Quick Answer Short-term disability provides financial support for those who are unable to work due to non-work-related injuries or illnesses. Short-term disability typically applies to temporary conditions that make it difficult for you to work, and qualifying for it can be challenging.
Our disability attorneys at Pond Lehocky Giordano can help you. Contact us for a free consultation.
How Does Short-Term Disability Work?
Some employers may offer short-term disability benefits. It works as a type of insurance policy. If you become unable to perform your regular job for a short period, you may qualify for compensation for the time you were forced to miss work.
Short-term disability is not a benefit of Social Security Disability. Rather, your employer may offer a disability plan with your benefits package, which is often managed by a third-party administrator.
Plans differ significantly, and not all employers offer plans. Some employers require employees to pay some or all of the cost for these benefits. You might see this as a payroll deduction in your paycheck.
Types of Conditions that May Apply for Short-Term Disability
To obtain short-term disability for an illness or injury, you must meet the qualifications set by the plan administrator. You will need to demonstrate proof of your injury to start receiving short-term disability benefits. The following are examples of some of the most common injuries, illnesses, and other conditions that may qualify for coverage.
- Accidents and injuries that occur outside of work, such as being involved in a car accident or a fall.
- Having a serious procedure that causes you to miss time for the procedure and recovery time.
- Severe illness, including cancer, heart attacks, or pneumonia, is specifically related to conditions your doctor requires you to take time off.
- Chronic conditions may qualify if there is a flare-up, such as a severe flare of arthritis or sudden complications to diabetes.
- Pregnancy complications and the childbirth process may be included.
- Mental health acute situations, including periods of depression, anxiety, or bipolar disorder episodes.
- Medical procedures that limit your ability to work for a short amount of time, including elective procedures in many situations.
Short-term disability policies can differ. When signing up for them, be sure to read the fine print. If you believe your condition qualifies, but the plan is denying coverage to you, our short-term disability attorneys can help.
Types of Conditions that Typically Do Not Qualify
Most short-term disability policies have limitations on when they apply. Most also have specific non-covered events, or types of illnesses or injuries that do not fall into the range of coverage. Some of the most common non-covered events may include:
- Coverage for pre-existing conditions
- Injuries you inflicted on yourself, such as attempted suicide
- Illness or injury resulting from illegal substance use, including alcohol or drug use
- Injuries or illnesses that occur while you are committing a crime or when you are in confinement
- Work-related injuries or illnesses
- Injuries or illnesses you suffer while serving in any branch of the Armed Forces
You may have coverage for some of these losses through other policies you have. However, there are situations where victims may face an injury or illness that does not seem to be covered but may be. If you were denied, reach out to a short-term disability attorney for guidance.
Key Elements of Short-Term Disability You Should Understand
Short-term disability can be a complex form of coverage. While these policies tend to be quite valuable when you become ill or injured, it is not uncommon for companies to try to find ways to reduce coverage or limit the instances of coverage. There are a few key factors to keep in mind:
Waiting Periods May Apply
It is not uncommon for short-term disability benefits to have a waiting period. This is during those weeks or months when you first sign up for coverage, which may not qualify for coverage yet. If you are ill or injured during these times, coverage may not have started yet.
Policies Always Have Exclusions
Most short-term disability insurance policies have exclusions, and these can range widely. Some are quite vague and can be misleading.
In these situations, you may not realize when or how your coverage applies or limits you. What makes them more frustrating is that exclusions differ between companies and between the tiers of policies they typically offer.
Documentation of Your Injuries Is Necessary
Nearly all short-term disability policies will require you to demonstrate proof of your injury or illness and that it meets the criteria set by that policy. Documentation typically must be in the form of medical records reported by a licensed healthcare professional. Your doctor must also fully document that you are unable to work and for how long.
Do You Need an Attorney for a Short-Term Disability Claim?
Hiring a short-term disability attorney could be necessary in situations where you are hurt or ill and are denied coverage. It is not uncommon for policies to be very limiting, and they may not be fully open and honest with you about the type of conditions that may be provided.
You may face limitations on the coverage limits, too. By working with a skilled legal team, you gain insight into what your rights are and how to appeal denials of coverage.
Schedule a Consultation with a Short-Term Disability Lawyer
At Pond Lehocky Giordano, we can provide you with the one-on-one support you need if you are denied coverage you believe you have. Call our office or submit our contact form now for a free consultation.
