A short-term disability is an occurrence that puts you out of work temporarily, such as an injury, illness, or a surgical procedure. When an event like this occurs, and you cannot work, you may qualify for benefits if your employer offers short term disability coverage or you have privately purchased a short term disability policy.
What Is a Short-Term Disability?
A short-term disability is any medical condition that stops you from working temporarily. This could be for a few weeks to several months. So, in effect, any illness or injury may be seen as a short-term disability as long as it meets the ‘total disability’ definition contained in your policy or plan. However, each employer or insurer can define ‘total disability’ differently. This means that you need to check your policy or plan documents to find out if your medical condition qualifies for short-term disability benefits.
However, here are some examples of how insurers could define ‘total disability’:
- ‘Total disability’ means the inability to work at your usual occupation, in other words, to carry out the material and substantial duties of your occupation.
- ‘Total disability’ means the incapability to work at any occupation. This definition is oftentimes softened by the inclusion of the following words: the inability to perform the duties of any occupation for which you are suited by training, education, or experience.
- ‘Total disability’ is the inability, solely owing to injury or sickness, to carry out the material and substantial duties of any occupation for which you are reasonably fitted.
It is often important to have a medical diagnosis to prove your short-term disability. However, at the initial stage of your treatment, your physicians might not know what is causing your restrictions and inability to work. Disability insurers often do not approve a short-term disability claim without a medical diagnosis from a relevant registered practitioner. Sometimes they use the fact that your providers are searching for a cause as a reason to deny the claim.
For example, the insurance company may allege that you are just burnt out or under stress or searching for a new job. That is why it is important for your doctors to document your restrictions and limitations. That can be more important than the actual diagnosis. For example, a medical diagnosis of depression, which is severe enough to prevent you from being able to function properly in your workplace, could be approved while your treatment team works through finding a solution.
What Injuries, Illnesses, and Conditions Can Qualify as a Short-Term Disability?
Any medical condition that causes significant restrictions and limitations or the inability to do your job can qualify as a short-term disability. Here are a number of qualifying events:
Cognitive issues can be caused by many medical conditions, but the most common cause is a mild traumatic brain injury. Concussions can cause decreased attention and concentration. They can cause reading and auditory comprehension problems, as well as visual disturbance. They can include symptoms such as memory loss, post traumatic headaches, and challenges with making day-to-day decisions. Mild traumatic brain injuries or post concussive disorder can executive functioning difficulties for many months. Cognitive issues may very well be temporary or permanent, but they are significant conditions that can affect an employee’s daily operations.
Impaired Hearing or Vestibular Issues
An employee can develop hearing issues owing to an underlying disease and need to take a leave from work to seek proper treatment. In addition, impaired hearing may result from other causes, such as aging, objects getting stuck in the ear, or persistent exposure to loud noises. Concussions can cause dizziness and vertigo or other vestibular symptoms. Concussions can also cause balance and spatial disorientation. Oftentimes sorting our hearing and vestibular issues can take some time to manage.
Impaired hearing may also qualify for a short-term medical disability and employees can receive payment for the period of work absence owing to the condition and finding the right treatment.
Breathing difficulties can take place suddenly or slowly develop over time until they become disabling depending on your job. Different conditions can cause breathing disorders however most stem from lung diseases such as asthma, lung cancer, chronic obstructive pulmonary disease (COPD), or other infections such as tuberculosis, influenza, or pneumonia. These conditions and any other symptoms affecting an employee’s breathing can qualify for short-term medical disability benefits. Often these conditions can cause sleep disturbance, fatigue, anxiety, and depression, which can all make it difficult to work.
Chronic pain is persistent pain or discomfort, which lasts for a protracted period and causes great difficulty in carrying out your job. Chronic pain can cause difficulty with activities of daily living, working, and maintaining your mental health. Examples of chronic pain can include chronic back or neck pain, arthritic pain, musculoskeletal dysfunction, gastrointestinal dysfunction, and many other causes. An employee with chronic pain who is unable to perform daily work-related tasks can file for short-term medical disability insurance to try and seek treatment to remedy things and break the cycle of pain.
Post-surgical rehabilitation can often qualify for short term disability, while the patient deals with a range of motion limitations, weakness, and pain that are typically experienced after surgery. Recovery from surgery often requires rehabilitation procedures, such as physical therapy, water therapy, and exercise therapy to help with recovery after an operation. All of these treatments take time and take you out of work. A patient may not have the energy for recovering and working at the same time.
