Short-term disability (STD), also known as temporary disability, is a type of insurance that replaces some of your income while you are temporarily unable to work. Pregnancy and childbirth, injury, surgery and serious illnesses are some of the conditions that could qualify you for STD payments. Applying for benefits involves informing your insurance carrier of your disability and providing proof that you cannot work.
Qualifying for Short-Term Disability
To qualify for short-term disability under your employer’s insurance policy, you have to meet certain qualifications. These include:
- The disability must not be work-related. If you were injured at work and cannot work because of it, that would fall under worker’s compensation and be your employer’s responsibility. Your disability must be related to an injury or illness that occurred outside of work.
- You must meet minimum work requirements. Depending on state laws and policy rules, that requirement could be anywhere from 30 days to six months before the injury occurred.
- You may need to meet minimum earnings requirements.
- You must prove your disability with a medical exam or copies of your medical records.
- You must have a disability insurance policy before the disability begins. Some employers offer such policies as a benefit to their employees, either fully paid or as a voluntary deduction. You can also purchase your own policy independently. However, if you do not have a policy in place before your disability occurs, you cannot apply for STD/TDI benefits unless you live in a state that offers such coverage to all employees.
The most important aspect of qualifying for short-term disability is that your injury or illness makes it impossible for you to work while you recover. For example, if you are having major surgery or receiving treatment for a serious illness that requires a significant recovery period, you can apply for benefits. If you break your ankle, but you can still work with accommodations, you’re less likely to receive benefits.
Applying for Short-Term Disability
Applying for short-term disability payments typically means following the insurance carrier’s policies in terms of making a claim. If you have a policy through your employer, visit HR to acquire the appropriate forms; otherwise, contact your insurance agent or carrier to get the materials you need to apply.
Most insurers will require you to submit a statement as to why you cannot work, as well as an employer’s statement confirming that you meet the qualifications for a claim. You will also have to submit a physician’s statement detailing your illness or injury and confirming that you cannot work. You may need to provide authorization for the insurance carrier or its third-party administrator to obtain information relevant to your claim. Once you’ve completed the forms and documentation, you submit the application; it usually takes seven to 10 days for claims to be processed.
You should submit your claim as soon as you know you will be unable to work longer than the standard seven-day waiting period for STD, or up to four weeks in advance of a planned surgery or childbirth.
Things to Know
Short-term disability is designed to be a stopgap measure to help you maintain some income while you can’t work. It is not intended to be a replacement for your salary; typically, your payments will only be about 40 to 60 percent of your earnings, and last for a short time. While you are on temporary disability, your employer can request updates on your condition, which may include exams or records from your healthcare provider, to document and monitor your progress.
Some employers may also require employees to use up their allocated paid time off or sick days, or a portion of them, before applying for short-term disability. Usually, this is the case when the employer funds the disability coverage for employees. Also, you can qualify for STD/TDI payments while you take time off under the Family Medical Leave Act (FMLA). FMLA is designed to protect your job while you take time off, not provide income, so you can apply for benefits when you take FMLA. Again, employer policies vary in terms of whether you need to use your sick time first, and how long you can collect payments under STD.
State Short-Term Disability Benefits
Some states -- California, New York, New Jersey and Hawaii -- offer short-term disability payments to residents who meet certain qualifications. Each state has its own rules about who can qualify for disability, but typically you must meet residency requirements and have worked for a minimum period of time with earnings above a certain threshold. To qualify for state benefits, you will need to apply directly with the state; this typically means asking your employer for the correct application, getting certification of the short-term disability with your healthcare provider and submitting the application to the appropriate insurance company.
In some states, like Hawaii, your employer is required to provide short-term disability coverage, so your state insurance application should be submitted to your employer’s insurance carrier. In Rhode Island, you must apply directly through the Rhode Island Temporary Disability Insurance program. Check with your employer to determine which options are available to you and how you need to apply.