Completing a Texas short-term disability application form does not guarantee benefits.
Many people in the Lone Star State overlook the most important rule. Texas does not offer state short-term disability. You must purchase a private policy before the need arises.
Limited options for financial assistance exist if you are facing a period without an income. Women planning a pregnancy must learn about key eligibility requirements.
Follow this four-part outline to find answers about short-term disability in Texas.
- Application rules for financial assistance and cost of coverage
- Eligibility requirements during pregnancy and maternity leave
- Benefits and drawbacks of different policy types
- Laws providing job protections during a leave of absence
Texas Short-Term Disability Application Rules
The number one short-term disability application rule trips up the majority of Texas visitors. You must purchase private coverage before becoming sick, hurt, or pregnant.
- Texas does not offer temporary disability benefits to private workers.
- A new policy excludes pre-existing conditions (including pregnancy) for one year.
- You must show evidence of good health to start a new plan.
You cannot file a claim form if you do not own a private policy. Therefore, we present alternatives for financial assistance before discussing the cost of coverage, and the one circumstance where hiring an attorney may help.
Two non-government sources of financial assistance are available to many Texas residents dealing with a temporary interruption in income or an unpaid maternity leave. The qualifications differ for each program.
- Request a personal loan to get the emergency cash you need. Repay the note in monthly installments. This alternative makes sense only if you expect to return to work very soon. Scroll to the bottom of the page to verify that the job protection laws apply to you.
- Debt consolidation programs sometimes offer delayed relief. If you already owe more than $10,000 in unsecured obligations (credit cards, personal loan, and unpaid medical bills) then you may quickly fall behind on payments without an income. A debt settlement program may be your best option to make ends meet.
Cost of Coverage
The cost of coverage for short-term disability in Texas has significance only to applicants passing the number one rule. Request a monthly cost quote for two types of insurance based on your current medical condition.
- Request a disability insurance cost quote – if you have a clean bill of health and you are not already pregnant. An agent will provide an estimate, and help you complete a new policy application. It will cover future accidents, illnesses, and pregnancy complications only.
- Request a health insurance cost quote – if you have a preexisting health condition. You do not qualify to purchase coverage to replace your income. However, many people lose their health plan when they stop working. Loss of insurance is a qualifying life event. You may be eligible for premium subsidies based on a much lower projected income.
Hiring an Attorney
Hiring a short-term disability attorney in Texas only helps when disputing a denied claim. This rarely happens because the majority of site visitors have no coverage. However, an attorney is far more likely to help with a temporary unemployment claim.
Apply for unemployment compensation for health reasons after your 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 own serious medical condition meets the good cause definition.
However, most applicants must wait until they are physically able and available to work. This option does not help while the individual remains disabled.
Texas Short-Term Disability Pregnancy Eligibility
The eligibility requirements for short-term disability for pregnancy and maternity leave also trip up many site visitors. Four rules in Texas break down the key issues.
- Already pregnant women missed an opportunity
- Expectant women have modest options for financial help
- Private plans cover complications of pregnancy only
- Worksite plans include recovery from normal labor and delivery
Private short-term disability in Texas covers pregnancy complications that prevent mom from working prior to her delivery. This personal form of coverage is very convenient to purchase, as you do not have to involve an employer. However, it will not include mom’s normal labor and delivery.
Twenty-five percent of women experience a serious medical issue while pregnant. A pregnancy disability beginning in the first trimester could last for six months. Therefore, buying private coverage prior to conception makes a great deal of sense.
During Maternity Leave
Worksite short-term disability in Texas covers maternity leave – while mom recovers from normal labor and delivery. This option is far more valuable. However, employers must offer the program to all personnel. Since employees pay the premiums themselves, women interested in this option should ask their employer to give them the choice.
The benefits paid during maternity leave make this extra step worthwhile.
- Vaginal delivery – 6 weeks less the elimination period
- C-section birth – 8 weeks less the elimination period
Short-Term Disability Policy Types in Texas
Learn about the four main Texas short-term disability policy types in this section. Each type has unique benefits and drawbacks. You can find examples of each described below.
- Individual direct channel
- Individual voluntary worksite
- Group voluntary worksite
- Group employer paid worksite
There are two types of individual short-term disability insurance policies in Texas. The distinction between the two is most meaningful for women planning to have a baby.
