Completing a Texas short-term disability application form does not guarantee approval. Many people overlook the most critical rule.

Texas does not offer state short-term disability. Therefore, you must purchase a private policy before the need arises. Otherwise, you cannot get benefits while you are unable to work because of a temporary medical condition.

However, people with long-term disabilities (permanent conditions lasting one year or more) can apply for SSDI or SSI and have a reasonable chance of approval for a small monthly amount. You have automatic coverage via your FICA tax payments.

An attorney can help you shorten the time it takes to gain approval.

Short-Term Disability in Texas (Temporary)

Short-term disability insurance in Texas helps people dealing with temporary medical conditions that cause wage loss. In this case, temporary means that your doctor expects you to recover from your injury or illness and return to work withing a limited period – within two years or less.

Keep these critical points in mind when researching applications.

  1. Texas does not offer state short-term disability that automatically includes workers in private industry or public service
  2. Social Security Disability does not cover temporary medical conditions
  3. You must purchase a policy from a private company before becoming sick, hurt, or pregnant to file a claim for benefits

New Policy Application

Request a short-term disability quote to buy a new policy – provided that you do not have a pre-existing condition. The insurance company will reject your application if you have a poor health history, just suffered an accident, or a doctor recently diagnosed a dread disease.

An insurance agent licensed in Texas may contact you to help you complete a new policy application. Be prepared to answer questions about your income, work history, and health, including details about surgeries, hospitalizations, and prescription medications. Once complete, the agent will submit the form to the insurance company for underwriting review.

Filing a Claim Form

Complete a claim form to apply for short-term disability benefits. Since Texas does not offer a state program, you must contact the private insurance company who issued your policy to find the appropriate form.

Many claim forms will require three signatures.

  1. A licensed physician indicating the medical reason you cannot perform your regular work duties
  2. Your employer verifying that you stopped working and receiving income
  3. The insured person confirming that the statements are true

However, many residents cannot file a claim because they did not purchase coverage on their own before becoming sick, hurt, or pregnant. These alternatives may offer modest help.

  • Financial assistance option during unpaid leave from work include loans, debt relief, and government support from Food Stamps
  • Collecting unemployment could be possible after recovery. Section 207.045 of the Texas Unemployment Act states that a person who voluntarily quits work due to a “good cause” is not disqualified for benefits. An employee’s injury, disability, or pregnancy meets the “good cause” definition.[1]

Covering Pregnancy

Short-term disability for pregnancy is a popular topic that disappoints far more Texas mothers than it helps. The benefits are precious for those who have the correct coverage already in force, but most women miss the boat.

Women who purchase a policy at work before conception enjoy partial income replacement for some or all of these qualifying reasons.

  • Pregnancy disability leave before her due date
  • Recovery from childbirth
    • Vaginal delivery: 6 weeks
    • C-section birth: 8 weeks
  • Postpartum medical disorders that delay return to work

Unfortunately, many mothers lose out on this crucial opportunity.

TIPP

The Texas Income Protection Plan (TIPP) is a voluntary benefit offering available to state government employees. Group Benefit Plan (GBP) eligible workers can enroll in two programs at work and fund the premiums through payroll deduction.[2]

Option Elimination Period Claim Duration
Short-Term 30 Days 5 Months
Long-Term 6 Months Until Retirement Age

Keep in mind that the TIPP offering works in the same manner as any private plan – even though it is sponsored by a public agency (Employees Retirement System ERS).

  • New employees can participate without evidence of insurability
  • Late entrants must show evidence of good health
  • The plan will not cover pre-existing conditions for six months

Applying for Permanent Disability in Texas

Texas residents applying for disability benefits have more success when they have a permanent (expected to last one year or longer) medical condition. The government forces most workers to pay FICA taxes, which funds Social Security.

Therefore, far more people meet the most critical qualifying criteria: they have coverage already in force. However, filing a claim does not guarantee approval, and you may need to hire an attorney to win the case.

Social Security

Social Security disability is a federal benefit available to Texas residents who suffer a permanent (lasting at least one year or longer) medical condition that prevents them from performing work in “any occupation.”

  • You can no longer work in your previous occupation
  • You cannot adjust to new work

Two programs target different groups of people.

  • Social Security Disability Income (SSDI) pays claims to you and some family members if you worked long enough and paid FICA taxes
  • Supplemental Security Income (SSI) covers disabled adults and children who have limited earnings and resources

Claimants apply for benefits themselves online at www.SSA.gov. A variety of financial support options can help you stay afloat while waiting for the government agency to make a decision.

People with shaky or complicated cases may find different justifications for hiring a lawyer across the two programs.

SSDI

Engaging a Texas Social Security Disability Insurance (SSDI) lawyer can be more difficult to justify because people who readily meet the qualifying criteria may not need legal help to gain approval for a modest claim check each month.

For example, people diagnosed by a licensed physician with specific impairments have a higher chance of having their application approved.[3] Applicants with diagnoses in these categories may be able to keep all of the very modest average monthly benefits of $1,200 without having to pay legal fees.

Musculoskeletal Senses and Speech Respiratory
Cardiovascular Digestive Genitourinary
Hematological Skin Endocrine
Congenital Neurological Mental
Cancer Immune System

SSI

Applying for Supplemental Security Income (SSI) in Texas frequently involves retaining an estate planning attorney to assist with your case. Potential SSI recipients often require guardianship paperwork, special needs trusts, and other legal documents to safeguard future government benefits from resource requirements.

SSI recipients did not pay into the system via FICA taxes, making this a welfare rather than an entitlement program. Therefore, parents and guardians must be cautious not to exceed asset limits and must structure family finances accordingly.

Long-Term

Retaining a Texas long-term disability lawyer can make sense (if you have coverage from a private insurance company) because the eligibility criteria are more lenient, and the payout is richer when compared to Social Security.

  • The typical “own occupation” legal definition is much easier to satisfy than its “any occupation” counterpart
  • The monthly benefit amounts are usually much higher
  • Claim payments can continue to age 65

For example, a surgeon who suffers permanent damage to his or her hands would satisfy the own occupation definition even though he or she could still perform other work – given the extensive training received in medical school. Then, the monthly long-term disability claim check could be $10,000, $15,000, or more each month.

[1] TX Unemployment Compensation Act

[2] ERS TIPP

[3] SSA Impairment Listings