Short-term disability benefits is a form of financial support that offers a portion of your regular income every week if you’re unable to work due to a non-work-related injury or illness.
Unlike workers’ compensation, which addresses on-the-job injuries, short-term disability benefits specifically help you during off-the-job accidents or illnesses.
What Qualifies For Short-Term Disability?
Short-term disability insurance typically covers a range of conditions, including but not limited to:
- Illnesses that incapacitate you for over a week, such as COVID-19, cancer, or pneumonia
- Injuries that require time off work
- Pregnancy and post-childbirth recovery
- Post-surgery or accident recuperation
- Mental health disorders that hinder your ability to perform your job
While this list isn’t exhaustive, it encompasses the most common reasons for qualifying for state disability insurance.
In general, if you need an extended leave of absence from work due to illness, injury, or pregnancy, you may be eligible for state disability benefits. It’s advisable to check your state’s requirements and consult with relevant authorities for precise details. Learn more on how to apply for short-term disability benefits.
What Doesn’t Qualify For Short-Term Disability?
Short-term disability insurance typically covers a range of medical conditions and situations that prevent you from working for a limited period. However, some situations and needs may not qualify for short-term disability benefits.
Some common examples of situations that may not qualify for short-term disability pay:
- Pre-existing conditions: Some policies may have a waiting period or exclusion for pre-existing medical conditions.
- Elective procedures: Short-term disability insurance typically doesn’t cover elective medical courses or surgeries you choose to undergo.
- Injuries or illnesses not documented by a medical professional: To qualify for short-term disability benefits, your condition usually needs to be diagnosed and written by a medical professional.
- Non-medical reasons: Short-term disability insurance typically covers medical conditions that prevent you from working.
Which States Provide Short-Term Disability?
The states that have their own TDI or SDI programs include:
- California (California State Disability Insurance)
- Hawaii (Hawaii Temporary Disability Insurance)
- New Jersey (New Jersey Temporary Disability Insurance)
- New York (New York State Disability Benefits)
- Rhode Island (Rhode Island Temporary Disability Insurance)
These state programs are designed to provide temporary disability benefits to eligible employees who cannot work due to non-work-related illnesses, injuries, or pregnancies. Eligibility criteria, benefit amounts, and duration of coverage vary from state to state.
Short-Term Disability vs. FMLA Disability Insurance
Short-term disability (STD) insurance and the Family and Medical Leave Act (FMLA) disability insurance are designed to provide job protection and financial assistance to employees needing to take time off work due to medical or family-related reasons. However, they serve different purposes and have distinct features:
- Short-Term Disability (STD) Insurance: STD insurance provides income replacement when an employee is temporarily unable to work due to a qualifying medical condition or disability.
- Family and Medical Leave Act (FMLA): FMLA provides job protection and unpaid leave for eligible employees to address specific family and medical issues.
- Short-Term Disability (STD) Insurance: Eligibility for STD insurance is determined by the specific insurance policy provided by the employer or purchased by the employee.
- Family and Medical Leave Act (FMLA): Eligibility for FMLA is determined by federal law and applies to eligible employees of covered employers. To qualify for FMLA, an employee must have worked for the employer for at least 12 months, accrued a certain amount of hours, and worked for an employer with at least 50 employees.
Paid vs. Unpaid:
- Short-Term Disability (STD) Insurance: STD insurance typically provides partial income replacement during the period of disability.
- Family and Medical Leave Act (FMLA): FMLA provides unpaid leave, meaning eligible employees can take time off but are not paid for that time.
- Short-Term Disability (STD) Insurance: STD insurance typically covers the individual employee who experiences a qualifying medical condition.
- Family and Medical Leave Act (FMLA): FMLA can be used for various family and medical reasons.
Do You Need A Lawyer To Apply For Short-Term Disability?
You generally do not need a lawyer to apply for short-term disability. Most individuals can apply directly through their employer or the insurance company administering the policy. Sometimes, claimants apply for the benefits without a lawyer, and their applications get rejected. Therefore, a lawyer can be beneficial for your case.
However, if your claim is denied or you encounter legal complexities, consulting with a Social Security disability lawyer experienced in disability law may benefit the appeals process.