What Qualifies for Short-Term Disability Benefits?

Whether you're eligible for government-based short-term disability benefits depends on where you live—only a few states offer a state short-term disability program, although about a dozen states have recently added paid medical leave programs. But many employers pay for private disability insurance for their employees, which usually includes short-term disability (STD) coverage.

Regardless of who provides your short-term disability insurance, qualifying for benefits generally requires that you:

• are unable to work due to a non-work-related illness or injury
• meet minimum earnings or employment requirements, and
• can provide medical certification of your disability.

Keep reading to learn what qualifies for short-term disability benefits and the factors that determine who is eligible.

How Does Short-Term Disability Work?

If you're temporarily unable to work due to sickness, injury, or pregnancy, you might qualify for short-term benefits—whether through a private STD policy offered by your employer or through your state's short-term disability or paid medical leave program.

Short-term disability benefits typically pay about 60% of your regular wages for a period of about three to six months (or more, depending on your state or your policy). A waiting period of a week or so usually applies, meaning you won't be eligible for benefits until you've been out of work for a week after your injury or illness started. State paid medical leave benefits typically last for a shorter length of time, though they don't always have a waiting period.

Learn more about the basics of short-term disability insurance that's provided by employers or purchased individually. Continue reading below to learn about eligibility for STD benefits.

What Conditions Qualify for Short-Term Disability?

To qualify for short-term disability benefits (or paid medical leave benefits), you must be unable to do your job, and your doctor must document this in writing.

Illnesses and Injuries Covered by STD Insurance

Common reasons that people qualify for temporary disability benefits include:

• severe illness like pneumonia
• injuries from an accident
• other severe injuries
• recovering from surgery
• pregnancy and childbirth, and
• mental health issues.

Illnesses that qualify for short-term disability benefits can be any sickness that prevents you from working and lasts longer than a week. Examples include:

• COVID
• cancer
• mononucleosis
• pneumonia
• digestive disorders, and
• flare-ups of chronic autoimmune illnesses, like lupus or multiple sclerosis.

Most serious injuries are eligible for temporary disability, including:

• broken bones
• sprained or torn ligaments
• back injuries
• head injuries and concussions, and
• recovery from surgery.

When STD Insurance Doesn't Cover Time Off

Many private STD insurance plans don't cover cosmetic surgery, sterilization (tubal ligation or vasectomy), or other surgeries that might be considered "elective," such as gastric bypass surgery. But some plans do cover elective surgeries, especially when the surgery is considered medically necessary.

Note that some private STD policies have waiting periods during which they won't cover surgeries for pre-existing conditions. (See below for more on pre-existing conditions.)

Some state short-term disability programs, including California's, do cover recovery from elective procedures, even if done for purely cosmetic reasons, as long as you can't work, but other states' programs don't.

Work injuries don't qualify for short-term disability benefits. Instead, workers' comp policies, which are required in almost all states for almost all businesses, pay benefits for work-related injuries.

Can You Get Short-Term Disability for Mental Health Conditions?

Short-term disability benefits often cover mental health conditions, just like physical illnesses or injuries. Examples of conditions often covered include:

• stress
• panic disorders
• trauma from a car accident (or other accident)
• depression (including postpartum depression)
• eating disorders, and
• substance use disorders.

California is the only state that requires any insurance policy with a short-term duration of two years or less—including employer-sponsored and private STD policies—to provide coverage for disabilities caused by severe mental illnesses. (Cal. Ins. Codes § 10144.55.)

But many employer-provided STD policies in other states also cover mental health conditions, although some might have exclusions or limits. Individually purchased short-term disability policies can include similar coverage and limitations.

For example, some plans explicitly exclude disabilities caused by intentional self-harm or suicide attempts, and some policies limit coverage for substance use disorders. Other plans (outside of California) might not cover claims related to mental illness at all.

Most state SDI/TDI programs, as well as states with paid medical leave policies, include coverage for mental health conditions. These programs often define a "serious health condition" to include mental as well as physical health issues.

How Do You Qualify for Short-Term Disability With a Pre-Existing Condition?

You can qualify for short-term disability for a pre-existing condition only if your policy allows it and any required waiting period has passed. Typical policy language might read:

"Benefits will not be paid for any disability for which you received medical treatment, care, or consultation, including diagnostic measures, or took prescribed drugs or medications during the three months preceding your effective date under this policy. A disability arising from any such injury or sickness will be covered only if it begins six months after the effective date of this policy."

