Applying for disability benefits in Virginia can be like eating a slice of Swiss cheese. Sometimes, you bite into a hole.

State employees get most of the cheese (at taxpayer expense) because their employer automatically enrolls them in VSDP, Workers Compensation, and Social Security.

Meanwhile, taxpayers who work in private industry often get the hole when they have a short-term disability caused by an off-the-job accident, injury, or pregnancy. Having a policy for these events is optional.

You cannot file a claim unless you have the coverage already in force. Act ahead of time to avoid a calamity. The alternative forms of financial help are sparse at best.

Short-Term Disability in Virginia

Applying for short-term disability benefits (under 12 months) in Virginia can be successful only if you have coverage in force before becoming sick, hurt, or pregnant. You could fall into one of three categories based on where you work, and what caused your medical problem.

  1. State employees have automatic coverage for non-occupational (off-the-job) conditions through VSDP
  2. Public and private employees have involuntary coverage for occupational (on-the-job) maladies via Worker’s Compensation
  3. People working in private industry must proactively purchase coverage well before an off-the-job loss occurs

Policy Applications

Any person working for a private employer in Virginia must purchase short-term disability on their own to have coverage for non-occupational damages. You could not file a claim for benefits if you did not complete a policy application first.

  • Financial assistance programs offer little help to people forced to take time off from work without pay. However, it cannot hurt to learn about the options that could be available.
  • Request a quote before buying a new policy to cover future medical problems. You must show evidence of good health. An agent licensed in Virginia can help you complete a new policy application and submit it to the insurance company for review.

State Plan

Virginia state short-term disability provides partial wage replacement benefits for occupational (on-the-job) incidents for private and public workers, and non-occupational losses for state government employees only.

Unemployment compensation can help both parties only after they recover and are physically able to resume working.

Unemployment

Unemployment compensation is a state-run program in Virginia that can help workers after a short-term disability who lose their jobs or quit because of their medical condition – once they recover. People from private industry dealing with non-occupational accidents or injuries must wait until they meet three critical criteria.

  • Physically able to work
  • Available for duty
  • Actively seeking a new job

On the other hand, VA unemployment law allows people to leave work voluntarily for a good cause reason if their health or physical condition made the work unsuitable.[3]

Therefore, file an unemployment claim after recovering from your temporary disability – if you lost your job in the interim.

Temporary

Worker’s Compensation provides temporary disability benefits to private and public employees who suffer an occupational injury or illness. This state-mandated insurance offers many forms of support to people with job-related medical conditions.

  • Medical treatment support including travel costs, doctor visits, hospitalizations, physical therapy, prescription drugs, and more
  • Death benefits including burial expenses and compensation to dependents
  • Lost wage replacement up to 66% of regular wages subject to a maximum weekly amount
    • Temporary total when you cannot perform daily job duties
    • Temporary partial when you can return to the job with restrictions
    • Permanent partial when your condition reaches the point of maximum improvement
    • Permanent total when you are unable to work indefinitely

Apply for Worker’s Compensation by notifying your employer first, and then submit a claim with the private company who issued the policy.

VSDP

The Virginia Sickness and Disability Program (VSDP) provides both temporary and long-term wage replacement support to state employees. VSDP helps those suffering an occupational and non-occupational accident or illness that prevents them from working.[1]

  • Temporary: commence after a 7-day waiting period and continue for a maximum of 125 days, and replaces up to 100% of income based on service time
  • Long-term: starts after the expiration of the temporary benefits and replace 60% of income until death or receipt of retirement payout

VSDP does not cover workers in private industry who pay the taxes funding these plans. It covers only the public employees actively participating in one of these related programs.

  • Virginia Retirement System (VRS)
  • Virginia Law Officers Retirement System (VALORS)
  • State Police Officers Retirement System (SPORS)

Affected public employees must contact the Reed Group toll-free at 1-877-928-7021 to file a claim.[2]

Pregnancy

Short-term disability for pregnancy leave in Virginia results in a wide disparity of outcomes for women working in public institutions versus private industry.

The coverage must begin before conception. Otherwise, the insurance companies treat pregnancy as a pre-existing condition and will deny any maternity-related claims.

  • VSDP covers pregnancy leave for eligible state employees, who automatically have the coverage and do not pay any portion of the premiums
  • Women employed at private companies must proactively buy a policy through work and may have to fund 100% of the premiums themselves

Social Security Disability in Virginia

Applying for Social Security Disability in Virginia can help people regardless of whether they work for private or public employers. A portion of your FICA taxes funds this program, which every worker must pay.

The federal government manages two programs in conjunction with the state of Virginia. Each plan provides benefits for long-term non-occupational medical conditions that prevent you from working (not temporary conditions lasting less than one year).

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

Claim Steps

The steps for filing a Social Security disability claim in Virginia begins at the ssa.gov website. Apply online from the comfort of your home or office without having to travel long distances or sit for extended periods in a waiting area.[4]

Be prepared with documents supporting your claim.

  • Personal identifying information
  • Details about your illness or injury
  • Data about your work history and earnings

How Much

Your earnings history determines how much Social Security will pay in benefits. The compensation level in Virginia follows the same formula as the rest of the nation.

Below are some average figures to use as a benchmark.

  • SSDI grantees receive from $800 to $1,800 monthly, depending on their previous earnings levels and years paying into the system. The average figure is about $1,200 per month.
  • SSI recipients take in less money each period because they did not pay into the system, and any countable income reduces the amount.

Determination Services

The Virginia Disability Determination Services (DDS) office administers claims decisions and recertification for three federal government programs.

  1. Supplemental Security Income (SSI)
  2. Social Security Disability Income (SSDI)
  3. Medicaid healthcare for low-income families

The DDS website lists phone numbers and physical addresses for offices located in major metropolitan areas, including Fairfax, Richmond, Norfolk, and Roanoke.[5]

[1] VA Department of Human Resource Management

[2] Virginia Retirement System

[3] Virginia Employment Commission

[4] Social Security Administration

[5] DDS