Applying for short-term disability benefits means different things to different people, in different circumstances. The term “applying” can have two meanings.
For some people it means, “What application form must I complete to purchase a policy?”
For others it means, “How do I file a short term disability claim so that I can enjoy income replacement benefits?”
Find answers to these related questions below.
- Applying for a policy while pregnant or after surgery
- Filing your claim form for maternity leave
Applying for Short-Term Disability Coverage
Applying for short-term disability coverage means that you may need to complete a policy application form before getting sick, hurt, or pregnant. Acquiring a policy is the first and most important step to take for most people.
People covered by state mandated programs are automatically enrolled, and do not need to take positive action. Only five states have mandated programs, but they are the larger states. People in other states often mistakenly assume they are automatically covered. They are not.
Employees with employer paid group plans also are automatically enrolled, and do not need to complete a policy application. However, this is very rare.
Applying While Pregnant
Applying for short-term disability coverage while pregnant is a frequent theme. Normal pregnancy is a covered medical condition for policies purchased at the worksite. It all comes down to timing.
You can apply for coverage while pregnant. Most carriers will not decline policy applications for pregnant women, but the policy will not cover the existing pregnancy.
Private policies do not cover preexisting conditions until 12 months after the policy effective date. Coverage must begin prior to conception. The carrier may approve the policy application, but deny any pregnancy related claim until the 12 months elapse.
Applying after Surgery
Things work differently when applying for short-term disability coverage after surgery. Most policies cover any surgery that is medically necessary, and does not correct a preexisting health condition. Again, it all comes down to timing.
Most carriers will deny your policy application after a recent surgery. You must show evidence of good health to qualify for new coverage.
If you have a policy that has been in force for more than 12 months, then applying for short-term disability after surgery means filing your claim form according to instructions.
Filing Short-Term Disability Claims
The first rule in filing short-term disability claims is that most people must apply for coverage before the need arises, and not after. The only exception to this rule is people automatically enrolled in state or group plans.
Filing Claim Form
Filing a short-term disability claim form requires that you first identify the issuing company.
Download an online claims form, and follow the instructions carefully. If you work in a state with mandated coverage, visit the state’s department of labor and download an online claims form.
Filing for Maternity Leave
How do you file for short-term disability for maternity leave?
Filing a claim for maternity leave benefits after a normal delivery is simple. After delivering your child, complete a specialized maternity leave claim form.
Since the benefit period is fixed, so your claim can be paid upfront in a single lump sum.
- Six weeks for vaginal delivery
- Eight weeks for C-section delivery
Your doctor will need to sign the claim form indicating only the type of delivery. There is no need to explain why you cannot work.
Filing Appeals Letters
If the carrier denies your claim, you may need to file a short-term disability claims appeal letter.
Carriers often deny claims because of insufficient documentation, or the instructions were not followed properly. Carefully review your denial letter to understand the reasons for why the claim was turned down.
An attorney can help file the appeal letter, but make sure that your documentation is correct first. Attorneys do not work free. Compare their charges with the expected benefit amount you are seeking to recover. In many cases the total claims amounts are too small to warrant legal expenses.
Filing On Your Tax Return
You may need to file your short-term disability claim on your tax return.
Claims payments are income taxable if any portion of the premium were paid using pretax payroll deductions, or if your employer contributed towards the premium costs.
Consult your tax adviser.