Preparing and Filing Your Short-Term Disability Claim

If you can't work because of a temporary or short-term disability, you might be entitled to get cash benefits while you're off work. There are a few different programs that might be available to you.

For temporary illnesses or injuries that aren't work-related, you might qualify for short-term or temporary disability insurance (SDI or TDI) benefits. Some short-term disability policies provide benefits when you're pregnant.

But you can't get short-term or temporary disability benefits unless you have insurance, either through a company-paid policy, a state government program, or a self-paid policy.

If you are covered by a policy and you can't work because of a temporary disability, the first step to getting benefits is to prepare and file a claim.

Where Do You Get Short-Term Disability Insurance?

You might get short-term disability insurance as an employment benefit or you can buy a private short-term disability policy directly from an insurance company. Also, a handful of states have laws that provide for short-term disability or temporary disability benefits.

State Government SDI or TDI Programs

The following states have SDI or TDI programs:

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

With state-mandated SDI or TDI, your benefits generally come from a state fund, or your employer might be required to provide them. Typically, these benefits provide some wage replacement for a few months.

In addition, several other states have recently started paid leave programs, some of which cover employee leave for serious health conditions or pregnancy-related issues.

Employer-Paid Short-Term Disability Insurance

If you don't work in a state with a government short-term disability or paid leave program, your employer might offer short-term disability insurance as a job benefit. Your employer might pay the premiums, or you might have to pay a portion.

When your employer provides short-term disability insurance (or if you buy a private policy), the policy terms will determine details like:

• eligibility for coverage
• how long benefits last
• how much you can expect to be paid
• qualifying conditions, and
• other details.

Short-term disability policies are usually provided alongside long-term disability insurance policies, also provided and paid for by some companies.

How Do You File a Short-Term Disability Claim?

Whether you buy your own short-term disability policy or your state or employer provides short-term disability coverage, there are certain steps you'll need to follow to make sure you can collect. Missing forms or deadlines can torpedo your claim.

Every short-term disability policy is a little different, so check with your company's HR department or your short-term disability insurance carrier to get specific claims procedures. But here are the typical steps you'll need to follow and some tips for filing your temporary disability claim.

Step 1 – Get the Short-Term Disability Claim Form

If you get your short-term disability insurance from your employer, ask your HR department for a copy of the form you need to file a claim for short-term disability benefits.

Claim forms might also be available online from the state department that handles the SDI or TDI program (in the states listed above). Your insurance company might also make the short-term disability claim forms available online. Contact your insurer to learn your filing options.

Your insurance company (or state agency that handles SDI/TDI) will likely have rules about when you can file a claim. And in some cases, if you wait too long, you could be disqualified.

For example, California suggests you wait until nine days after you become disabled to file a short-term disability claim. And you must file your claim within 49 days, or you could lose eligibility. In New York, you must file your claim within 30 days of becoming disabled.

Step 2 – Complete the Claim Form

The short-term disability claim form asks for all the information your insurer or stage agency needs to open a claim for you. You'll need to provide your name, address, and contact information. You'll also need to provide some details about your illness or injury, including when you stopped working and when you expect to return to work.

The claim form might also include an authorization to release information for you to sign so that your insurance company can get your medical and employment information. The authorization could also be on a separate form you're required to complete.

Make sure your answers are accurate and as complete as possible. Missing information can delay your claim, and inaccurate information could cause the insurance company to deny your short-term disability benefits.

Step 3 – Ask Your Employer to Complete the Employer Section of the Form

Every state that provides temporary disability benefits asks employers to provide information about you, including the following:

• your job duties
• your salary
• how many hours you work
• how long you've been at the company, and
• whether you paid part of the insurance premium.

Most employer-sponsored policies also ask the employer to provide this type of information.

Your employer will likely also have to provide information about any pay you're entitled to receive from the company after you stop working, including:

• sick leave
• paid time off (PTO)
• vacation pay, and
• any other wages (like from part-time work).

Step 4 – Get Your Doctor to Confirm Your Disability

Whether you get your short-term disability coverage from the state or an insurance company, the insurer will require your doctor to verify your condition and sign the claim form. The doctor's portion of the claim form will ask for details about things like:

• your diagnosis and limitations
• your doctor's opinion about your condition
• applicable test results
• surgeries and hospitalizations for this injury or illness
• your treatment plan (including medications and therapies)
• your current condition and limitations, and
• how long you'll need to be off work.

Step 5 – Submit the Claim Form

Once the claim form is completed, submit it to the insurance company or state agency according to the instructions. Keep a copy of the completed form for your records. Ask the insurance company (or state agency) when you can expect to hear back and when you can expect your first check once your claim is approved.

Learn what to do if your short-term disability claim is denied.