robert Andrew Kerr

    Contributor Level 12

    Answered . Your rights depend on two things: the terms of the policy and the applicable law.

    You need to see a copy of the policy to know what the insurance company is obligated to do, and at the same time you can learn what you have to do to qualify for benefits.

    You also need to know if the policy is governed by ERISA, which is a federal law, or if it is governed by state law. If your policy was provided through work, and you did not work for for a governmental entity or church organization (i.e. you worked for a private company), your policy is probably governed by ERISA. If so, then the insurance company has certain specific requirements and duties it has to meet in making a decision on your claim and the handling of it in general. If your claim is not governed by ERISA, then your claim likely is governed by state law.

    The applicable law can be very tricky, but also very important, so it is important to speak with someone who deals with these types of claims if you look for someone to help you answer this question. There are times when the applicable law determines whether I take a case because of its importance.

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