Short-Term Disability Insurance in Wisconsin | Eligibility

Short-term disability insurance in Wisconsin can protect your finances if a non-occupational accident or illness stops you from earning money at your full-time occupation.

You must have coverage already in force to be eligible to apply for benefits (file a claim). Therefore, each person should take proactive steps to enroll before getting sick, hurt, or pregnant.

The state offers a voluntary program to government employees, so take advantage during open enrollment if you are a public servant.

People working in the private industry can sign up at the worksite (if offered) or buy a policy outside of their employer with lesser benefits for childbirth.

Individual Short-Term Disability WI

In Wisconsin, individual short-term disability insurance is a critical policy to have because the state does not mandate coverage for non-occupational losses. Government employees have a voluntary group option, but residents working in the private sector might not.

How to Apply

Applying for short-term disability in Wisconsin is a two-step process. An individual must first complete a new policy application before becoming sick, hurt, or pregnant. Only then can you file a claim for benefits.

Filing Claims

Apply for short-term disability through Social Security if you do not own a private policy and expect your medical condition to prevent you from performing any work for at least twelve months.

Your job is to compile the medical evidence supporting your claim for benefits.

  • What are your illnesses, injuries, or conditions?
  • When did they begin?
  • How do they limit your activities?
  • What did medical tests show?
  • What treatment did you receive?

New Policy

Request an individual short-term disability quote as your first move. An agent licensed in Wisconsin may contact you to present premium rates for three feature options.

  1. Elimination period
  2. Claims payment duration
  3. Monthly benefit amount

The agent can also assist you in completing the new policy application. Expect to answer detailed questions about your medical, job, and earnings history. You must show evidence of good health to qualify.

Pregnancy

Wisconsin maternity leave laws do not include paid time off for mothers or fathers. However, women who purchase short-term disability before conception may qualify for valuable benefits during pregnancy and after childbirth.

However, the place where you enroll and the type of policy can impact your claims experience.

  • Medical complications of pregnancy that cause you to miss work before your due date: all plan types may include
  • Recovery from labor and delivery after normal childbirth have two outcomes
    • Individual plans bought outside of employers do not cover
    • Personal and group plans obtained at the worksite include coverage
      • Vaginal delivery: 6 weeks
      • C-section birth: 8 weeks
  • Postpartum disorders that delay your return to work
    • All plan types address postpartum medical issues
    • Only group plans include postpartum depression

Covid-19

Covid-19 could be a covered illness under short-term disability and replace a portion of your income if you meet critical qualifiers. The Coronavirus pandemic provides an excellent opportunity to illustrate several key features and criteria.

  • Preexisting conditions may prevent you from buying a new policy or exclude payments for twelve months (as with pregnancy)
  • Only the covered person qualifies to file claims when sick with COVID-19, not other family members requiring care or supervision at home during a lockdown

State Short-Term Disability WI

The eligibility for state-sponsored short-term disability insurance in Wisconsin follows the two golden rules: you must have a policy in force before suffering a covered accident or sickness that prevents you from working.

The four state programs have holes that fall into two categories.

  1. It covers temporary non-occupational losses but requires proactive measures to enroll first
  2. Provides automatic coverage but does not pay for temporary absences from off-the-job medical problems

Unemployment

The State of Wisconsin requires participation in the Unemployment Insurance program, which provides temporary income benefits for laid-off workers. By law, you pay premiums through payroll deduction and do not have to take extra steps to have this coverage.

However, you do not qualify for unemployment when a medical reason prevents you from working. You must first meet three primary criteria.

  1. Physically able to work
  2. Available for employment
  3. Actively seeking a new job

On the other hand, once you recover from your ailments, a related legal provision could make you eligible: “The employee’s health left the employee with no reasonable alternative but to quit.”

Social Security

The State of Wisconsin administers the federal Social Security disability program for resident applicants. By law, your mandatory FICA taxes fund the premiums for this insurance, so you have automatic coverage and do not have to sign up first on your own.

However, the two Social Security programs do not cover temporary disabilities. To be eligible, a doctor must certify that your condition should last at least twelve months or longer. Plus, long approval times make it challenging to survive.

Government Employees

The State of Wisconsin offers short-term disability to government workers as a group policy. The Department of Employee Trust Funds administers the Income Continuation Insurance program, which you must apply to enroll in first.

In other words, you are eligible to file a claim for benefits only if you enrolled in the income continuation program before getting sick, hurt, or pregnant. The coverage is not automatic or required by law.

Temporary Disability

The State of Wisconsin mandates that employers purchase Workers Compensation Insurance, which covers temporary disabilities caused by occupational accidents and illnesses.

In this case, you have automatic coverage for temporary disabilities connected to on-the-job injuries and sicknesses. You do not have to sign up in advance to file a claim. However, you must prove that the medical problem arose at work and not elsewhere to qualify.