Applying for Short Term Disability
Applying for Short Term Disability: Filing Your Claim Form
Applying for short term disability means: contacting your insurance company for a claim form, completing the paperwork, and filing your claim. Pregnancy and maternity claims are very simple for normal labor and delivery.
Your doctor and employer may need to provide you help in applying for benefits when complications, accidents, or illnesses cause your loss.
Applying for Short Term Disability While Pregnant
Applying for short term disability while pregnant can mean a few different things depending upon your situation. If you bought your policy prior to conception and are experiencing complications that prevent you from working, then applying for benefits is the smart thing to do. Your policy will replace a portion of your income if you are unable to work while pregnant. Get the rest that you need to protect your infant’s health.
Most disability companies will want you to file your claim only after you are unable to work. If you and baby are perfectly healthy, applying for benefits while pregnant will likely result in a denial of your claim. For normal pregnancy, it is best to wait until after giving birth to file your claim.
Some women search online frantically looking to apply for a policy while pregnant. Applying for a policy is very different from filing a claim for payments. Coverage must begin prior to conception, or your claim will be denied. If you work in one of the five states with mandated coverage, or your employer provides a group plan, then your coverage probably began in time to cover you while pregnant.
Applying for Maternity Leave
Applying 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, six weeks for vaginal delivery and eight weeks for c-section delivery, your benefit can be paid upfront in a single lump sum. Your doctor will need to sign the claim form indicating only the type of delivery. There is no need to explain why you can't work. The reason is understood.
It is quite common for women to start maternity leave prior to giving birth. After all, who wants to work right up until the day of delivery? Doing so puts your health and the viability of your infant at risk. Most disability plans will not cover any pregnancy leave that occurs prior to delivery unless there is a medically certified reason why you can no longer work. A simple need or desire for bed rest is not adequate.
Your doctor will need to certify that your pregnancy is experiencing some type of abnormality, or that your pregnancy prevents you from performing the regular duties of your full-time occupation. If your employer is unwilling or unable to accommodate your condition, it is possible that the insurance company will pay your claim.
It is also quite common for women to experience postpartum depression, or the baby blues. Check your policy language for mental health disorders. Most likely your policy will not cover any extended time after your physical recovery. If it does, apply for an extension of benefits. Your doctor will need to complete additional paperwork.
Other medically-based postpartum conditions may delay your return to employment. Almost every policy will extend your maternity disability time-frame if your gynecologist diagnoses and treats a lingering condition related to childbirth. Apply for extended payments after the standard time frame for recovering from normal delivery.
Applying for Benefits: Accidents, Illnesses
Applying for benefits after suffering an accident, or while dealing with an illness: may require you to have a doctor certify that you are unable to work, and your employer to verify that you are no longer getting paid. Your doctor must establish the medical reason why you can’t perform the regular duties of your full time job, and an estimated time frame for your recovery.
The insurance company may request periodic evaluations from your doctor, and may provide help so that you can return to work. Your employer may need to verify your income prior to your accident or illness, along with signing the claim form verifying that you are no longer receiving income from your full time employment.
It is never too early to early to download a claim form from your insurance company, if only to read through the instructions, and begin preparations for compiling the correct paperwork. Most carriers make it easy to find the right forms and instructions on their website. Make sure that to involve your human resources department, as they may have experience helping others.
Applying for State Entitlements
Applying for state disability entitlements requires that you contact the state office that administers each program. Benefits for permanent disabilities are primarily funded by the federal government, but administered at the state level - usually by your state's office of disability determination. You must show that your disability is expected to last at least one year or result in death. You will find access to many office locations, phone numbers and other contact information on the state disability page.
Five state states have mandated programs: California, Hawaii, New Jersey, New York, and Rhode Island.
Some states administer the plans directly so contacting the state office is your best approach. Others mandate coverage which is then issued and managed by a private insurance company. New York, for example works this way. You need to contact your employers Human Resource person to find out who the insurance carrier is and contact that insurer directly. Other states allow private carriers to offer coverage provided the group's employees approved. Again you need to determine which type of coverage you have, and contact the appropriate insurance carrier.
Remember that these plans are mandated for workers in those states. Some exceptions apply such as workers in government jobs. Each state rule varies.