Short-term disability insurance pays out benefits to those who are temporarily unable to work due to an illness or injury that isn't work-related. (On-the-job injuries and illnesses are generally covered by workers' compensation, not short-term disability insurance). If you suffer an injury off the job, and you are covered by a short-term disability plan, you will most likely be entitled to benefits.
How Short-Term Disability Insurance Works
Many employees have short-term disability insurance coverage. There are a few ways coverage might be available:
- If you work in California, Hawaii, New Jersey, New York, or Rhode Island, state law provides for short-term disability insurance. Some states have created a state fund, paid for by employee contributions, employer contributions, or both, that provides short-term disability benefits. Or, your state may require your employer to self-insure or purchase a policy for employees.
- Your employer may voluntarily provide short-term disability coverage. Some employers may require employees to chip in for coverage; others pick up the whole tab.
- You may have purchased your own short-term disability plan.
Short-term disability is intended to provide income replacement while you are temporarily unable to work due to pregnancy, illness, or injury. If you suffer a work-related injury, you will typically look to your employer's workers' compensation policy for coverage. For injuries or illnesses that aren't related to work, however, short-term disability benefits may be available.
How much and for how long you will receive benefits depends on the terms of your state's law or your policy. These programs generally pay a percentage of your salary (60% is a common figure) for three to six months, while you are unable to work. If you are still unable to work when your short-term disability benefits run out, you may be eligible for long-term disability benefits.
Filing a Claim for an Injury
If you are injured off the job and are temporarily unable to work, you should file a claim for short-term disability benefits. For example, if you are in a car accident and break your leg, you will likely be unable to work for a while. As long as your injury causes you to miss work for more than a week and isn't job-related, you will probably be eligible for benefits. (Many policies impose a waiting period of a week or so, during which you may not collect benefits.)
To file a claim, get a claim form from the appropriate state agency (in one of the states listed above that requires short-term disability insurance), your company's human resources department, or your insurance carrier. Complete your section of the form; your doctor and your employer will also have to supply information about your injury and how long you are expected to be out, among other things.
Getting Legal Help
If you believe you were improperly denied short-term disability benefits for an injury, you may want to get some help from an experienced lawyer. A lawyer can assess the strength of your claim and help you decide how to proceed. If you appeal the denial, the attorney can help you gather evidence and present it in the most persuasive way.