Quick Answer Short-term disability benefits typically last anywhere between 13 and 26 weeks. However, there are situations where an extension may apply. How long these benefits last depends on the unique circumstances surrounding your case.
Short-term disability benefits help cover the lost wages and reduced earning capacity workers may suffer after a non-work-related illness or injury. These benefits exist to protect workers who are temporarily unable to perform their job due to a medical procedure or condition. Employees should not expect short-term disability benefits to last forever, nor should they expect them to cover their wages entirely.
Instead, they should expect reasonable benefits to help them cover essentials and expenses while away from work. However, if you find that your short-term disability benefits are not reflective of your earning potential or if they were cut short, get in touch with an experienced attorney who can help you fight for the benefits you deserve.
Understanding Short-Term Disability Benefits
Short-term benefits are for employees who need a portion of their wages covered while they are unable to work for a specific period. While “disability” is a part of the name, being disabled is not a hard requirement.
In many cases, broken bones, severe illness, and pregnancy all qualify for short-term disability benefits. All you need is a doctor’s certification that proves you need to take a short period off from work to qualify.
Of course, it is never that simple; just applying is not a guarantee that you will receive benefits. Many states also implement a waiting period before you can receive benefits, which is meant to ensure that your extended time off work is medically necessary.
Short-term disability benefits are not for people who need to take one or even two weeks off. It is for those who will be gone for a substantial amount of time but still expected to return at full capacity after the duration is complete.
Typical Duration of Short-Term Disability Benefits
Short-term disability benefits usually last 13 to 26 weeks. Some states offer longer programs, others slightly shorter.
How long your benefits last will also depend on whether you are receiving your benefits through your employer. If you are, each private insurance company will determine its guidelines and timelines.
Typically, the state or the employer’s insurance will determine through your application how long your benefits will last. Some illnesses and conditions will call for a longer benefits period than others. Ultimately, if you need an extension, you may apply for one, and they are granted on a case-by-case basis.
Factors that Determine How Long Your Benefits Will Continue
Several factors determine how long your benefits will last.
Type of Medical Condition and Medical Evidence
When you submit your application, your medical condition and any evidence you submit will be reviewed. From there, your insurance company or the state will determine your benefits amount and how long you will get them.
Some policies and states will have predetermined lengths for conditions like back pain or mental health. However, something longer, like an extensive recovery from surgery, will likely be a lot longer.
Maximum Benefits Period
The maximum benefits period is how long your benefits will last. This is set by the state or the insurance company. Once you reach the maximum allotted time, your benefits will automatically end.
The maximum is anywhere up to 26 weeks in most instances. Thus, it is important to understand that the maximum amount of time you can receive benefits will likely be 26 weeks or less. More often than not, unless your situation is very serious, you will likely not reach 26 weeks in its entirety.
Return to Work Assessments
The state and insurance companies both routinely conduct return-to-work assessments on those receiving short-term disability. To continue receiving benefits, they will ask you to undergo functional capacity evaluations or determine if your condition has improved enough so that you can have modified work arrangements. If they determine you have recovered enough to return to work, your benefits will terminate, even if the amount of time you were given to receive them has not expired yet.
Pre-Existing Conditions
Pre-existing conditions are also a significant factor in the length of your benefits. If you have a pre-existing condition and your current inability to work is related to it, your benefits will likely be shorter.
With the proper medical evidence and documentation, you should not have to worry about receiving benefits. However, do not expect them to last for a long time or even for as long as the usual amount of time that someone with an equivalent injury or disability receives benefits.
Reasons Why Short-Term Disability Benefits Can Be Terminated Early
Short-term disability benefits are often terminated early for the following reasons:
- Your insurance company or the state has determined that you have recovered enough to return to work. This can be done even in direct contrast to your doctor’s assessment.
- It was determined that you did not adhere to the medical treatment requirements to continue to qualify for benefits, such as missing medical appointments or refusing certain procedures.
- Conflicting medical opinions exist about your condition, or the information provided was deemed insufficient for your benefits.
While there can be many reasons, these three are often the most common. When your short-term disability benefits are terminated early, it is not always a reflection on you. Early termination happens to a lot of people who deserve to have benefits for a longer period.
What to Do When Short-Term Disability Benefits End
If your short-term disability benefits reach their projected end, there is not much you can do to continue to receive benefits. While you can request an extension, extensions are not always guaranteed. Applying for an extension or a different benefits program seems straightforward, but there are often complications along the way that can cause delays or other issues.
Alternatively, if your short-term disability benefits end earlier than you expected, you may need to take legal action. Remember, insurance companies are not on your side. They do not want to provide full benefits if it means saving their bottom line, and so taking legal action is an important step in ensuring you get the benefits you rightfully deserve.
Whether you are requesting a potential extension or need to take direct action to continue receiving benefits, you should let an attorney help you. A short-term disability benefits lawyer can assist you with your case and help you fight while you focus on your recovery.
Get in Touch with a Lawyer Today
Do not let yourself get shortchanged. You paid into this system; it is only right that you receive the benefits you deserve in your time of need.
Do not hesitate to reach out to one of our experienced short-term disability benefits lawyers today. Contact us for a free consultation at no risk to you.
