Newfield Law Group

In many states, and to varying degrees, Short-Term Disability (STD) insurance seeks to provide a financial safety net by covering a portion of your income if you’re unable to work due to a temporary injury or illness. However, it’s common for STD claims to be denied, even when they are valid. Below, we outline the common reasons STD claims are denied and offer practical advice to help you navigate the process and protect your right to benefits.

 

Missing or Incomplete Paperwork

One of the most frequent causes of STD claim denials is errors or omissions in paperwork. Insurers typically require multiple forms—often including statements from your physician and employer—and even a single missing signature can halt your claim. Another reason for claims to be denied? If you fail to respond promptly to requests for additional documentation, insurance claims adjusters will assume you no longer wish to pursue benefits or that you have inadequate proof.

You’ll want to be highly organized, even though you are unable to work because of your disability. If you can’t manage this task, you may want to consider retaining an attorney or asking a trusted, very organized family member to take over the paperwork for you. You’ll need to create a checklist of every form required (physician statement, employer statement, personal questionnaire, etc.) and track filing deadlines on a calendar. Don’t forget to double-check everything to be sure you’ve filled out all the documents completely, and make sure all the dates are correct and consistent. Staying on top of the paperwork can prevent administrative issues that often result in swift denials.

 

Insufficient Medical Evidence

Another common pitfall is inadequate proof of a disabling condition. Insurers want detailed, objective records confirming why you cannot perform your job duties, even temporarily. If your application for short-term disability includes vague doctor’s notes that fail to specify functional limitations, the insurance adjuster will question the severity of your condition.

Be sure the medical documents you provide are current, show consistent care, and don’t present a conflicting picture of your health.

Disability insurance attorney Jason Newfield devotes a fair amount of his time to discussing records with his clients’ doctors. This is because they – the treating physicians – are not knowledgeable about how disability claims work. It’s not their job. And their support staff is typically overwhelmed, also. Your claim is not their first priority. But when an attorney is developing a case to protect your short-term disability claim so that you will be better positioned for a long-term claim, how your medical records are presented is incredibly important.

Your request for detailed notes about your condition and treatment plan will be treated differently than when attorney Jason Newfield makes those requests. He will also make sure your medical records contain information about the physical or mental tasks of your occupation and how your disability makes it impossible for you to perform those tasks. Consistent, robust medical evidence helps insurers understand your diagnosis and how it prevents you from working.

 

Does Your Short-Term Disability Insurance Policy Contain Exclusions or Pre-Existing Conditions?

Before you file a disability insurance claim, it is critical to know what your STD policy covers, what it doesn’t, and what disability insurance benefits may be available. Many plans contain specific exclusions that can form the basis for denials. For instance, if your injury or illness started before your coverage began, your short-term disability insurer may argue it’s not covered. There are also policies that exclude certain injuries (e.g., self-inflicted injuries or complications from elective procedures).

Disability attorney Jason Newfield offers free policy reviews to help claimants understand the terms of their policies. Your policy may have riders, waiting periods, or exclusions that mean you won’t be covered. If you don’t know what they are, you won’t know how to prepare for a claim. This is critical when considering whether to file a claim for disability insurance benefits.

If you run into a situation where the insurance company challenges a condition, you will need to prepare by gathering strong documentation showing when your symptoms first appeared or when you received a diagnosis. Understanding the fine print of your STD plan can help you anticipate and address potential coverage issues as outlined in the short-term disability claims and appeals regulations and secure your disability insurance benefits.

 

Does your Short Term Disability Policy Include an Elimination Period? 

Most STD policies include a short elimination period—often 7 days—during which no benefits are paid. If you submit a claim before fulfilling the elimination period, this can result in immediate denial. So can return to work (even on a part-time basis) during this waiting period.

Review your policy so you know what the elimination period is and file a claim at the right time. Mark the exact start date of your disability and wait until you meet the policy’s minimum timeframe before filing. Also, keep thorough records of the date your symptoms started and any workplace absences.

 

Conflicting Information About Ability to Work

If you’re partially able to work, that discrepancy can lead to confusion and suspicion from insurers reviewing your STD claim. If you have a side hustle and are working or even volunteering, this may be used as evidence that you can still work.

Inconsistencies between what you state on your forms and what’s observed or noted in medical records will give the insurance company ammunition to question your claim.

