There are many times in life where a person may need to file a private disability claim. Whether you're recovering from childbirth, dealing with a personal injury, or recuperating from a serious health condition, filing a private disability claim is crucial in ensuring you don't experience a loss in pay throughout your leave.
What is private disability?
Private disability is a type of insurance that companies pay for to cover a portion of wages (i.e. your pay) if employees become sick or injured and are unable to do their jobs for a specified period of time, usually ranging from about 3 to 12 months. Disability insurance also applies to pregnancy and typically covers the first several weeks of parental leaves for birthing parents.
Initiating your private disability claim
After submitting your leave in Cocoon (which will notify your HR team and manager of your leave plan) we'll surface any claims you need to file on the Your tasks tab. We'll walk you through the steps you need to take, including:
Downloading your leave forms
Working with your medical provider "certify" your leave dates on your claim forms by filling out certain fields
💡 This is often called a medical certification or "med cert"
Re-uploading the completed forms to your Cocoon Dashboard
If you're taking a parental leave ➡️ See here for guidance on medical certifications
When all your steps are compete, Cocoon will submit your private disability claim to the insurance carrier on your behalf.
Your involvement in the claim process
Keep in mind, your insurance carrier may reach out to you directly to request additional information regarding your claim due to privacy considerations and the sensitive nature of private disability claims. This involvement is necessary to finalize any outstanding questions about your claim before approval, and Cocoon cannot take these
Understanding your leave pay
On your Cocoon Dashboard, you can see the segments of your leave, if any, during which you'll pay from private disability insurance.
You can also track your pay from various sources, including private disability, across all pay period on the Your payments tab.
When to file your private disability claim
It's crucial to file your claim at the right time. Filing too early or too late can lead to delays or denials, which can impact impact when you receive full pay. The good news is Cocoon walks you through exactly when to complete each step for claims on the Your tasks tab of your Cocoon Dashboard.
If you're a birthing parent ➡️ We'll need to wait to file until you've confirmed your child's arrival. Changes to your delivery method or your child's arrival date may cause you to need to re-do your claims forms and/or reach out to the relevant entities with new information. Don't worry—we'll remind you when it comes time.
Filing claims for medical leave
Your medical leave will require your provider to complete a Serious Health Condition (SHC) form in addition to the short term disability claim forms. This could either be a general FMLA SHC form or a state-specific version, depending on your benefit state.
Serious Health Condition ("SHC") form
The SHC form is a federal form used to officially request and gain approval for leave. You can download the form, have your medical provider complete it, and then upload it back to your Cocoon Dashboard.
If your claim requires an SHC, you'll see a step for it on the Your tasks tab.
Once we receive your completed Serious Health Condition form, your leave will be approved in Cocoon. While this doesn't mean your short term disability claim is approved, it does allow us to move forward with filing your claim with private insurance.
Staying in the Loop
Keep an eye out for any notices you receive in the mail. Your private insurance carrier may reach out to you directly for more information before processing your claim.
If you have any questions about submitting your private disability claim, you can always reach out to [email protected]. Our Support Team will be happy to help you!
Have Questions? We're here to help!
Email us at [email protected]