In other words, if you received treatment for a condition shortly before your coverage began, many policies will exclude it for a set period before benefits apply. The three-month look-back period for pre-existing conditions and the six-month waiting period for coverage could be longer or shorter, depending on your policy.

Filing a Short-Term Disability Claim

To apply for short-term disability benefits from a short-term insurance plan provided by your employer, or an individual plan you purchased on your own, you'll need to follow a few steps:

• Get a copy of the claim form. Ask your employer's HR department for the form. If you purchased coverage on your own, get the form from your insurance carrier. The claim form will ask you for details about your medical condition and the date you last worked, as well as some personal information.
• Ask your employer and doctor to fill out their portions of the claim form. Your employer will need to provide your job description, salary, and history with the company. Your physician must certify that your medical condition keeps you from working. The insurance company's claims administrator will then review your medical records to make sure they support your claims of disability.
• Appeal if your claim is denied. If you're denied short-term disability benefits, it's a good idea to appeal. Many claims that are eventually approved are turned down initially. You might consider hiring a long-term disability (LTD) lawyer to give yourself the best chance (most LTD lawyers also handle short-term appeals).

State Short-Term Disability and Medical Leave Programs

The rest of this article discusses the state temporary disability programs (abbreviated as TDI, for temporary disability insurance, or SDI, for state disability insurance). These programs are partly funded by payroll deductions.

The only states that have state short-term disability programs are:

• California
• Hawaii
• New Jersey
• New York, and
• Rhode Island.

Follow the above links for more information on each state's program.

Many states now also offer paid family and medical leave programs, including:

• California
• Colorado
• Connecticut
• District of Columbia
• Massachusetts
• New Jersey
• New York
• Oregon
• Rhode Island, and
• Washington.

And several states have passed paid leave programs that begin in 2026 or 2028:

• Delaware
• Maine
• Maryland, and
• Minnesota.

Learn more about these state-paid medical leave programs.

Eligibility Requirements for State Temporary Disability

State temporary disability benefits are easier to get than Social Security disability. In the states that provide for short-term disability, here are some general requirements that apply to all of the states.

• The worker must have worked a certain length of time before being eligible for benefits—30 days to six months, depending on the state.
• Some states have a minimum earnings requirement. For instance, in Hawaii, you must have made $400 in the previous year.
• There's a one-week waiting period before benefits are payable. (You can't receive benefits until the 8th day you're temporarily disabled.)
• The illness or injury must be non-work-related.
• The weekly benefit is approximately 60% of your wages (up to 90% in California).
• Benefits last no more than 26-30 weeks (but 52 weeks in California).
• Pregnant women can receive short-term disability for several weeks for the last few weeks of pregnancy, delivery, and recovery.
• You'll need to submit medical records or go to a medical exam to prove your disability.

For information on your state's specific rules, see our article on state temporary disability benefits.

Filing a TDI/SDI Claim With Your State

To file a claim, call or go to the website of your state's department of labor or employment development department to request or obtain an application form. Your company's human resources department might also be able to provide you with one.

Complete your section of the form and give the form to your employer and/or doctor to complete the remainder.

Most states (except for Hawaii) now allow you to file a short-term disability claim online, and your doctor can certify your disability online as well.

Read more about preparing and filing a short-term disability claim.

Making Sure Your Job Will Be There When You Return

Employer STD policies and state short-term disability programs offer wage replacement, but they offer little to no job protection. To make sure your employer will take you back after a period of disability, you need to request leave from your employer under the federal Family and Medical Leave Act or a state medical leave law—or rely on the Americans with Disabilities Act (ADA). Read our article on getting your job back after disability leave for more information.

When to Contact a Disability Attorney

Most people can file a short-term disability claim without the help of an attorney. Short-term disability claims tend to cost less for insurance companies and states, so they're often more straightforward than long-term disability claims and easier to get approved.

But if your claim is denied, consider appealing the denial. If you have a long-term disability or Social Security disability claim in addition to your short-term claim, you might want to consider hiring an attorney. Most disability lawyers offer free consultations and don't charge a fee unless you win your case.