 

Failure to Comply with Treatment Plans

Insurers generally require proof that you’re taking all reasonable steps to recover and return to work as soon as possible. This is where many claimants trip themselves up and put their claims at risk. If you miss appointments, refuse recommended treatments, or don’t follow a prescribed treatment plan, insurers may claim you’re not doing your part to regain the ability to work. Non-compliance can be interpreted as “lack of effort” to mitigate the disability.

If you know you are going to be filing a claim, or if you are on a claim, it’s very important that you attend scheduled appointments, follow prescribed treatments or physical therapy, and take medications as directed. In addition, you should maintain accurate and detailed notes of your appointments, therapies, and medications to demonstrate compliance. Do NOT rely upon your doctor’s office to maintain notes about all of your appointments, and don’t rely on your company’s HR office to accurately maintain notes about your absences or dates you leave early to go to doctor’s appointments. If you can’t manage the record keeping, ask a trusted person to help you.

Short-Term Disability insurance is designed to offer a financial lifeline when you can’t work due to a temporary medical issue. It is also the doorway to long-term disability insurance for many people. If you are unsuccessful in filing a claim for short-term disability and expect to be disabled for an extended period of time, you would be wise to contact Jason Newfield for a complimentary review of your policy and your overall situation.

Many companies self-insure their short-term Term Disability policies, meaning the company itself pays the benefits for employees who are temporarily unable to work. Often, the company contracts with a long-term disability insurance company or a third-party administrator company to manage the short-term claims, with the understanding that the employees on claim for Short Term Disability may need long-term disability coverage in the future. The same company trying to dodge its responsibility for short term is going to be less likely to want to pay benefits for Long-Term Disability. They will be relentless with paperwork during this process.

Do not treat your Short-Term Disability claim lightly. Contact short term disability attorney Jason Newfield to learn what you can expect from your insurance company. The call is free, and you’ll learn important information about your financial future.

One of the most common questions high-income professionals ask is about timing—when is the right moment to file a Long Term Disability Insurance Claim? Should you keep working despite physical or mental challenges? Is it better to reduce your hours to part-time? These are not just career questions—they have serious legal and financial implications.

When Continuing to Work Becomes a Risk

If your health condition poses a risk to you, your clients, or your patients, it’s time to reconsider your work duties. Professional ethics, along with malpractice or liability insurance requirements, may require you to stop certain tasks or step away from critical responsibilities. This is often the point where a Long Term Disability Insurance Claim should be considered.

Know Your Policy Inside and Out

The terms of your LTD policy will determine how and when you can file a claim. These provisions typically cover:

• The date you must document your disabling condition.
• The time allowed from the onset of disability to filing a claim.
• Whether your policy includes partial work or residual coverage.
• How your income and disability benefits will be calculated.
• The type of proof of loss required to support your claim.

Creating a personal claim timeline can help you stay compliant and avoid missed deadlines.

Should You Involve HR Early?

If your LTD policy is part of your employee benefits package, you may have an obligation to notify your HR department before filing. However, privacy laws limit the medical information they can request without your consent. An experienced Long Term Disability Attorney can guide you on what to disclose and how to protect your rights.

Why You Shouldn’t Resign Before Filing

Resigning before you file is one of the biggest mistakes people make. If you’re no longer employed, your LTD insurer has an easy reason to deny your claim, and regaining benefits after resignation is often impossible. Stay on the payroll until your benefits are secured.

If your policy is employer-provided, get a copy of the exact version in effect when you enrolled—not a newer one that might have reduced benefits. You don’t need to explain to HR why you want it; you could say your spouse or personal insurance adviser requested it.

What an Attorney Knows That HR Doesn’t

Your HR team may be helpful, but they are not specialists in LTD law. This is a unique area that blends federal benefits regulations (ERISA), insurance law, and contract law. A seasoned LTD Attorney can advise you on:

• How insurers handle claims for your specific disability.
• What to expect with monthly benefits of $5,000, $10,000, or more.
• How your age, occupation, and income sources can affect your claim.
• The likelihood of approval and the best strategies to strengthen your application.

