Short Term Disability

A short-term disability is an occurrence that puts you out of work temporarily, such as an injury, illness, or – alternatively – a surgical procedure. When one of these events happens, and you cannot earn an income, you may be able to qualify for benefits if you have signed up for a short-term disability insurance plan ahead of time.

What Is a Short-Term Disability?

A short-term disability is any medical condition that stops you from working temporarily. This could be from a couple of weeks to 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. However, each insurer defines ‘total disability’ differently. This means that you need to check your policy to find out if your condition qualifies for short-term disability benefits.

However, here are some examples of how insurers could define ‘total disability’:

• ‘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.
• ‘Total disability’ means the incapability 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 by which the individual is suited by training, education, or – alternatively – experience.

It is very important to have a medical diagnosis to prove your short-term disability. Not only does this offer detailed information regarding your health but it will also outline a thorough treatment plan. Disability insurers are not likely to approve a short-term disability claim without a medical diagnosis from a relevant registered practitioner.

For example, if you claim burnout, stress, or pregnancy, the insurance company could reject it.

Burnout or stress may not be deemed as reasonably meeting the criteria for a medical diagnosis of disability. However, in some instances, a medical diagnosis of depression, which is severe enough to prevent you from being able to function properly in your workplace, could be approved.

Pregnancy is not seen as a disability; however, you may suffer from pregnancy-related complications that can prevent you from carrying out the main tasks of your profession. In this case, your claim may be approved. The law requires employers to allocate maternity leave and maternity leave is usually not inclusive of your annual leave.

What Injuries, Illnesses, and Conditions Qualify as a Short-Term Disability?

Several injuries, illnesses, and conditions qualify as a short-term disability. Here are a number of qualifying events:

Cognitive Issues

Cognitive issues are those conditions that affect a person’s brain and cause abnormal brain functioning. They can include symptoms such as memory loss, a lack of concentration, or – alternatively – challenges with making day-to-day decisions. This may also entail identity confusion or delirium in quite severe cases. Cognitive issues may very well be temporary or permanent but they’re significant conditions that can affect an employee’s daily operations.

Impaired Hearing

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.

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 the treatment thereof. Employers can offer additional compensation or reimbursement if an employee’s condition worsens at work.

For instance, if an employee works in a company’s manufacturing unit and develops impaired hearing due to prolonged exposure to machine noises, the company may provide extra compensation for the affected employee.

Breathing Disorders

Breathing difficulties can take place suddenly or develop gradually in a person. 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.

Chronic Pain

Chronic pain is any persistent pain or discomfort which lasts for a protracted period. The pain can be temporary or continuous. It may affect people to the extent that normal eating, working, and daily physical activities become extremely challenging. Examples of chronic pain can include back pain, pain that is caused by cancer, or arthritis pain that continues beyond the usual recovery period. An employee with chronic pain is unfit to perform daily work-related tasks and can file for short-term medical disability insurance.

Surgery Rehabilitation

Post-surgical rehabilitation deals with the stiffness and weakness which is typically experienced after surgery. It entails rehabilitation procedures, such as physical therapy, water therapy, and exercise therapy to help with recovery after an operation. If you have short-term medical disability insurance as an employee and undergo a surgical procedure, you can usually claim this insurance to cover the period of your surgical rehabilitation.

Digestion Disorders

Common diseases of the digestive system involve irritable bowel syndrome, gastroesophageal reflux disease, and cancer. Treatment of digestive disorders may last up to six months and is dependent on the severity of the situation. Should the situation be very severe it could qualify as a short-term medical disability.

Limited Body Mobility

Limited mobility is a disability that affects body movement and 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 for several years.

What Is Short-Term Disability Insurance?

Short-term disability policy products pay benefits for short periods – typically three months, six months, or one year, after a short waiting (elimination) period. Short-term disability insurance can be quite expensive to purchase as an individual, however, group plans are usually less expensive as opposed to long-term group plans. Many employers offer a short-term group plan as company-paid benefits to all employees.

How Long Does a Short-Term Disability Last?

As previously mentioned, short-term disability insurance is envisioned to cover your salary for a short period after an illness or injury which keeps you out of work.

