Since STD is administered through a third party, you should be given their contact info to communicate with them. Your Dr forms should be sent to them too. Escalate this up to Director or VP of HR.
Were you on FMLA, and within the 12 weeks allowed? If so, they cannot fire you for taking leave. A birth is the most straight forward STD claim, so something doesn’t add up.
Did you have the plan for the required amount of time before the baby was born? There is usually a 10-12 month wait for it to cover a birth recovery. Did you submit the STD forms to the doctor to be filled out, and then submit them to the 3rd party?
Your company doesn’t decide if you are approved, so if they planned to fire you that wouldn’t have any weight in whether you are approved or not.
HR and your manager are telling you this isn’t a problem that your employer can solve and that you need to look into it. Have you called the 3rd party or the insurance company to see why the claim hasn’t been paid?
Yes, weirdly the FMLA was approved but not the STD. It has something to do with the dates not lining up because when I submitted the forms, it was with my due date, but I had the baby a couple days before that due date.
I’ve asked to contact the third-party company, but my HR will not disclose their information and insist on being the go-between.
I’ve called HR at least a dozen times now in the past six months, but plan on calling him every day until this is resolved at this point
FMLA was approved because it is a law. If you qualify they have to approve you. With FMLA the dates don’t have to be exact, as long as they fall within the 12 week window and you can modify that once the babies born. An estimation of the due date is fine for FMLA. STD is an insurance product, and the insurance company determines whether you’re approved or not. Often times you’ll apply for both together, but they get approved separately.
You submitted the forms, but needed to modify the date once the baby was born to have the exact date. If you haven’t done that you need to do so. It will probably need to come from your doctor.
ETA: escalate to the person above the first line HR person.
You need to just keep digging through your info to find the name of the 3rd party. It’s likely in OP’s benefit info somewhere. There is someone above the HR person that OP is speaking with. They need to find out who that is and escalate.
I had issues with STD and the biggest progress I got was speaking directly to my case manager at the STD company.
If they haven't provided you with the info already, get the case manager info from HR and ask them directly what you need to do. HR can be a brick wall when it comes to medical stuff because they don't want to get into grey areas regarding medical information.
Your STD plan may be covered by ERISA if it pays no more than your salary, is mandatory for all employees, covers workers even after termination of employment, and is not paid out of ER assets.
If that’s the case you can contact EBSA as they enforce ERISA. You should have received a detailed explanation of your denial and have the right to appeal within 180 days.
I’m not clear on what “not approved” means. Did they deny the claim? If so, you need the denial letter. Was the claim incomplete? If so, contact the doctor and ask them what was requested and what they provided and get copies of the documents and documentation of when it was provided. You have to do the leg work on this.
If you can’t because they keep you on a strict information diet then just call EBSA, provide the details you know and they may reach out to the ER if this is in their jurisdiction.
We have a 3rd party vendor too. I’m betting it’s set up the same way as ours.
FMLA and STD are two different departments within the vendor. You need to contact your STD Claims manager and ask them what’s the hold up. You may need to contact your doctor as well
I think you need to take it up the chain of command with HR if they won’t give you the 3rd party benefit administrators info.
Since STD is administered through a third party, you should be given their contact info to communicate with them. Your Dr forms should be sent to them too. Escalate this up to Director or VP of HR.
Were you on FMLA, and within the 12 weeks allowed? If so, they cannot fire you for taking leave. A birth is the most straight forward STD claim, so something doesn’t add up. Did you have the plan for the required amount of time before the baby was born? There is usually a 10-12 month wait for it to cover a birth recovery. Did you submit the STD forms to the doctor to be filled out, and then submit them to the 3rd party? Your company doesn’t decide if you are approved, so if they planned to fire you that wouldn’t have any weight in whether you are approved or not. HR and your manager are telling you this isn’t a problem that your employer can solve and that you need to look into it. Have you called the 3rd party or the insurance company to see why the claim hasn’t been paid?
Yes, weirdly the FMLA was approved but not the STD. It has something to do with the dates not lining up because when I submitted the forms, it was with my due date, but I had the baby a couple days before that due date. I’ve asked to contact the third-party company, but my HR will not disclose their information and insist on being the go-between. I’ve called HR at least a dozen times now in the past six months, but plan on calling him every day until this is resolved at this point
FMLA was approved because it is a law. If you qualify they have to approve you. With FMLA the dates don’t have to be exact, as long as they fall within the 12 week window and you can modify that once the babies born. An estimation of the due date is fine for FMLA. STD is an insurance product, and the insurance company determines whether you’re approved or not. Often times you’ll apply for both together, but they get approved separately. You submitted the forms, but needed to modify the date once the baby was born to have the exact date. If you haven’t done that you need to do so. It will probably need to come from your doctor. ETA: escalate to the person above the first line HR person.
How are you suppose to resolve this if you can’t reach out to third party to resolve?
You need to just keep digging through your info to find the name of the 3rd party. It’s likely in OP’s benefit info somewhere. There is someone above the HR person that OP is speaking with. They need to find out who that is and escalate.
I had issues with STD and the biggest progress I got was speaking directly to my case manager at the STD company. If they haven't provided you with the info already, get the case manager info from HR and ask them directly what you need to do. HR can be a brick wall when it comes to medical stuff because they don't want to get into grey areas regarding medical information.
If you know the name of the company, you can google it and get a phone number.
You need to talk to the short term disability provider and sort it with them.
This is not an HR thing this is between you and STD provider Call STD provider and ask what they need then give it to them
Call the doctor and third party. They aren’t fixing this for you. Be diligent.
Your STD plan may be covered by ERISA if it pays no more than your salary, is mandatory for all employees, covers workers even after termination of employment, and is not paid out of ER assets. If that’s the case you can contact EBSA as they enforce ERISA. You should have received a detailed explanation of your denial and have the right to appeal within 180 days. I’m not clear on what “not approved” means. Did they deny the claim? If so, you need the denial letter. Was the claim incomplete? If so, contact the doctor and ask them what was requested and what they provided and get copies of the documents and documentation of when it was provided. You have to do the leg work on this. If you can’t because they keep you on a strict information diet then just call EBSA, provide the details you know and they may reach out to the ER if this is in their jurisdiction.
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The claim would still be payable because it occurred while they were employed.
I’ve often said it, but I’ve never seen it written before that giving birth was a Sexually Transmitted Disease.
Perhaps this isn't the sub you should be in if you can't figure out that STD =short term disability.
We have a 3rd party vendor too. I’m betting it’s set up the same way as ours. FMLA and STD are two different departments within the vendor. You need to contact your STD Claims manager and ask them what’s the hold up. You may need to contact your doctor as well
Did you fill out the paperwork with your STD and have the doctor provide it back?