Why Early Legal Guidance Pays Off

Think about the long-term value of your claim. If you’re in your 40s, expect to work for another 20 years, and qualify for $10,000 per month, your total claim value could reach $2.4 million. This is why insurance companies work hard to deny claims—and why you need to be just as aggressive in protecting yours.

For older professionals with substantial monthly benefits, the duration of coverage is crucial. Some policies pay for life, making them especially valuable to protect.

Protect Your Career and Your Benefits

Transitioning from work to disability benefits is a major decision. Before you act, consult with an experienced Long Term Disability Attorney who can help you navigate the process, safeguard your income, and protect your professional reputation.

If you have questions about your rights or the timing of your claim, contact Jason Newfield for a free consultation. Your career, financial security, and health are too important to leave to chance.

As the summer of 2025 advances, public health officials are sounding the alarm: emergency room visits for tick bites have climbed to their highest levels since 2019. The Centers for Disease Control and Prevention (CDC) attributes this surge to mild winters and wetter springs—conditions that allow ticks to thrive and extend their reach into new regions.

Lyme disease remains the most well-known tick-borne illness, firmly established in the Northeast, Upper Midwest, and Mid-Atlantic. But beyond the rash and flu-like onset lies a more complicated reality: many patients who are not treated early or thoroughly face persistent, disabling symptoms that can alter their ability to work, manage daily routines, and maintain independence.

The Hidden Toll of Untreated Lyme Disease

Lyme disease stems from the bacterium Borrelia burgdorferi, transmitted through black-legged ticks. While early signs may include fever, fatigue, headaches, and the signature bull’s-eye rash, untreated cases often progress. Advanced stages can bring painful arthritis, neurological impairments, and lasting cognitive decline.

For some, even after treatment, symptoms do not fully resolve. This condition—known as Post-Treatment Lyme Disease Syndrome (PTLDS)—can produce chronic fatigue, widespread pain, memory issues, and deficits in executive function. These lingering effects are frequently disabling, yet they often lack the “objective proof” insurers demand.

Diagnostic Gaps and Insurance Challenges

Recent research published in Frontiers in Medicine illustrates just how elusive a Lyme disease diagnosis can be. Data drawn from the Lyme Disease Biobank (2014–2023) revealed that only one-third of symptomatic patients initially tested positive. Many failed to return for follow-up care, leaving significant gaps in their medical records.

These gaps become ammunition for disability insurers. Carriers routinely deny claims by arguing that without conclusive test results or documented impairments, a disabling condition cannot be confirmed. For patients battling real, debilitating symptoms, this disconnect between clinical reality and insurance requirements is devastating.

Why Medical Documentation Matters

For individuals pursuing long-term disability benefits, robust and consistent medical documentation is critical. Lyme disease and PTLDS are episodic, unpredictable, and widely misunderstood. Without strong medical records, claimants may struggle to prove the legitimacy of their condition.

Best practices for claimants include:

• Securing a diagnosis from a specialist familiar with tick-borne illnesses.
• Following prescribed treatment plans, including extended therapies if recommended.
• Keeping detailed records of symptoms, especially their impact on work and daily functioning.
• Responding promptly to insurance requests for evaluations or examinations.

Insurers frequently press for laboratory proof, challenge cognitive or fatigue-based symptoms as “subjective,” and lean on policy exclusions to minimize or deny payouts. Each of these tactics underscores the importance of thorough, ongoing medical evidence.

Complicating Factors: Other Tick-Borne Diseases

Ticks do not only spread Lyme disease. Anaplasmosis, babesiosis, ehrlichiosis, Rocky Mountain spotted fever, and Powassan virus can all cause severe illness, often with overlapping symptoms. For claimants, documenting these potential co-infections may strengthen a disability case by presenting a broader, medically supported narrative.

Protecting Your Disability Claim

At Newfield Law Group, we recognize the uphill battle many Lyme disease sufferers face when pursuing disability benefits. Our attorneys collaborate with infectious disease experts, rheumatologists, and neuropsychologists to build compelling claims that withstand insurer scrutiny.

We understand that your symptoms may not always show up on a test—and that does not make them any less real. With skilled legal advocacy, your story can be told, your evidence strengthened, and your rights defended.

If you or a loved one can no longer work due to Lyme disease or a related tick-borne illness, contact our office for a confidential consultation. The path forward may feel uncertain, but your right to disability protection should never be in doubt.