Short-Term Disability Benefits After an Injury

Short-term disability insurance (SDI) pays out benefits when you're temporarily unable to work due to an 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're injured away from work, and you're covered by a short-term disability plan, you'll most likely be entitled to benefits. Read on to learn more about getting short-term disability benefits when you can't work because of an injury or accident.

How Short-Term Disability Insurance Works for Injuries

Many people have short-term disability insurance coverage that can cover injuries that don't happen at work. Short-term disability coverage is intended to provide income replacement while you're temporarily unable to work due to an injury, an illness, or a pregnancy-related disability.

What Kinds of Injuries Are Covered by Short-Term Disability Insurance?

Short-term disability insurance pays benefits when you have an injury or illness—either physical or mental—that prevents you from doing your job temporarily. Some common injuries that might keep you off work for a few weeks or months include things like:

• burns
• torn ligaments
• sprained muscles
• simple fractures.

You might also collect short-term or temporary disability benefits for the first few months following a more severe injury like a stroke or traumatic brain injury. For severe injuries that don't heal before your short-term disability coverage runs out, you might be able to get long-term disability or even Social Security disability benefits.

For example, broken bones usually heal within a few months, and it's not uncommon to collect short-term disability benefits while you recover from a bone fracture that keeps you from working for a few weeks. But if you develop complications from a bone fracture, you could be disabled for much longer.

Likewise, most soft tissue injuries heal within a matter of weeks. But soft tissue injuries or burns that require multiple surgeries might take a year or more to heal. And some car accident injuries can leave long-term or permanent impairments, like those involving:

• spinal cord injuries
• compound fractures, or
• traumatic brain injuries (TBI).

(Read our overviews on long-term disability insurance or Social Security disability insurance for information on getting disability benefits over a longer term.)

Where Do You Get Short-Term Disability Insurance?

You might get SDI as a benefit from your employer. If not, there are a few other ways coverage might be available.

State-mandated SDI: Some states have laws providing short-term or temporary disability benefits. Most employees in the following states are covered:

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

Your state might have created a state fund that provides temporary disability insurance (TDI) benefits. Employee contributions, employer contributions, or a combination of the two generally finance these funds. Or, your state might simply require your employer to self-insure or purchase a policy for employees. (Learn more about state-mandated SDI.)

Employer-sponsored SDI: If you don't work in one of the states that mandate SDI or TDI coverage, your employer might voluntarily provide short-term disability coverage through an insurance company. Some employers require employees to chip in for coverage (usually through a payroll deduction), while others pick up the whole tab.

Private SDI policy: If you don't have SDI coverage through your state or your employer, you can purchase your own short-term disability plan from a private insurance company.

How Much Does Short-Term Disability Pay When You Can't Work?

How much and for how long you'll receive short-term benefits depends on the terms of your state's temporary disability insurance law or your policy. Short-term or temporary disability insurance generally pays a percentage of your salary (60% is a typical figure).

Also, if you receive disability benefits through your employer's insurance company (whether short-term or long-term disability), and your employer pays all or part of the policy premium, at least some of the disability income you receive is usually taxable. But you generally don't have to pay taxes on disability income from a private policy you purchased on your own.

How long your short-term disability benefits will last depends on your state's rules or your policy terms. Most SDI policies will pay benefits for three to six months, but some pay as long as a year.

And if you still can't work when your short-term disability benefits run out, you might be eligible for long-term disability benefits.

How Soon Can You File a Short-Term Disability Claim for an Injury?

If you're injured off the job and won't be able to work for more than a few days, you should probably file a claim for short-term disability benefits. (If you were injured at work, you should be covered by your employer's workers' compensation insurance.)

For example, if you fall while skiing during your vacation and break your leg, you'll likely be unable to work for at least a few weeks. As long as your injury causes you to miss work for more than a week and isn't job-related, you'll probably be eligible for benefits.

But if you're only going to miss a few days of work, you won't usually qualify for short-term disability benefits. Many policies impose a waiting period of a week or so (called the "elimination period"), during which you can't collect benefits.

How to File a Short-Term Disability Claim for an Injury

To file a claim, you need to start by getting a claim form from one of the following:

• the appropriate state agency (in one of the states listed above that have short-term or temporary disability insurance)
• your company's human resources department, or
• your insurance carrier.

The form should have three parts. Complete your section of the form. You need to include information about your injury and the limitations it causes. For example, don't just say you broke your collarbone (clavicle). Explain that you can't drive while wearing a sling or raise your arm and that your doctor has restricted you to lifting no more than five pounds.

In the other sections, your doctor and your employer will have to supply information about your injury and how long you're expected to be out, among other things. Make sure the claim form is complete and correct.

Learn more about the steps to file a short-term disability claim.

Why Was Your Short-Term Claim for an Injury Denied?

Generally, you should be approved for benefits if you have short-term or temporary disability insurance, you're injured off the job, and your doctor agrees you can't work. But there are factors that can cause your SDI claim to be denied.

Short-term disability claims can be denied for technical reasons, like if you haven't had the policy long enough to be eligible for benefits or you didn't file your claim fast enough. (Check your state's rules or the policy terms for deadlines.)

A short-term disability claim might also be denied for other reasons, like if your disability involves a preexisting condition or a self-inflicted injury. Some policies also include the following "exclusions from coverage," meaning you won't be covered for injuries that you get while:

• committing a crime
• participating in a riot
• attempting suicide
• participating in a hazardous activity like extreme sports, or
• fighting in a war.

Getting Legal Help With Your Short-Term Disability Claim

Sometimes, the insurance company gets it wrong. If you believe you were improperly denied temporary disability benefits for an injury, you have the right to appeal. Insurance companies generally have one or two levels of administrative appeals.

You might want to get help from an experienced lawyer to appeal a denial of benefits. 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.

Learn more about how to appeal a denial of short-term disability benefits.