Digestive or Gastrointestinal Disorders
Common diseases of the digestive system involve irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), constipation, chronic nausea and vomiting, and diarrhea are common examples. Treatment of digestive disorders may take time. Figuring out the cause of the problems may require referrals to several specialists and lots of testing. Discovering the cause and treating these problems can take many months and depending on the severity take a person out of work for months.
Limited Body Mobility
Limited mobility can be caused by injuries resulting from falls, motor vehicle crashes, or participation in sports like skiing. Bio-mechanical restrictions from chronic conditions like Multiple Sclerosis or dystonia can gradually worsen over time. These kinds of restrictions can be permanent or temporary. Mobility impairment ranges from lower body impairment – requiring wheelchairs, canes, or walkers – to upper body impairment, which may include limited or no use of the hands. An employee can claim short-term medical disability insurance if they develop limited body mobility and it can extend to long-term disability if the condition persists beyond three to six months.
What Is Short-Term Disability Insurance?
Short-term disability policies or plans pay benefits for short periods: typically three to six months. Benefits commence after a short waiting (elimination) period. The difference between short term and long term disability really comes down to two things: the length of time from the occurrence of a disability until benefits are payable, and the duration of time benefits will be paid. Many employers offer a short-term group plan or policy as an employer paid benefit to all employees. The percentage of your salary that is protected can range from 60% to 100% of your pre-disability earnings.
Are There Any Disadvantages of Short-Term Disability Insurance?
The pros of short-term disability coverage far outweigh the cons as short term disability benefits can be a lifesaver when you need it. However, you need to be informed about the possible drawbacks. These are:
Your Policy May Not Cover All Health Conditions or Have Offsets
Many short-term disability policies or plans have exclusions as well as limitations. It is a very good idea to understand and read your policy before making a claim.
- Self-inflicted injuries: Some policies or plans will not cover self-inflicted injuries.
- Workers’ compensation: Most short-term disability policies will not cover claims that involve an occupational illness or injury.
- Offsets for other benefits: The insurance company may offset your monthly benefits dollar-for-dollar with any other benefits that you may receive from programs like Washington State’s Paid Family Medical Leave.
Insurance companies often read these exclusions and limitations too broadly, thus denying valid claims. If the adjuster tries to limit your short-term disability claim or deny it completely, consult a lawyer – such as AEL Law – as soon as possible.
Waiting Periods Are Common in Short Term Disability Coverage
While most short-term disability exclusion periods are not as long as their long-term disability counterparts, you’ll still have to wait a bit before you’re eligible for a monthly benefit. For short-term disability claims, the elimination period can be up to 30 days, although a seven-day waiting period is most common. This means that you will not receive benefits for the elimination or waiting period.
How Can You Find the Right Short-Term Disability Plan for You?
Most employers offer a short term disability policy as part of your benefit package or have a self-funded short term disability plan. Alternately, they will offer you the ability to purchase a STD policy. You can also buy short term disability policies from an outside agent of your choosing. The best advice is to review what your employer offers and to shop around if the coverage does not provide enough protection for you to pay your bills, mortgage, car payments, and other household expenses should you not be able to work for three to six months.
Should I Buy Individual Disability Products In Addition to the Group Plan Offered by My Employer?
This is something that you should opt for if you are looking for more protection as it will give you extra coverage on top of your group long-term or individual disability plan. Supplemental insurance available through your employer could be a great add-on for you as it will help you protect a greater percentage of your income, bonuses, or commissions.
A supplemental disability policy will even help you in covering the difference between what you will receive from your current group’s long-term disability policy and what you will need to maintain your current lifestyle in the times when you are not able to work due to an injury or illness.
The cost of an individual or supplemental disability policy, varies based upon several factors such as benefit length, benefit amount, definition of disability, age, and occupation. Contact a reputable agent and shop around or speak to a disability attorney to review your options. Individual policies can also have tax advantages versus group policies that are paid for by your employer.
Get Assistance from the Experts at Aaron Engle Law
At Aaron Engle Law, our goal is to help you get your life back on track after an injury or illness. If you need any assistance with your short term disability insurance claim, get in touch with us, and let’s get working on your case!
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