What Are the Advantages of Short-Term Disability Insurance?

It’s a policy type that provides nearly full income replacement if you are not able to work for an extended period owing to an approved medical condition (We have mentioned these approved conditions earlier on in this article.) When you have fulfilled the applicable waiting period, you have income protection – for instance – up to 66 2/3% of your yearly base benefits pay (up to $5 000 per week at the maximum).

Short-term disability offers a no-cost base coverage, which is paid for by the employer, as well as buy-up coverage, which is paid for by the employee. The base share pays 66.7% of your weekly wages on the first $24 000 of your annual base salary with just a two-week waiting period (14 calendar days).

The costs for the buy-up are dependent on your yearly salary. You can opt-out of the buy-up coverage at any time you choose. If you would like to re-enlist in the buy-up coverage at a different time, you will be subjected to medical review and you may be denied.

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 life saver at the time that you need it. However, you need to be informed about the possible drawbacks. These are:

Your Policy May Not Cover All Health Conditions

Most short-term disability plans have exclusions as well as limitations. It’s a very good idea to understand this fine print before choosing a private disability plan or applying for benefits. Consider major medical insurance should you have health related issues. Keep an eye out for these common exclusions and limitations:

• Pre-existing conditions: Many employer-funded plans have waiting periods that you need to complete before the plan will cover a pre-existing condition.
• Self-inflicted injuries: Many policies will not cover self-inflicted injuries.
• Normal pregnancy: While many short-term disability policies will cover your recovery time after labor and delivery, some plans will limit your benefits unless you’ve undergone a C-section or have suffered complications.
• Workers’ compensation: Some short-term disability policies will not cover claims that involve an occupational illness or injury. Other plans have specific limitations. For instance, the insurance company may offset your monthly benefits dollar-for-dollar with anything you receive in workers’ compensation benefits.

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 between 0–90 days, although a seven-day waiting period is most common. Some policies have different elimination periods for illnesses and injuries, so make sure that you review your plan’s terms and conditions carefully.

You should also pay close attention to how elimination periods and limitations interact. Many policies treat these waiting periods like a deductible — you lose out on benefits during the elimination period regardless of your claim’s length.

How Can You Find the Right Short-Term Disability Plan for You?

You can buy insurance for disability privately however for a pretty high price. The short term disability payments can be different based on your age and the level of benefits but some estimations state that you should expect to pay anywhere between one and three percent of your annual gross income. For instance, if you’re earning a $50,000 salary, purchasing your short-term disability policy could cost between $500 and $1,500 every year. The most significant barrier to securing private coverage is cost, so shop around to get the best deal.

Are You Eligible to Collect Short-Term Disability Insurance?

Most short-term disability coverage plans consist of certain specifications regarding the employee’s eligibility to gain benefits. For instance, some plans indicate a minimum service requirement or a minimum period that an employee must have been employed for. The organization may stipulate that the employee works full-time or has worked sequentially for a particular period.

In addition to these requirements, some employers specify that an employee needs to use all of their sick days before becoming eligible for short-term disability benefits. However, companies should always follow the medical leave act.

Also, employers may require a doctor’s note to verify an employee’s affliction, commonly including illnesses such as arthritis or back pain, cancer, diabetes, or a couple of non-work-related injuries.

Can the Cost of Individual Disability Coverage Rise as Your Earnings Grow?

If you are part of a graded premium policy then it would let you pay lower premiums initially, which will then increase according to a predetermined, guaranteed schedule. You might even have the option to convert to a level premium, which is a fixed premium that never increases.

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. Companies often offer group disability plans, from which you can receive benefits.

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.

Approximately How Much Will Long-Term Disability Insurance Cost Per Month?

While the cost of a disability policy, particularly an individual policy, varies based upon several factors such as benefit length, benefit amount, gender, age, and occupation you should expect to pay somewhere between 1 and 3% of your annual salary. Thus, if you are making $100,000, then you can expect to pay between $83 to $250 per month. The short term disability taxable amount should be established by both the employee and official authorities.

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 requirements, get in touch with us, and let’s get working on your case!