Does the Commonwealth of Pennsylvania offer short-term disability insurance? How long do the claim checks continue to arrive?

Unfortunately, the state does not provide wage-replacement benefits for temporary non-occupational conditions (lasting less than one year). Residents must proactively purchase private coverage before the need arises.

Applying for Workers Compensation can help PA employees dealing with on-the-job injuries and illnesses. Meanwhile, filing for Social Security Disability Insurance (SSDI) makes sense for applicants with permanent medical conditions (lasting more than one year).

Short-Term Disability in PA

Short-term disability insurance in Pennsylvania is available for purchase at the workplace and through direct channels. Do not rely on the state to take care of you if a temporary medical condition prevents you from working. You must enroll in a private program before the need arises.

Commonwealth

The Commonwealth of Pennsylvania does not have mandatory short-term disability insurance like some of its neighboring states. You cannot assume that a state-based program will provide you with wage replacement benefits if you suffer a temporary off-the-job (non-occupational) accident or illness.

The Commonwealth does require Worker’s Compensation (see below), which covers occupational injuries and sicknesses. However, these work-related incidents affect far fewer people.

Private Insurance

Workers in Pennsylvania need to purchase short-term disability insurance from a private company before becoming sick, hurt, or pregnant. Once you have a pre-existing condition, it will be tough to qualify for coverage or file a claim for temporary non-occupational benefits.

Quotes

Request a short-term disability quote online to start the process. An agent licensed in PA may contact you to review pricing for various policy configurations. These features will affect the premiums you must pay.

  • Monthly benefit amount up to 67% of income
  • Elimination period: when the policy begins claim payments
  • Benefit period: how long the claim checks could last

Pregnancy

Short-term disability is the primary vehicle for maternity leave income. As before, PA does not have a paid family leave program similar to what neighboring states have.

Women who buy a policy before conception could enjoy wage benefits during any of these situations that frequently occur.

  • 2nd or 3rd-semester pregnancy leave
  • Recovery from labor and delivery
    • Vaginal birth: 6 weeks
    • C-section: 8 weeks
  • Postpartum medical disorders

Surgery

Short-term disability in PA may cover a surgical procedure provided the operation did not address a pre-existing condition, the policy covers the reason, and the recovery time exceeds the elimination period.

  • New policies will not cover surgery for a pre-existing health condition until the coverage has been in force for at least twelve months
  • All plans will not pay for cosmetic surgery which enhances your appearance and is not medically necessary
  • Many people recover from surgical procedures very quickly and can return to work well before the elimination period ends

Phone Number

The only people who can find the short-term disability PA phone number are those who bought coverage from a private company in advance of their need. Retrieve the policy from your files (if you stored it somewhere you could find). The document should include all of the contact information you need.

In the event of a claim, you can also find the phone number in other places.

  • Monthly bills from the insurance company
  • Human resources person at your employer
  • Search online by the issuing company name

Taxable

Short-term disability claims payments may be income taxable. The answer depends on how you fund the premium and varies for federal and PA 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
  • PA income taxes are not due on any third party disability claims payments[1]

Unemployment

Filing an unemployment claim could be viable after recovering from a temporary disability. Many people lose their jobs after an accident or illness causes them to miss months of work.

Pennsylvania unemployment law permits benefits for people who quit their job for a good cause reason, which can include a health condition. The claimant must inform the employer of any limitations before resigning so the employer can make accommodations.

Of course, you must be physically able to resume working before applying.

PA State Disability Insurance

Pennsylvania does have two state disability insurance programs that cover occupational incidents and permanent medical conditions that prevent you from earning a living.

Occupational

Workers Compensation is a Pennsylvania state-mandated program that provides disability insurance for occupational episodes, and other benefits. The State Workers Insurance Fund (SWIF) oversees the implementation of this required coverage.[2]

  • Services rendered by physicians or other health care providers
  • Reasonable surgical and medical care
  • Hospital treatment and supplies
  • Prescription medicines and supplies
  • Orthopedic appliances and supplies
  • Replacement of lost wages up to 2/3 of salary

Many people feel a need to hire a lawyer when filing a claim. An attorney can help you prove that you injured yourself, contracted a disease, or a medical condition worsened because of employment.

Social Security

Social Security is a federal disability insurance scheme that Pennsylvania administers at the state level. Two programs provide partial wage replacement benefits for people dealing with permanent non-occupational impairments.

Keep in mind that neither Social Security program covers temporary disabilities expected to last less than one year (12 months). Be prepared.

SSDI

Social Security Disability Income (SSDI) pays claims to you and some family members if you worked long enough and paid FICA taxes. PA residents can apply for permanent benefits online at SSA.gov.

The Bureau of Disability Determination (BDD) is the state agency that assists in processing claims started at the federal website. BDD determines whether you qualify and how much to pay. Your ability to gather documents and make a strong case determines how long you must wait for the approval.

SSI

Supplemental Security Income (SSI) covers disabled adults and children who have limited earnings and resources. Most SSI recipients did not contribute to the system via FICA taxes.

Applying for SSI in PA often means retaining an estate planning attorney to assist with your case. Potential recipients often require guardianship paperwork, special needs trusts, and other legal documents to safeguard future government benefits from resource requirements.

Footnoted Sources:

[1] PA Department of Revenue

[2] PA State Workers Insurance Fund