How do you get short-term disability approved while pregnant? Can you apply for maternity leave benefits when already expecting? Is my pregnancy a pre-existing condition?
These are important questions for women facing unpaid time off from work. You will find the answers here – plus some alternatives for financial help.
First, we have to point out that the word “approve” can tap different factors based on the context. For example, an insurance company can accept your new policy application but then decline a subsequent claim for benefits. Plus, people often use the word “apply” to refer to both transactions.
Learn how timing affects your possible benefits, why it makes sense to buy a policy no matter when you expect to conceive or give birth, and where is the best place to sign up.
Short-Term Disability Pregnancy Pre-Existing Condition
Many short-term disability insurance policies deem pregnancy as a pre-existing condition. This means that many women will not qualify for benefits right away. However, it should not prevent you from buying a new policy.
The new policy will not cover any pregnancy-related claims, which means that you may want to seek alternative solutions to deal with lost income.
Financial help resources for pregnant women are scarce but worth pursuing as every penny counts. Look under every rock including personal loans, debt relief, access to affordable medical care, and government assistance programs.
Applying for Benefits
Applying for short-term disability benefits is less likely to yield approval while pregnant. The insurance company may invoke the pre-existing condition clause when you file your claim form.
Women filing these claims will find themselves in one of several categories.
- Approved Claims: losses that occur after the effective date that are not pre-existing conditions
- Illnesses such as cancer, heart disease, and more
- Injuries to bones, joints, and organs
- Pregnancy complications, childbirth, postpartum disorders
- Denied Claims: losses excluded by policy legal language
- Pre-existing pregnancy, illness, or injury
- Normal childbirth occurring within 9 months of the effective date
Women working in states with a mandatory state disability program often have their claim paid – because their participation started in time. The same holds true for those who sign up for private coverage prior to conception. However, this is rare. Many are unaware of the need and the rules. Plus, only five states have a required program.
- Massachusetts (2021)
- New Jersey
- New York
- Rhode Island
- Washington State (2020)
Short-term disability has two possible waiting periods that affect how the pregnancy pre-existing condition clauses work. Pay careful attention to how these two definitions may impact your odds for a claim approval by the insurance company.
“If you become disabled because of a pre-existing condition, the insurer will not pay for any disability period if it begins during the first 12 months the policy is in force.”
The first statement means that the insurance company will deny any pregnancy-related claims when coverage begins after conception. However, the conception date can be difficult to pinpoint. Therefore, expect to provide a sonogram to verify timing on claims that arise before your due date.
“We will not pay benefits for any losses caused by your giving birth as a result of normal pregnancy within 9 months after the policy effective date.”
This second statement allows the insurance company to make a claim ruling based on concrete evidence: the date on your child’s birth certificate. Many babies deliver pre-term. Therefore, try to start coverage several months before conception to avoid this exclusion.
Applying for Coverage
Applying to buy short-term disability coverage is more likely to yield approval while pregnant. Most new policy applications ask a series of medical questions designed to establish that you are in good health. However, many do not ask any pregnancy-related health questions at all.
Therefore, most insurance companies will accept your new policy application – despite your pre-existing pregnancy – unless you fail the other underwriting rules.
- Do you have a serious illness?
- Have you suffered a recent accident?
- Have you missed ten consecutive days of work in the last 12 months?
- Are you currently working?
Short-Term Disability Maternity Leave Already Pregnant
Buying short-term disability insurance for maternity leave can still make a great deal of sense even when you are already pregnant. No – a new policy will not cover any pregnancy-related losses until well after you give birth.
However, you may suffer an income loss because of an accident or illness. Plus, you could conceive again in the near future. It would be a shame to miss maternity leave benefits twice in a row!
Consider the advantages of buying voluntary short-term disability for maternity leave when already pregnant. You obtain voluntary policies through employment. This type of group coverage is the only option that makes claim payments for normal childbirth.
- Vaginal birth: 6-weeks minus the elimination period
- Cesarean Section: 8-weeks less the elimination period
People change jobs often. In addition, employers can alter their benefit offerings. Some employers limit the enrollment time to one month out of the year. Therefore, you could easily miss out if you opt out at work.
Buy voluntary short-term disability for maternity leave when you can. The policies are portable. This means you can keep the coverage in force wherever you work. This way, you avoid falling into the already pregnant pre-existing condition trap should you conceive again.
Buying individual short-term disability for maternity leave when already pregnant has fewer advantages. These policies do not make claim payments for childbirth for any future conceptions – let alone your existing gestation.
However, buying a policy outside of your employer can still make great sense. You would still realize several important ways of protecting your income.
- While Pregnant
- Accidental injuries
- Unrelated illnesses
- Pregnant in the Future
- Medical complications before your due date
- Postpartum medical disorders after delivery