How do you apply for disability benefits in Florida, and how much do you get in your monthly claim checks?

This seemingly simple two-part question has many possible right answers.

People need to buy a short-term disability policy from a private company to cover temporary losses resulting from off-the-job accidents and sicknesses. The state does not offer this type of coverage – although unemployment could kick in after you recover.

On the other hand, the state administers two disability programs that cover occupational incidents and permanent impairments. However, people who bought long-term policies from a private insurance company fare the best.

Applying for Short-Term Disability

Short-term disability insurance in Florida is available for purchase from private companies. The state does not have a mandatory plan covering temporary medical conditions. Therefore, you cannot apply for benefits unless you bought a policy at work or as an individual before becoming sick, hurt, or pregnant.

Individual

Individual short-term disability insurance in Florida illustrates the need for people to take proactive steps. You can buy a personal plan at work or privately outside of your employer. Either way, expect to encounter three obstacles if you waited too long to apply.

  1. You must show evidence of good health to qualify for coverage
  2. Any approved policies will exclude pre-existing medical conditions for one year
  3. You cannot file a claim for coverage you do not own

New Policy

Request a quote for an individual short-term disability policy before you have a pre-existing condition. An agent licensed in Florida may contact you to present costs for a variety of configurations. These features determine premium rates.

  • Elimination period
  • Monthly amount
  • Benefit period

Once you arrive at a comfortable price point and feature combination, the agent can help you complete a new policy application. The agent will then submit the paperwork to the insurance company for underwriting review.

Filing Claim

Applying for individual short-term disability benefits requires completion of the correct claim form. Contact the insurance company that issued the coverage, or surf over to their online customer service web portal.

Download the claim form and follow the instructions carefully to avoid delays and possible rejections. Keep in mind that most companies require three signatures.

  1. Policyholder attesting the information is accurate
  2. Doctor verifying the medical reason you cannot work
  3. Employer confirming they are no longer paying wages

Debt relief may be the only alternative for people who did not buy private coverage. It is easy to fall behind on bills when you lose an income.

Pregnancy

Short-term disability for pregnancy in Florida is an excellent program for families planning to have children. However, most women miss the opportunity to apply for benefits because you must purchase an individual policy before conception.

Women aware of this requirement may still encounter challenges finding the ideal coverage because of a seemingly minor distinction based on where you buy the coverage.

  • Personal worksite plans cover all maternity leave scenarios
    • Pregnancy complications before birth
    • Recovery from normal labor and delivery
      • Vaginal birth: 6 weeks
      • C-Section: 8 weeks
    • Postpartum medical issues that delay return to work
  • Private polices (outside of an employer) do not cover normal childbirth

Unemployment

Filing an unemployment claim could be a reasonable alternative after you recover from your temporary disability if you quit or lost your job because of an extended absence. Florida unemployment law includes in its definition of a “good cause reason” for a voluntary quit that opens the door a crack.[1]

Attributable to the individual’s illness or disability requiring separation from his or her work.”

The Florida Department of Economic Opportunity maintains an online resource, which serves as a good starting point when starting an application for reemployment assistance benefits.[2] Begin the process at this government website.

Applying for State Disability

Applying for state disability benefits in Florida is a viable option for residents who either have a permanent medical condition (Social Security) or suffered an occupational (Worker’s Compensation) injury or illness.

As before, these two state-based programs leave holes which a private plan can close, if you obtained coverage before the need arose.

Long-Term

Long-term disability insurance (LTD) in Florida presents an opportunity to bridge gaping holes in the two state-based programs. As above, you must purchase a policy from a private company before becoming sick or getting injured to enjoy these three advantages.

  1. The requirements for claim approval are more lenient
    • LTD: own occupation legal definition
    • SSDI: any occupation (see below)
  2. The monthly benefit amounts can be much higher
    • LTD: up to $10,000 or higher
    • SSID: average $1,200 each month
  3. Covers the most frequent claim reasons
    • LTD: off-the-job (non-occupational)
    • Worker’s Compensation: on-the-job

Social Security

Social Security is a federal benefit administered at the state level. Florida residents suffering from a non-occupational impairment expected to last one year or longer, or result in death should complete an application.

Residents can file for one of two possible programs.

  1. Social Security Disability Income (SSDI) pays claims to you and some family members if you worked long enough and paid FICA taxes
  2. Supplemental Security Income (SSI) covers disabled adults and children who have limited earnings and resources

Requirements

Social Security Disability requirements are uniform across the country. The State of Florida does not set special eligibility rules for its residents. You must suffer from an off-the-job injury or illness that prevents you from performing work in “any occupation” for at least one year.

  • You can no longer work in your previous occupation
  • You cannot adjust to new work

The SSA.gov website provides a detailed listing of the medical criteria for specific sets of impairments.[3] Review these guidelines with your doctor when completing an application for benefits.

Pay Amounts

The benefit amount that Social Security pays to recipients is also uniform across the nation. The state of Florida does not kick in any extra money to boost the size of the monthly claim checks.

Your earnings history and FICA tax contributions determine the amount. The local Disability Determinations office makes the final decision.

  • SSDI grantees receive from $800 to $1,800 monthly, with an average figure of about $1,200
  • SSI recipients take in less money each period because they did not pay into the system
    • Eligible individual: $783
    • Eligible couple: $1,115
    • Essential person: $392

Lawyers

Hiring a Social Security disability attorney licensed in Florida can make sense when filing your initial submission, preparing for an appeal, or fighting your case in court.

The government rejects approximately 67% of initial applications, which delays potential claim checks. Plus, you must survive a five-month waiting period before benefits begin – if you win your case. A lawyer will charge fees but could speed up the approval process and improve your chances of approval.

Decide for yourself whether to invest in legal help.

Worker’s Compensation

Worker’s Compensation in Florida is a state-required disability insurance program that covers occupational (on-the-job) accidents and illnesses. Employers must obtain coverage through a private company.[4]

Therefore, contact your Human Resources department as the first step in filing a claim. They will provide you with Form DWC-1 (First Report of Injury or Illness).

Filling out an application could provide you with a wide range of possible benefits.

Medical Care Wage Replacement
Doctor visits Temporary total
Hospitalization Temporary partial
Physical therapy Permanent partial
Prescription drugs Permanent total
Prostheses Death benefits
Travel expenses

Footnoted References:

[1] FL Statutes 443.101(1)(a)1

[2] FL Department of Economic Opportunity

[3] SSA Impairments Listing

[4] FL Chief Financial Officer