Employees frequently ask about Short-Term Disability Insurance (STDI) and the Family Medical Leave Act (FMLA) while sick, injured, pregnant and unable to work, or when they need to care for a family member.
The two workplace benefits are not the same.
Primarily, STDI may replace a portion of income while you are not working, while FMLA may protect your job and the continuation of employer-sponsored healthcare. Also, the two benefits have other nuances that may matter to your situation.
Examine six primary comparison points to understand how the two vary but can also work together in harmony with each other.
Short-Term Disability vs. FMLA
Comparing short-term disability insurance (STDI) versus the Family Medical Leave Act (FMLA) can help you determine how the two programs can support your time off from the job.
Eligibility is the most alarming distinction between short-term disability and the Family Medical Leave Act. The rules governing who can claim benefits under either program catch many people by surprise.
Eligibility is not automatic for either program. The requirements omit a big group of people, and the affected parties are entirely different for each.
- Approximately 22% have STDI
- About 58% qualify for FMLA
- Roughly 13% have both
|Covered employer||Private employers in a mandate state: CA, HI, NJ, NY, RI, and WA||50 + employees in a 75-mile radius nationwide|
|Eligible employee||Work in a mandate state|
Employer opts to pay premiums
Personnel volunteer to pay if offered
|12+ months tenure with the employer|
Logged 1,250 hours over 12 months
|Included individuals||People who buy private coverage outside of work||Does not apply|
Remember that FMLA is a federal law that applies equally across the country. Meanwhile, STDI is an insurance policy that becomes effective only after someone (state agency, employer, or individual) purchases the coverage.
The qualifying health conditions for short-term disability and the Family Medical Leave Act are sometimes the same but more frequently diverge. In general, both programs address medical conditions that prevent the person from working, but only FMLA touches on caretaking duties.
|Employee’s disabling medical condition||Yes||Yes|
|Stress or anxiety||Maybe||Yes|
|Care of sick family member||No||Yes|
|Baby bonding time||No||Yes|
How much short-term disability pays compared to the Family Medical Leave Act provides the starkest contrast. The two programs address two completely different pain points. A person taking time off from work needs both set of benefits.
|Paid Leave||50% – 66% of income|
Weekly cap $150 to $1,500
|Unpaid time off|
|Legal job protection||No||Yes|
|Health insurance continuation||No||Yes|
When the benefits start is an employee-determined distinction between short-term disability and the Family Medical Leave Act. FMLA begins right away for every qualifying applicant while STDI kicks in after 0, 7, 14, 30, 60, or 90 days based on a decision made previously by the insured at enrollment.
STDI policies always have an elimination period, whereas FMLA does not. This feature describes the length of time that must elapse after the disability begins until the insured is eligible for any monthly benefits.
Each policy could have a unique combination of elimination periods for accidents versus illness, depending on what the owner chose when signing up. The monthly premiums are lower when the elimination period is longer.
How long the benefits last is another employee-determined difference between short-term disability and the Family Medical Leave Act. FMLA continues for up to 12 weeks during the time you meet the qualifying criteria, whereas decisions made by the owner at enrollment determine the duration of STDI claim payments.
The STDI benefit period describes the maximum time during which the policy will make claim payments while you remain unable to perform your job duties and under the care of a doctor. The monthly premiums cost more when the benefit period is more extended, and owners can choose between several options at enrollment.
- 3 Months
- 6 Months
- 1 Year
- 2 Years
How to Apply
The steps when applying for benefits represent a point of distinction between short-term disability and the Family Medical Leave Act that hinges on previous decisions. The application process for STDI requires earlier proactive action in many cases, whereas FMLA is always reactive.
You must have STDI coverage already in force to file a claim for benefits. If so, apply for benefits with the insurance company who issued the policy, or the state agency that manages the entitlement.
- A government agency automatically enrolls people who work for private employers in mandate states: California, Hawaii, New Jersey, New York, and Rhode Island
- A small number of employers automatically enroll personnel in group plans and pay the premiums on their behalf
- The majority of people must proactively enroll in voluntary coverage and pay the premiums themselves before becoming sick, hurt, or pregnant
Applying for FMLA benefits does not require any proactive steps by employees (other than satisfying the tenure and hours-worked requirements). You can react (file the claim forms) after becoming sick, hurt, or pregnant with no need to sign up in advance.
The US Department of Labor hosts multiple FMLA forms. Choose the paperwork that pertains to your situation and submit the documentation to your employer.
- Health Care Provider for Employee’s Serious Health Condition
- Health Care Provider for Family Member’s Serious Health Condition
- Qualifying Exigency for Military Family
- Serious Injury or Illness of Current Service Member
- Serious Injury or Illness of a Veteran for Military Caregiver
How Disability Works With FMLA
Several frequently occurring scenarios and questions help illustrate how short-term disability insurance works with the Family Medical Leave Act. The two programs often complement each other, as you will shortly see.
The Family Medical Leave Act can work together well with short-term disability for pregnancy. Maternity leave is a time when families rely heavily on both programs, only to find out that they missed the boat on one in many cases.
FMLA provides up to 12 weeks of job and healthcare protection for maternity leave split across several qualifying scenarios.
- Pregnancy complications before mom’s due date
- Recovery from labor and delivery
- Baby bonding time with her newborn
STDI can provide partial income replacement during maternity leave that could last from 6 weeks to 24 months, depending on the circumstances and the benefit period embedded in the policy (see how long it lasts above).
- Pregnancy disability leave before birth (up to 9 months)
- Recovery from labor and delivery
- Vaginal birth (6 weeks)
- C-Section (8 weeks)
- Postpartum medical complications (up to 24 months)
However, pregnancy is a pre-existing condition for new STDI policies. Too many families delay purchasing coverage until after it is too late and miss the opportunity to take advantage.
Long-term disability insurance (LDTI) rarely works in unison with the Family Medical Leave Act – with two notable exceptions. The primary issue is the lengthy elimination period, but care by a family member can come into play.
The LTDI elimination period almost always exceeds the length of FMLA – except when the owner opts for the most expensive premium option. Again, the shortest elimination period costs more.
Therefore, an employee will almost always exhaust his or her legal job and healthcare protections before an LTDI policy begins making claim payments.
- FMLA lasts 12 weeks maximum (84 days)
- LTD elimination period options in days (60, 90, 180, 365)
However, a person out on long-term disability may require care at home. A close family member (spouse, parent, or child) could qualify under FMLA as a caretaker without concern for the policy elimination period.
Many people ask whether you can get short-term disability and the Family Medical Leave Act at the same time. The short answer is that you can tap into both programs concurrently because they offer benefits that do not conflict or overlap.
- STDI provides partial income replacement
- FMLA provides job and healthcare protection
However, to work both programs simultaneously, you must have a coinciding reason. Also, dual application is not guaranteed every time since the eligibility rules determining who has coverage are so different (see above).
|Care of family member||X|
The Family Medical Leave Act works to minimize employer contact for employees out on short-term disability. When interpreting FMLA law, the courts have allowed minimal communication with absent workers to pass on institutional knowledge or documents, or as a professional courtesy.
However, excessive employer contact with an employee out on disability could be grounds for an FMLA-based lawsuit. Of course, these legal safeguards limiting phone calls, text messages, and emails only apply to covered and eligible workers.