Applying for Short-Term & Permanent Disability in Georgia

Your approval rate when applying for disability benefits in the State of Georgia depends on whether your medical condition is temporary or permanent, or it occurred on or off the job.

People with temporary conditions caused by non-occupational incidents will have the most difficulty – because the state does not have a short-term disability insurance program.

However, you can buy a policy from a private company, which helps if you start the coverage before the need arises.

Individuals with permanent medical conditions have more luck because they can tap into two government-mandated programs (Social Security and Worker’s Compensation) that cover occupational and non-occupational disorders.

Temporary Disability in Georgia

Short-term disability insurance is the only solution for non-occupational temporary (lasting less than one year) work absences in Georgia. However, the state does not provide a program for taxpayers employed in the private sector.

Therefore, most people will be unable to apply for benefits – unless they took action to purchase a private policy before becoming sick, hurt, or pregnant.

Application Forms

Georgia residents need to complete two types of short-term disability insurance application forms – in the correct sequence. You must take the first step proactively because the state does not provide a program covering temporary medical conditions.

New Policy

Request a short-term disability quote to begin the purchase process. An agent licensed in Georgia may contact you to review premium rates for a variety of policy feature configurations: monthly amount, elimination period, and benefit period.

Keep in mind that you must show evidence of good health to qualify for new coverage. Also, expect to encounter a one-year exclusion for any non-disqualifying pre-existing health conditions such as pregnancy.

Filing Claims

File a short-term disability claim by contacting the issuing insurance company to obtain the correct paperwork. Of course, you are eligible to take this step only if you purchased a policy from a private company in the past.

Follow the instructions carefully to avoid delays and possible denials.

Have a doctor complete and sign the medical section on the claim form. Also, your employer will need to sign the paperwork to verify that you are no longer earning an income. Finally, file the claim by faxing or mailing the paperwork, and keep copies for your records.

Pregnancy

Short-term disability insurance for pregnancy is the primary avenue for Georgia mothers to create maternity leave pay. However, most women miss out because the state does not require this valuable program.

You must purchase a private policy before conception. The new coverage will exclude your pre-existing pregnancy for a minimum of twelve months.

Mothers who enroll before conception can enjoy partial income support during some or all of these common scenarios.

  • Pregnancy leave before childbirth for qualified medical reasons
  • Recovery from normal labor and delivery
    • Vaginal birth: 6 weeks
    • C-Section: 8 weeks
  • Postpartum medical complications that delay your return to the job

Unemployment

Filing a claim for unemployment compensation is a poor substitute for short-term disability insurance. People facing temporary income loss because of accidents and illnesses do not meet the three critical criteria.

  1. Physically able to work
  2. Available for duty
  3. Actively seeking new employment

Collecting unemployment could be possible after you recover. However, Georgia law does not include poor health in its definition of good cause reasons for a work separation.[1]

Long-Term Disability in Georgia

Applying for permanent (one year or longer) disability benefits in the State of Georgia often proves more fruitful because citizens have coverage in most instances. Two mandatory programs address both non-occupational and on-the-job incidents.

  • The federal government mandates that most residents contribute to Social Security via payroll tax deductions to cover possible off-the-job earnings losses
    • Social Security Disability Insurance (SSDI)
    • Supplemental Security Income (SSI)
  • GA requires most employers to purchase and fund the premiums for Worker’s Compensation insurance to protect employees from occupational wage losses

Hiring Lawyers

You do not need to hire an attorney when applying for permanent disability benefits in the state of Georgia. However, many people feel the need for legal help because of the many delays and risks of denials.

An experienced lawyer can help you navigate the labyrinth of confusing rules.

  • Review your case in advance and make suggestions
  • Ensure completeness of your application
  • Assemble and organize medical records
  • Communicate with SSA on your behalf
  • Represent your interests at appeals hearings

Most attorneys work on a contingency basis, which means you do not pay anything unless they win your case. If successful, the government agency or insurance company will take a portion of your proceeds to compensate the lawyers for their efforts.

Benefit Amount

The size of monthly disability checks that Georgia residents receive for permanent medical conditions can vary quite a bit because three different programs could come into play.[2]

  1. SSDI grantees contributed into the system during their working years via FICA payroll taxes. They receive from $800 to $1,800 monthly, depending on their previous earnings levels and time funding premiums. The average figure is about $1,200 per month.
  2. SSI recipients take in less money each period (about $600) because they did not pay into the system. In many cases, their condition prevented them working from an early age. Plus, any countable income from part-time employment reduces the monthly stipend.
  3. The Worker’s Compensation disability amount is hardest to pinpoint because of multiple categories, and the extra benefits claimants can receive. The most a person can get is 66% of their wages before their on-the-job accident or illness, subject to a maximum monthly amount.
    1. Total incapacity: $2,900
    2. Temporary partial: $1,935
    3. Permanent partial: $2,900
    4. Other benefits
      1. Death & burial expenses
      2. Medical care
      3. Mileage reimbursement

Apply for Worker’s Compensation by completing and filing Form WC-14 with the state board. Then send a copy of the paperwork to your employer and their workers’ compensation insurance carrier.

Footnoted Sources:

[1] GA Department of Labor

[2] GA Board of Workers Compensation