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COVID-19 Coronavirus and Long Term Disability Insurance Claims

Monday, April 6th, 2020

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Disability insurance companies are being faced with big challenges as a result of the current pandemic. A number of issues regarding short and long-term disability claims are intersecting with mandatory business closures, sharply curtailed hours for employees or employees who are being furloughed or fired.

The situation is unprecedented, with many unresolved issues. However, based on our decades of experience and our knowledge of short and long term disability claims, we thought the following would be useful.

Large numbers of employees are having their positions reduced. Some disability insurance companies are making changes to their eligibility requirements in order to proactively provide coverage on group disability insurance coverage. As long as premiums are being paid, some full-time workers who now find themselves to be part time workers may still have disability coverage until a certain date. These are temporary accommodations being made by only some disability insurance companies. Check with your employer to find out if you will continue to have disability insurance coverage.

Short term coverage may be extended, as long as premiums are paid. Long term disability coverage may not be.

A report by Cigna Group for policy holders states that the company will extend eligibility for employees until May 31, 2020, as long as they were eligible on March 1, 2020 and as long as they remain employed and again, premiums continue to be paid.

CIGNA’s online resource center states someone with a COVID-19 diagnosis would be evaluated against the terms and conditions of their Cigna disability policy or plan as they would any other confirmed sickness.

Unum, one of the largest disability insurance companies in the world, has a resource center for COVID-19, but the information about Short Term Disability ins somewhat limited. Unum says it is continuing to administer ASO (Administrative Services Only) programs, where the employer pays for short term disability and Unum’s role is solely to manage and administer payments.

However, Unum recommends that employees be given the ability to work from home, or provide pay during a mandated quarantine or stay at home order. Unum says clearly it will not waive elimination periods for confirmed COVID-19 cases. However, the company will waive the earnings-loss requirement during the elimination period, as long as the employer will compensate employees through payroll.

Unum also states that if employees receive payments from the FFCRA program, they will consider this an offset against their disability payment.

Furthermore (this is from the Unum site):

• Unum STD/LTD disability payments will be reduced if an employee receives payment under a state-mandated disability law, as that payment would be considered a deductible source of income.
• Unum STD/LTD disability payments will not be reduced if an employee receives a payment under a state paid family leave law. However, state paid family leave payments will be considered as earnings when analyzing the employee’s loss of earnings.

There are riders in many short term disability policies that extend to illnesses that require quarantine, but remember that the disability policies were written before any pandemic. Now they are being modified by some companies because of new federal and state legislation – including the Families First Coronavirus Response Act (FFCRA). In New York and New Jersey, quarantined individuals have recently been covered if the employer has a state mandated temporary disability benefits and paid family leave policy with certain insurance companies.

Guardian insureds with short term disability may be covered due to a COVID-19 quarantine. If the employee is disabled due to COVID-19, they may be moved to long term disability if they cannot perform the duties of their jobs.

Here’s what we think you can expect from disability insurance companies if you become too sick to work, even from home, because of COVID-19 or for any disability:

• Many people are going to be filing for short term disability insurance, so getting a disability claim processed may become more difficult because of the sheer volume of claims.

• A clogged processing system may mean that both short and long term disability claims are delayed even longer than usual.

• Expect the insurance sector to be overwhelmed with claims, so that short and long term claims are delayed, even longer than usual.

• Expect push back from insurance companies that, despite the warm and fuzzy language on their COVID-19 resource centers, may begin seeking to establish that claimants were laid off before they became sick and therefore may not have short term or long-term disability coverage.

The elimination or qualification period for Long Term Disability is not going to change, so establishing a disability date will become increasingly important to the success of a claim.

Short term disability insurance claims requires a doctor or other medical professional who can verify that you are unable to go to work. In a time where almost every physician is being brought to hospitals to help with COVID-19 patients, you may not be able to get a doctor’s appointment.

These are unprecedented times, which we anticipate will make a successful disability insurance claim even harder than before without the help of experienced long term disability insurance attorneys. Our office is still open and we are still accepting new clients. Call us at 877-583-2524 to learn how we can help.

Justin C Frankel

Written By:

Justin C. Frankel

Disability Insurance Attorney

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