- Individual policies purchased through a direct channel do not cover normal childbirth. However, they are much more convenient to obtain if your employer does not offer the coverage.
- Individual voluntary policies bought through the worksite do cover normal childbirth. The underwriting criteria are often more forgiving as well. The participating personnel pays the premiums themselves through payroll deduction. Employees own the contract, not the group.
There are also two types of group short-term disability policies in Texas. Both forms of coverage pay for mom’s normal labor and delivery. Access is the most distinguishing feature.
- Group voluntary policies obtained at the worksite often feature lower premiums and better benefits than individual plans. They pool risks. Employees pay the premiums, so more companies elect this option. However, a minimum number of people must volunteer to enroll.
- Group employer-paid policies obtained at the worksite feature the lowest premiums and best overall benefits. Many group plans guarantee issue very sick workers and may include pre-existing conditions. However, they are very rare – as employers must pay the premiums.
Long-term disability insurance in Texas is another policy type worth considering. This form of coverage has a different set of benefits and drawbacks compared to a temporary contract.
Long-term disability insurance pays claims for a much longer (benefit period), while its temporary counterpart begins payments more quickly (elimination period). Long-term disabilities have a heavier financial impact, while temporary disabilities are more frequent.
|Policy Type||Benefit Period||Elimination Period|
|Long-term||5 – 45 years||6 to 12 months|
|Temporary||3 – 24 months||7 to 90 days|
Employee Retirement System
The Texas ERS short-term disability plan is an example of a voluntary group policy. The Employee Retirement System Texas Income Protection Plan offers both a temporary and long-term option.
State employees pay the premiums themselves through a payroll deduction. New hires have thirty days to enroll on a guaranteed issue basis – no health questions asked. It covers pre-existing condition after only six months.
Teacher Retirement System
The Texas Teacher Retirement System (TRS) disability program provides another interesting example of coverage type differences. The existing entitlement represents an employer-paid group long-term policy. It automatically covers all member teachers regardless of health history. It only pays claims when the member suffers from a permanent medical condition.
TRS is an example of a where a voluntary individual short-term disability policy would fit. Many teachers have babies and take maternity leave. The existing plan will not cover any pregnancy-related condition because it is temporary – not permanent.
Texas State Short-Term Disability Labor Laws
Texas short-term disability labor laws nibble around the edges. There are no regulations requiring coverage, or modifying the way that carriers issue and market the options. Several federal and state-level regulations provide job protections and alternative ways to protect income.
Texas does not offer state short-term disability insurance for non-government workers. State government workers have the option to enroll in a worksite plan through ERS. However, the state does not have a law requiring private employers to offer an employer or employee paid option.
Residents can either ask at work for a voluntary program or buy something with lesser benefits on their own.
Family Medical Leave Act
The Family Medical Leave Act (FMLA) in Texas supplements short-term disability benefits. Each program addresses a different need and helps a unique group of people.
- FMLA provides unpaid job-protected leave and continued access to group health insurance. Employees who have logged more than 1,250 hours for the same employer qualify – if the group has 50 or more people working within a 75-mile radius.
- Short-term disability provides partial income replacement while an employee is physically unable to work. Only workers who purchase personal coverage before becoming sick, hurt, or pregnant qualify.
Texas Workforce Commission short-term disability provides benefits for on-the-job accidents and illnesses only. This is worker’s compensation, which also pays for medical expenses associated with workplace injuries.
The commission oversees the worker’s compensation laws. Workers compensation does not address your exposure to any injury or sickness that occurs while away from work.
Department of Labor
The Texas Department of Labor does not require short-term disability coverage either. This department administers the payday law, and the child labor law, and disseminates information about minimum wages.
The payday law requires that employers must provide any promised fringe benefit written in the company handbook. Fringed promises may include sick pay, vacations, family leave, holiday pay, and severance.
Residents waiting for a disability approval have few options for interim assistance. Social Security does not provide short-term disability in Texas or any other state. It makes claim payments for permanent conditions only. Applicants qualify if the medical condition will last a year or longer or result in death.
Social Security program rules assume that working families have access to other resources to provide support during periods of temporary disruptions in wages.