Short-term disability insurance for federal government employees is an important option to consider before becoming sick, hurt, or pregnant.

Choose between individual and voluntary policies.

People seeking to file a claim for a temporary non-occupational loss may find it difficult to qualify for state programs, Workers Compensation, Social Security, or via OPM benefits.

But, it is worth a try.

Women planning to conceive in the future can enjoy paid maternity leave benefits and protect her income in case of pregnancy complications, accidents, and illnesses.

Federal Employee Disability Benefit Options

The best short-term disability insurance benefit options for federal government employees vary widely based on the question. Timing and reasons are key considerations.

  • Filing a claim requires you to have coverage already in force
  • You must buy coverage before a pre-existing condition arises
  • Women planning to conceive have an ideal alternative

Pre-Existing Conditions

A new short-term disability policy issued by a private company will not cover any pre-existing health condition for at least one year – if you are healthy enough to qualify. Federal employees seeking to file a claim or acquire coverage for a pending work absence must look elsewhere for support.

You must buy a new policy before becoming sick, hurt, or pregnant in order to qualify to file a claim for benefits. If you overlooked this step, the two resources noted above may help.

Individual Policies

Individual short-term disability may be an attractive option for federal employees working in certain job roles. Buying privately can help you overcome the reluctance many insurers have for dealing with such an unusual large whale. There are 2.6 million workers in 20 departments and countless agencies such as Veterans Affairs, FBI, Department of Defense, and more. The list is huge.

Many insurers respond to the size and diversity by prohibiting the entire group or with uniform pricing that is higher than the norm. People in certain classes may fare better by going direct.

Some of the companies offering this policy type are listed below.

  • MetLife
  • Mutual of Omaha
  • State Farm

Voluntary Coverage

Voluntary short-term disability is the preferred option for a larger number of federal employees. Employees pay the premiums through a PayCenter allotment and own the policy. If you separate from your government job, you can keep the coverage by paying directly from a checking account.

Initially, you set up automatic premium withholding through a Paycenter allotment. This confirms that you work for the government and ensures prompt monthly payment. Below are some of the companies in this market.

  • AFLAC
  • FedAdvantage
  • GEHA
  • Humana

State Programs

Are federal employees eligible for state temporary disability benefits? Do workers pay into the state premium pools to fund coverage? The answer to both of these questions is no – with one very unlikely exception.

  1. Only five states have a mandatory program and one is pending
    1. California1
    2. Hawaii2
    3. New Jersey3
    4. New York4
    5. Rhode Island5
    6. Washington State (2020)
  2. All exempt government employees from the requirement to fund premiums
  3. Each allows select government entities to enroll voluntarily

Your department or agency would need to participate proactively in the state program. Each permits certain government entities (state and local yes – federal unclear) to opt in with a requirement that all employees join.

Look on your paystub for the state payroll deduction. If none appears (most likely), you cannot file a claim for benefit and need to look elsewhere for monetary help.

DFEC

Division of Federal Employees’ Compensation (DFEC) administers workers’ compensation coverage for approximately 2.6 million federal and postal workers. Workers compensation provides wage replacement benefits (and more) for employment-related injuries and occupational diseases.6

File a claim with DFEC if your disabling medical condition is occupational. Many cases are difficult to tie back to an on-the-job accident or work-related illness. Hire a workers compensation attorney if denied.

Social Security

Federal employees can apply for Social Security disability benefits. However, Social Security does not cover temporary disabilities, the primary requirement is very strict, and your tenure at with the government may affect eligibility or benefits.

  • A licensed doctor must expect the medical condition to last at least one year
  • You must be unable to perform any work as opposed to your own occupation
  • Civil Service Retirement System covered workers did not pay Social Security taxes

Employees beginning service after 1984 began paying Social Security taxes. Therefore, FERS covered workers are eligible and required to apply. The FERS program may coordinate benefits with this program.7

Office of Personnel Management

The Office of Personnel Management (OPM) does not offer short-term disability insurance. However, OPM does provide other alternatives that may help federal government employees with existing medical conditions in need of wage replacement benefits.8

A supplemental policy can fill the gaps in OPM program offerings.

FERS

The Federal Employees Retirement System (FERS) provides a long-term disability option for federal employees with 18 months of creditable service. You should consider applying for this benefit if you meet these criteria.

  • A licensed doctor expects the condition to last at least one year
  • You provided your employing agency with documentation
  • The agency has exhausted all reasonable accommodations or reassignment
  • Your agency must certify that it is unable to accommodate your condition
  • You must apply before your separation or within one year thereafter
  • You must apply for social security disability benefits

CSRS

The Civil Service Retirement System (CSRS) also provides a long-term disability option for federal employees with 5 years of service in a job subject to CSRS coverage.

You must be disabled:

  • For useful and efficient service in your current position and any other vacant position at the same grade or pay level within your commuting area and current agency for which you are qualified
  • Prior to retirement and the medical condition should be expected to last for more than one year.

Policies

OPM work leave policies offer an additional opportunity for federal employees to obtain wage replacement benefits during a temporary work absence.

  • Sick Leave: Use accumulated days for your own injury or illness
  • Annual Leave: Use for any reason including your own medical condition
  • Leave Sharing: Coworkers can donate annual leave for medical emergencies

H.R. 4806

Representative Eleanor Holmes Norton introduced a bill (H.R. 4806) during the 115th session of Congress.9 This proposed act would require OPM to establish and administer a short-term disability program for federal employees who:

  • Suffer a non-work related injury or sickness
  • Take leave to care for a family member
  • Take leave to adopt a child or become a foster parent

The bill also proposes that the contract shall not charge higher premiums, deny coverage, drop coverage, or impose an exclusion for an employee with a preexisting condition. If passed into law in 2019 or later, expect the premiums for everyone to become unaffordable very quickly because of this rule.

Federal Employee Benefits Maternity Leave

Short-term disability insurance offers federal government employees the opportunity for paid maternity leave benefits. FMLA protects your job and access to health benefits for up to 12 weeks but the time off is unpaid.

Coverage must begin prior to conception. All insurers consider pregnancy a pre-existing condition. Buy a policy when you are in the planning stages to avoid missing out.

Pregnancy Complications

Most short-term disability policy types pay for an unplanned pregnancy disability leave when caused by a covered medical condition. Female government employees can enjoy months of partial income replacement if she needs to stop working prior to her due date.

Bed rest by itself is not a qualifying condition. “High-risk” is also insufficient. Your doctor must indicate the medical reason why you must stop working prior to delivery. Many pregnancy complications fit the bill.

After Childbirth

Only voluntary short-term disability covers a planned maternity leave after normal childbirth. You cannot find this feature on policies purchased outside of work. You can receive this popular benefit for something you want to happen.

  • Vaginal birth: 6 weeks
  • C-section delivery: 8 weeks

Most policy types should cover unplanned biological postpartum disorders that extend your maternity leave. You may have to delay your return to work because of bleeding, infections, and other physical problems (not depression).

Sources:

  1. California SDI
  2. Hawaii TDI
  3. New Jersey TDI
  4. New York SDI
  5. Rhode Island TDI
  6. DFEC
  7. Social Security
  8. OPM
  9. R. 4806
Posted