Applying for short-term disability benefits covering off-the-job losses 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 after one year of service.
Meanwhile, federal government personnel and private sector employees find the holes. They must enroll in a program before becoming sick, hurt, or pregnant.
Simultaneously, the Commonwealth requires coverage for temporary disabilities with limitations such as occupational losses and conditions lasting more than twelve months.
Short-Term Disability in VA
Applying for short-term disability covering off-the-job (non-occupational) losses in Virginia can have two possible meanings, with severe consequences for people misunderstanding the distinctions.
- You can apply for benefits only if you have coverage in force.
- Federal government employees do not have mandated coverage
- State government workers have benefits after one year of service
- Private sector employees must purchase a policy proactively
- You can apply to buy a new policy before getting sick or hurt
Filing a Claim
Applying for short-term disability in Virginia for off-the-job benefits (under 12 months) can mean filing a claim with the insurance company that issued your policy. However, other considerations might affect possible approval.
Surgery
You can get short-term disability benefits after surgery, provided you purchased a policy from an insurance company before the surgeon recommended the operation.
The time it takes to recover from your surgery and your policy elimination period determine how long the benefits will last. Many people can return to work before exhausting the elimination period.
Mental Health
Some short-term disability policies cover mental health problems, while others exclude benefits for anxiety, stress, depression, drug and alcohol rehabilitation, etc.
Group policies with hundreds of enrolled employees are more likely to cover mental health issues, while individual plans do not.
COVID-19
Short-term disability often covers Coronavirus as a qualifying illness because the severe breathing issues, profound aches, and lack of energy cause a loss of income and require medical care from a doctor.
However, the insurance company could deny your short-term disability claim for COVID-19 for other reasons typical in most policies.
- You recover before satisfying the elimination period
- Long COVID exceeds the benefit period
- COVID quarantine is ineligible because you are not ill
- Care of family members sick with COVID is also ineligible
Buying a Policy
Applying for short-term disability in Virginia can also mean purchasing a new policy to cover future illnesses and accidents that cause loss of income. Most people working for private employers or the federal government must take these steps.
Request Quote
Request a short-term disability 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.
Pre-Existing Condition
Short-term disability covers pre-existing conditions after twelve months if you qualify for a new policy. Expect the new policy application to include a long list of health-related questions.
Some pre-existing conditions knock out applicants for consideration, while less severe health issues are okay, provided they do not cause a loss during the first twelve months.
VA Disability Pregnancy
Virginia has a perplexing law regarding short-term disability for pregnancy. The new rule discourages others from purchasing coverage while duplicating benefits a related program addresses.
12-Week Benefit
Virginia 2020 Senate Bill 567 requires individual and group short-term disability insurance policies covering childbirth to provide at least a 12-week benefit after delivery. The new law pertains to coverage issued after July 1, 2021.
The previous standard claim payment length is much shorter.
- Vaginal childbirth: 6 weeks
- C-section delivery: 8 weeks
Short-term disability costs are bound to increase to underwrite the extended benefits paid to women after normal childbirth – an event many plan years ahead. Meanwhile, people seeking to cover unexpected illnesses and accidents suffer negative consequences with higher premiums.
Paid Maternity Leave
Virginia paid maternity leave programs duplicate the extra childbirth benefits associated with short-term disability for pregnancy. The redundancy makes you wonder what this new law accomplishes.
Federal and state government employees have iron-clad maternity leave benefits, while those working in the private sector might participate in a voluntary plan thanks to a newly enacted program.
Temporary Disability in VA
Getting temporary disability benefits in Virginia proves easier when the Commonwealth or federal government requires the coverage or funds the premiums on behalf of workers.
Employees do not have to take proactive steps to sign up in advance but may face other limitations when filing a claim.
Worker’s Compensation
Virginia workers could file a claim for temporary disability benefits if they suffered an on-the-job (occupational) accident or illness. The Commonwealth requires most employers to purchase and fund Worker’s Compensation Insurance premiums.
Apply for temporary disability benefits through the Virginia Worker’s Compensation Commission after an occupational incident to protect your rights. Also, report the accident to your employer within 30 days of the incident.
Social Security
Virginia workers can file a claim for temporary disability benefits connected with an off-the-job accident or illness through the Social Security Administration. The federal government requires most employees to participate, and a portion of your payroll taxes (FICA) fund the premiums.
Apply for temporary disability through Social Security, paying close attention to the fine print. The administration deems medical conditions that prevent you from performing any substantial gainful activity for one year or longer as eligible.
A disabling five-year medical condition is temporary, allowing approved applicants to collect benefits for over four years. You do not have to have a permanent disability to qualify.
VSDP
Many state government employees can file for temporary disability benefits through the Virginia Sickness and Disability Program (VSDP). The Commonwealth automatically enrolls workers on their first work anniversary and funds the premiums.
Apply for temporary VSDP benefits by calling the Reed Group at 1-877-928-7021 as soon as possible to submit your claim. A family member or friend can call on your behalf.
Unemployment
Virginia unemployment might provide temporary disability benefits with a significant delay – after you recover and can resume working. The Commonwealth requires this coverage and forces people to pay the premiums through payroll deduction.
Virginia unemployment statutes (Paragraph F “Health or Physical Condition) define leaving work due to a disability as a good cause. However, you cannot collect benefits until you meet three universal criteria.
- Physically able to work
- Available for employment
- Actively seeking a new job
