Disability insurance coverage details depend on the insurance provider and state regulations (mandatory in California, Hawaii, New Jersey, New York, Puerto Rico, and Rhode Island). Choose from these plan options:
- Traditional coverage: Employer pays the premium.
- Contributory coverage: Both employer and employee contribute.
- Core buy-up coverage: Employees can purchase additional coverage.
- Voluntary coverage: Employees take full responsibility for disability benefits.
In case of disability during an active plan, consult a doctor for necessary paperwork, file a detailed claim, and await approval. Claims are usually approved within one to two weeks, ensuring payments start within 14 days of filing. Payments continue until you can work again or until the end of your benefit period, whichever occurs first. (See more to have a clear understanding of what is short-term disability?)
What Is Covered In Short-Term Disability?
When you file for short-term disability, eligibility for benefits depends on the nature of your injury or illness. The most common claims, ranked from highest to lowest, cover:
- Pregnancy
- Musculoskeletal disorders (back, spine, knees, hips, and shoulders)
- Muscle and ligament issues
- Digestive problems (like gastritis and hernias)
- Mental health conditions (such as depression and anxiety)
What Is Not Covered In Short-Term Disability?
Short-term disability policies vary in coverage, but they typically exclude specific disabilities, considering them not eligible for coverage. These exclusions may include:
- Injuries related to a crime if the disabled person is convicted
- Disabilities occurring during incarceration
- Injuries during active participation in a riot
- Pre-existing conditions within the first year after the effective date
- Self-inflicted wounds
- War or acts of war
- Workplace injuries (with potential exceptions not covered by workers’ compensation)
Where Can You Get Your Short-Term Disability Insurance?
To find the most suitable short-term disability insurance:
- Check if your employer provides a discounted plan: Explore if your employer offers coverage. If they have a group plan, but you feel it might not be sufficient, consider considering private insurance options.
- Purchase your policy through an agent or broker: You can buy a short-term disability policy by contacting an insurance company or collaborating with a broker. Keep in mind that acquiring individual short-term disability insurance may be pricier compared to your employer’s group plan.
Regardless of how you acquire short-term disability insurance, understand the insurer’s definition of disability, as it can significantly impact your coverage. Moreover, closely examine your policy’s benefit period.
- Coverage amount (aim for a policy that replaces 60% to 70% of your income).
- Waiting period (the duration before your benefits become effective).
Discuss specific details like partial benefits, transitional benefits, and ongoing coverage with an agent for a comprehensive understanding.
Am I Eligible For Short-Term Disability Insurance?
You must be signed up for either a group or privately owned plan to be eligible for short-term disability insurance benefits. Inform your doctor if your insurance is still in effect when you become disabled so they can get the necessary paperwork to record important information about your illness or injury.
You may file a claim if your handicap is unconnected to work (worker’s compensation may cover work-related injuries) and fits your insurer’s accepted conditions list. Payments begin following the expiration of the waiting period outlined in your policy once your claim has been approved.
Short-Term Vs. Long-Term Disability Insurance
| Feature | Short-term disability (STD) | Long-term disability (LTD) |
|---|---|---|
| Duration of coverage | Typically covers weeks to months | Extends for months, years, or lifetime |
| Purpose | Addresses temporary disabilities | Provides support for prolonged disabilities |
| Waiting Period | Short waiting period before benefits start | Longer waiting period, often after exhaustion of sick leave or STD |
| Coverage Percentage | May cover a higher percentage of pre-disability income | Typically covers a percentage of pre-disability income |
| Common Triggers | Recovering from surgery, short-term illnesses | Extended illnesses, chronic conditions, or disabilities |
| Return-to-work incentives | Encourages a quicker return to work | Focuses on supporting individuals unable to return to work for an extended period |
| Policy availability | Often available through employers | Can be obtained through employers or individually purchased policies |
| Coordination with other benefits | May work in conjunction with sick leave | Can complement Social Security Disability Insurance (SSDI) benefits |
This table highlights key features that differentiate short-term disability (STD) and long-term disability (LTD) insurance, helping individuals choose the right coverage based on their needs and circumstances.
What Is The Elimination Period For Short-Term Disability?
Referred to as the elimination period, the waiting period is the duration you must wait before you begin receiving short-term disability benefits. Generally, short-term disability policies come with a two-week waiting period, though your elimination period may vary, ranging from one week to one month.
Need Legal Help? Contact A Disability Lawyer
A Social Security disability lawyer can assist you with short-term disability benefits by navigating the legal complexities, ensuring proper documentation, and representing your case. They can help gather necessary evidence, handle paperwork, and represent you in appeals if your claim is denied.