Short-term disability benefits in Indiana consist of taxpayer-funded plans for state employees, voluntary programs offered to private workers, and individual coverage residents can purchase directly.

All three versions cover temporary wage losses due to non-occupational accidents and illnesses – if you have the coverage, which is automatic for public employees, but not workers in private industry.

The government requires participation in Social Security Disability, which covers permanent conditions (lasting one year or longer), but does not pay much, and the application process can prove lengthy.

Therefore, people who work for non-government employers must take proactive steps to address future temporary disabilities and have a way to survive while waiting for SSDI to kick in.

Short-Term Disability Indiana

Short-term disability insurance in Indiana has three possible sets of rules depending on where you work and whether your loss occurs on or off-the-job.

  1. State government employees have automatic coverage for temporary disabilities for both on and off-the-job incidents and illnesses
  2. Residents working in the private industry face two diametric rules
    1. Required Worker’s Compensation covers temporary and permanent occupational incidents
    2. People must purchase off-the-job coverage proactively; before getting sick, hurt, or pregnant

Applications

Residents working for private employers in Indiana face a two-step short-term disability application process and strict requirements. You must purchase a policy from an outside company before the need arises to be eligible to file a claim.

New Policy

Request a short-term disability quote for individuals as your first step. An insurance agent licensed in Indiana may contact you to review premium costs for various policy configurations.

  1. Elimination period: how quickly claim payments begin
  2. Monthly amount: what the policy pays
  3. Benefit period: how long claim checks continue

You must show evidence of good health to qualify. The new policy application will include questions about your medical history and earnings record.

File Claim

File a claim for short-term disability benefits by contacting the insurance company that issued the policy. Log into their online web portal or download the claim form and follow the instructions carefully. Expect the document to require at least three signatures.

  1. Policy owner who is unable to work due to a covered medical condition
  2. Licensed physician stating the medical reason you cannot perform work duties
  3. Employer representative stating you are no longer earning wages

Pregnancy

Short-term disability for pregnancy is the primary vehicle for maternity leave pay because Indiana does not have a separate paid family leave program for state government employees or workers in private industry.

Maternity related conditions reveal a significant hole unique to each primary group of affected individuals.

  1. Public employees have automatic coverage with a 30-day elimination period. Most women experience a standard vaginal delivery and can return to work after 42 days, which means the benefits last only 12 days.
  2. Women working for private employers must purchase the coverage before conception, as each new policy excludes pre-existing conditions for at least twelve months. Plus, the point of sale determines what the maternity-related claim available.
    1. Voluntary policies bought at the worksite cover mom’s recovery from labor and delivery
    2. Individual plans purchased outside of employers exclude mom’s recovery from childbirth

State Employees

Indiana Code 5-10-8-7 requires the personnel department to establish and require participation in two disability plans covering state government employees for non-occupational losses.[1] Public workers with six months of continuous full-time service split the premium costs with the relevant agency for each program.

  1. Short-term disability begins after a 30-day elimination period and continues making claim payments for up to five months after. The benefit amount is 60% of the base biweekly wage before taxes and insurance.
  2. Long-term disability kicks in after the initial six-months of incapacity (30-day elimination period plus five months) and pays a lesser amount each period.
    1. Years 1 & 2: 50% of base earnings
    2. Years 3 & 4: 40% of base income

State employees wishing to file a claim have the enormous advantage of actually having the coverage without having to enroll because the government mandates participation. Apply for benefits by contacting the personnel department or JFW Specialty Company, the third-party administrator of the program. 

Applying for IN Social Security Disability

Both state employees and workers in private industry in Indiana pay into the Social Security Disability Insurance program automatically through their payroll taxes and could qualify under two programs.

  1. Social Security Disability Insurance (SSDI) covers workers who paid into the system via FICA taxes payroll deducted by employers
  2. Supplemental Security Income (SSI) addresses the needs of adults and children who have limited earnings and resources

The legal requirement to pay FICA taxes means that all residents can apply for non-occupational (off-the-job) benefits for permanent losses (lasting one year or longer – not temporary).

Hiring Attorneys

Many Indiana residents find they need to hire an attorney to guide them through the Social Security disability application process. An experienced lawyer can boost your odds of approval while shortening the waiting time before the government agency makes its determination.

The disability qualifying criteria are stringent because you must demonstrate that you are unable to perform any substantial gainful activity. Consider these odds of success and decide for yourself whether assigning a portion of your future claim checks to an attorney makes sense.

  • Initial Awards: 23%
  • Reconsideration Awards: 2%
  • Appeals Council Awards: 15%
  • Medical Denials: 25%
  • Technical Denials: 35%

Medically Frail

The Healthy Indiana (HIP) State Plan provides additional benefits to disabled residents deemed medically frail. The extra goodies include coverage for vision, dental, non-emergency transportation, chiropractic services, and medical rehabilitation options.[2]

These supplemental benefits provide another rationale to hire an attorney because a Social Security approval decision helps you meet the medically frail definition.

  • Disabling mental disorder
  • A chronic substance abuse disorder
  • Severe and complex medical conditions
  • Physical, intellectual or developmental disability that significantly impairs the individual’s ability to perform one or more activities of daily living
  • A disability determination based on Social Security Administration criteria

Footnoted Sources:

[1] Indiana Code 5-10-8-7

[2] Healthy Indiana Plan FAQ