How do you get short-term disability approved while pregnant so you can enjoy maternity leave benefits? Is my pregnancy a pre-existing condition?
These are essential questions for women facing unpaid time off from work. You will find the answers here – plus some alternatives.
First, we must point out that the words “apply” and “approved” can both pertain to two separate transactions that might have opposite conclusions.
For instance, the insurance company might approve your application for a new policy but deny your subsequent claim for benefits.
Learn how timing affects your possible benefits and why it makes sense to buy a supplemental policy at work no matter when you conceive or give birth.
Denied Short-Term Disability for Being Pregnant
You can be denied short-term disability for being pregnant. Still, your choice of words greatly matters because coverage applications and benefits claims are two critical underwriting points.
Pregnancy is typically a pre-existing condition for short-term disability, meaning you can get approved for coverage but denied for benefits during the first twelve months the policy is effective.
Short-term disability pre-existing condition clauses have two components that come into play. Your summary plan description might include legal language similar to these excerpts.
- “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 twelve months the policy is in force.”
- “We will not pay benefits for any losses caused by your giving birth as a result of normal pregnancy within nine months after the policy effective date.”
Applying While Pregnant
You can apply for short-term disability while pregnant and get approved for coverage but denied benefits when filing your claim.
Applying for Coverage
Applying for short-term disability coverage while pregnant can easily lead to approval, provided you are in good health. The insurance company might ask medical questions on the new policy application while ignoring maternity-related work absences.
The covered medical conditions for short-term disability include injuries and illnesses that begin after the effective date, making the purchase a sound decision. Most people buying new policies want to safeguard their paycheck from these disorders. Half of the policyholders are men!
Applying for Benefits
Women who apply for short-term disability benefits while pregnant get approved when the coverage begins before conception. However, most wait until it is too late.
You can be denied short-term disability benefits for being pregnant before the coverage effective date. Most policies issued by private insurance companies include legal language, excluding payments for pre-existing health conditions, as noted earlier.
However, women have four remaining options to apply for maternity leave benefits through other programs.
Short-Term Disability for Maternity Leave Already Pregnant
Women have four possible avenues for getting short-term disability benefits for maternity leave approved when they are already pregnant – because they had the coverage in force beforehand.
If offered, women can buy supplemental short-term disability for maternity leave when already pregnant through their employer. However, you may have to plan for delayed gratification – unless you become sick or injured.
Supplemental short-term disability will cover your next maternity leave because the pre-existing condition exclusion will rule out benefits for your current pregnancy. However, you might still want to buy a policy to avoid the same problem again in the future.
Short-term disability not through employers does not cover your recovery from childbirth. Only policies purchased at worksites include these coveted benefits. Plus, the coverage is portable, so you can continue the contract if you change jobs.
Now could be your only chance to sign up! Many employers do not offer these programs.
Some women can get state-mandated short-term disability for maternity leave when already pregnant because they have the coverage beforehand. Their local government forces them to fund premiums through a payroll deduction, so the pre-existing condition exclusions are not an issue.
However, only seven states have a required program, and you must work (not live) in those regions to get your benefits approved while pregnant.
- New Jersey
- New York
- Rhode Island
Social Security Disability
A tiny handful of women can get short-term disability through Social Security for an extended maternity leave when already pregnant. The federal government requires most workers to contribute to the system via FICA payroll taxes.
Therefore, most women have the coverage and do not have to worry about pregnancy pre-existing condition exclusions.
However, their medical condition must last at least twelve months to gain approval, which rarely happens. Only new mothers experiencing significant postpartum depression and medical disorders may pass the test.
Another tiny group of women can get a group short-term disability program at work to cover maternity leave even when they are already pregnant. However, they may have to change employers to gain approval for benefits.
Many insurance companies will waive pre-existing condition clauses to entice large employers to offer the programs to their employees. As a new employee, you would have to enroll during the initial enrollment period to enjoy this advantage.
Speak to the human resources department and ask specific questions when interviewing for a new position.