Appealing Short-Term Disability Claim Denials

If a claim for a short-term disability leave under the JPMorgan Chase STD Plan for a non-occupational illness or injury is denied, either in whole or in part, you can appeal the denial by following the appropriate procedures described below.

You have 180 days from the date of your denial to send a written appeal of the short-term disability leave decision. To appeal the short-term disability leave decision, you must send a letter of appeal, medical records, progress notes, test results, and any other applicable documentation to Sedgwick at:

Sedgwick National Appeals Unit
PO Box 14748
Lexington, KY 40512

Fax: (855) 673-2488

You may request copies of all documents, records, and other information relevant to your claim decision; and you may submit written comments, documents, records, and other information relating to your claim for short-term disability benefits.

Sedgwick will make a decision no more than 45 days after your appeal is received, unless it is determined special circumstances exist that require an extension of time to process the appeal. If your appeal requires an extension, a decision will be made no more than 90 days after your appeal is received.

If during the appeal process you determine you will require additional time to secure medical or behavioral health information and documentation to support your appeal, you may contact the Sedgwick Appeals Coordinator to request an extension of time to submit additional information. Up to 45 days of additional time may be granted.

The written decision will include specific references to the contract provisions on which the decision is based.

In the appeal of a claim denial based upon medical or behavioral health judgment, the claims administrator will consult with an appropriate, independent licensed physician. You will have the right to obtain the name of such person if your appeal is denied.

For additional information regarding appealing claims under the STD Plan, please see "Additional Plan Information." Claims and appeals under the STD Plan will be handled in accordance with applicable Department of Labor regulations.

For Employees Who Work in the State of New Jersey

If you disagree with the determination of Sedgwick, you have the right to appeal to the Division of Temporary Disability Insurance. You have one year from the date your disability began to file your appeal.

Send your written appeal to:

Division of Temporary Disability Insurance
Private Plan Operations
Claims Review Unit
PO Box 957
Trenton, NJ 08625-0957

Telephone: (609) 292-6135