Sometimes taking time off work to sit at home and watch television counts as an excused absence. But these situations are not the stuff dreams are made of. If you’re home with your feet up in the middle of the workday without penalty, chances are you’re suffering from a short-term disability. It is important to know what is considered short-term disability by an insurance company, i.e. disability insurance.
Here are 5 facts to know about short-term disability insurance so you can maximize your payout.
1. What is a short-term disability?
One important thing to note when referring to an injury is where it happened. Short-term incapacity refers only to non-work-related conditions.
This means that they did not occur in the office, on the construction site or as a result of anything at either of these places. There are a few exceptions to this rule.
For example, if you have a nervous breakdown at work due to stress, you may not be able to claim it as workers’ compensation. It is difficult to prove that the cause of your mental illness is entirely caused by work.
Things like genetics, environmental factors, and more could be to blame for your strain. Laws regarding how workers’ compensation varies by state.
Consult an attorney if you are having trouble qualifying your injury as short-term disability or workers’ compensation. Short-term disability is a type of insurance benefit that should cover part of your income for any injury that is not work-related.
2. Where can I get short term disability?
Most states do not require employers to offer short-term disability insurance. These states include Rhode Island, California, Hawaii, New Jersey, and New York.
Employers in these states offer a benefit that is either self-funded or through an insurance company. A self-funded employer plan means that they cover the expenses themselves.
When you get injured, they pay to cover part of your earnings until you can return to work. Other employers work with insurance companies to handle payment themselves.
There are pros and cons to both options, but either requires you to prove your injury with substantial medical information. Work with HR to ensure you have the correct documents on file so your claim is expedited.
If your employer can’t or won’t offer short-term disability, you can do the process on your own. Contact an insurance agency for coverage options.
The amount you pay will generally be based on your age. Expect to pay around 1% of your gross salary when you get your own short-term disability.
3. Duration matters
The key thing to note with short-term disability is that it is something that is expected to end within a certain period of time. If you have a condition that doctors just can’t seem to diagnose, it doesn’t necessarily mean a short-term disability.
You could need a lawyer if your disease falls into a gray area that makes it difficult to define. You won’t want to miss out on the income you’re entitled to because of an administrative error.
Employers can choose not to pay claims that seem questionable or when you don’t seem to intend to return to work.
Permanent disabilities are classified as a separate issue and are not covered by short term disability insurance. Make sure you get the right care for your claim by getting professional legal help.
4. It’s a slippery slope
Whether or not you are still able to do your job may be subject to interpretation. For example, if you injure a hand that is not your dominant hand.
This is why legal aid is recommended in certain cases of short-term disability. Your employer has the right to request as much information as necessary to make a fair decision.
In the meantime, if your claim is not paid, it will put a strain on you financially while you wait for a final decision. People claim that everything is a short-term disability, from having wisdom teeth removed to having a child.
There is no fixed category of items that will necessarily guarantee approval of your application. Every short-term disability policy and plan is different.
Just make sure you meet at least the first two criteria for having a non-work related injury and that the situation is short term. The employer will not allow you to cash checks on the way to another job.
5. What is the duration of the short-term disability?
Here is another gray area when it comes to short-term disability. You can’t put your finger on an exact duration and say it’s definitely a short-term disability.
There are wounds that take more than a year to heal. Meanwhile, your insurance plan might still cover your lack of income.
Employers will look at standard recovery times for your specific illness or injury. They seek to have a reasonable payment, because it costs them money the longer you are out of work.
So things like childbirth could be questioned as a cause of short-term disability if you were to try not to work for 12 months. Keep your claim reasonable until your employer follows up frequently to make sure you are within your claim.
Do I need short term disability insurance?
It’s a good idea to have short-term disability insurance in most cases. You never know when a non-work related injury will disrupt your income.
Don’t get caught unprotected. Use an insurance broker to locate low cost policies available in your state.
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