Does Pennsylvania offer short-term disability insurance? How long do the benefits last?

The state of Pennsylvania does not provide short-term disability for off-the-job medical conditions. Residents must proactively purchase private coverage before the need arises.

Private short-term disability claims payments last up to the time the person can return to work, or the benefit period spelled out in the outline of coverage – whichever is less.

  1. Required application and claim forms and alternatives for assistance
  2. Options for pregnancy complications and maternity leave
  3. State and federal laws protecting rights and requiring income support

Pennsylvania Short-Term Disability Forms

Finding the appropriate short-term disability insurance form is not an easy task in Pennsylvania. Remember, the state does not offer or provide an entitlement covering off-the-job accidents and illnesses. Private companies issue off-the-job coverage in PA.

Benefit Application Form

Applying for short-term disability benefits in Pennsylvania means that you must follow two hard and fast rules. You must complete the forms in the correct order at the appropriate time.

  1. Complete a policy application form and have the coverage in force prior to suffering an off-the-job accident, or illness or becoming pregnant.
  2. Preexisting conditions are ineligible for at least twelve months.

Consider these alternatives if you do not have existing private coverage already in force.

  1. Request a short-term loan. Get the cash you need while you are temporarily unable to work. Complete a simple online form to start the process. Make certain you can repay the lender with interest before borrowing money.
  2. Debt relief application. If you already owe more than $10,000 in credit card and other unsecured debt, you may fall hopelessly behind on payments without any earnings. In addition, your health condition may lead to unpaid medical bills. A settlement program may help.

Apply for short-term disability benefits if you did purchase a private policy prior to becoming sick, hurt, or pregnant. Complete your carrier’s claim form. Your doctor and employer may also need to sign the paperwork.

Policy Application Form

In Pennsylvania, you must complete a new policy application form to purchase short-term disability insurance before becoming sick, hurt, or pregnant. Policies exclude preexisting health conditions for twelve months. You must prove that you are healthy enough to qualify.

Begin by requesting an online quote to estimate the monthly premium rates. An agent will ask you to provide salary verification and answer medical questions. You may be asked to provide blood and/or urine samples if purchasing a policy directly. The agent will submit the completed application to the carrier for underwriting review.

Women planning to have children fare better when applying for new coverage through the worksite – provided her employer offers a voluntary option. If not, an individual policy is a reasonable alternative. See the maternity leave section below.

Pennsylvania Short-Term Disability Maternity

Private short-term disability insurance for maternity-related medical conditions is a smart purchase choice for Pennsylvania women. However, two important requirements rule out many site visitors.

  1. Women must buy the coverage prior conception
  2. Worksite policies cover mom’s recovery from normal childbirth

Pregnancy Complications

Individual short-term disability for pregnancy complications helps Pennsylvania women who must stop working prior to delivery. 25% of pregnant women experience one or more medical complications. A woman who must stop working during her second trimester could miss 26 weeks of earnings before her labor and delivery.

Request a quote for an individual policy if you are planning to conceive and want to take this risk off the table. Please by aware that this plan type does not cover mom’s recovery from normal childbirth.

Maternity Leave

Personal short-term disability for maternity leave helps Pennsylvania mothers after labor and delivery for a normal childbirth. This policy type is much more popular, but also more difficult to obtain.

Maternity leave policies are most popular because they cover a planned medical event. Women of childbearing age take proactive steps to have a normal childbirth experience. The benefits often exceed the yearly premium costs by a wide margin.

  • Vaginal birth lasts 6 weeks – less the elimination period
  • C-section delivery last 8 weeks – less the elimination period

Only worksite policies cover maternity leave. Women purchase this type of coverage via payroll deduction at work. Their employer can offer the program on a voluntary basis. Since the employer has few direct costs, interested employees should ask their boss for a voluntary option.

Pennsylvania Short-Term Disability Laws

There are only a few short-term disability insurance laws unique to the state of Pennsylvania. The regulations that do exist nibble around the edges of what many site visitors are hoping to find – an easy way to replace income while not working.

Collecting Unemployment

Collecting unemployment compensation for health reasons is viable under Pennsylvania law. However, the requirements are very restrictive. Four criteria eliminate most applicants from this entitlement.

  • Terminated employment
  • Physically able to work
  • Actively seeking a new job
  • Available for suitable work

Disabled individuals may be eligible once they have recovered physically. The same holds for any family members providing their care at home.1

Job Protections

Pennsylvania family medical leave laws offer specific job protections for employees with disabilities. They consist of both federal as well as state specific regulations.

  • The Family Medical Leave Act provides twelve weeks of unpaid job protections. It also requires continuation of group healthcare programs.
  • The Americans with Disabilities Act requires employers to make reasonable accommodations for personnel with impairments.
  • The Human Rights Act makes it unlawful to discriminate based on race, color, religion, ancestry, age, gender, national origin, non-job related disability, and known associations with a disabled person.

State Disability Insurance

Pennsylvania does have state disability insurance. However, it often goes by alternative names but leaves a gaping hole for many families: coverage for off-the-job accidents and illnesses expected to last less than one year.

State Short-Term

Pennsylvania does not provide state short-term disability insurance covering off-the-job medical conditions. Only five states have laws requiring this program for employees in private industry. Two of these share a border with Pennsylvania.

Some Pennsylvania residents who commute across borders to work do enjoy state short-term disability benefits. The laws apply where they work, not where they live.

  • Residents living in the Philadelphia area and along the Delaware River who commute to NJ have mandated coverage.
  • Citizens living near the northern border who commute into NY also have required coverage. However, the payout is not a good.
  • People living near Pittsburgh and the western border who commute into OH or MD are not as lucky.

State Temporary

Pennsylvania law does require state temporary disability insurance for on-the-job accidents and illnesses. The State Workers Insurance Fund (SWIF) provides a government-run workers compensation program. The Workers’ Compensation Act requires that all businesses carry this coverage.

These mandated on-the-job disability benefits break down as follows.

  • Temporary total disability
    • Wage replacement of 2/3 of salary
    • No maximum payment period
    • Not subject to income taxation
  • Temporary partial disability
    • 2/3 wage replacement of the drop in earnings
    • Maximum 500 weeks payment period

Obtain a claim form from SWIF or the private carrier chosen by your employer in order to file for compensation. Although many people associate temporary disability with worker’s compensation, the duration of benefits is actually quite long.2

State Long-Term

The state of Pennsylvania oversees several government-run long-term disability programs. The Department of Labor administers these entitlements. They help citizens with permanent medical conditions that impair their ability to work and earn a living.

  • The Social Security Disability Insurance (SSDI) provides income assistance to people who paid premiums via FICA taxes paid on earnings.
  • The Supplemental Security Income Program (SSI) makes cash assistance payments to the aged, blind, and disabled people who have limited wages and resources.

These federal government entitlements do not cover temporary disability for off-the-job accidents and illnesses. Your doctor must expect the medical condition to last for one year or longer or result in death.3

Income Tax

Short-term disability insurance claims payments may be income taxable. The answer depends on how you fund the premium payments and varies for federal and state income taxes.

  • Federal income tax is due in proportion to any premiums funded by the employer or paid by the employee using pre-tax payroll deductions.
  • Pennsylvania income taxes are not due on any third party disability claims payments.4
  • Worker’s compensation payments are not income taxable on the federal or state level.

Sources:

  1. Unemployment compensation
  2. On-the-job benefits
  3. Department of Labor
  4. State income tax
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