What Are the Pros and Cons of Short-Term Disability?
At Bryant Legal Group, we know how short-term disability benefits can provide much-needed peace of mind and financial security while you deal with a disabling illness, injury, or chronic condition.
However, short-term disability insurance policies have their imperfections too. If you don’t understand your plan’s shortcomings from the beginning, you may have unpleasant surprises later on.
Here, Bryant Legal Group’s team of respected short-term disability lawyers outlines the power and challenges of short-term disability coverage.
Pro: Short-Term Disability Provides Monthly Income When You’re Ill or Injured
Whether you have a self-funded or employer-sponsored short-term disability plan, the goal is the same: the plan is supposed to pay you a monthly benefit when you’re unable to work due to a medical condition or injury.
Typically, short-term disability benefits pay between 40% and 60% of your monthly income, although this varies. (Some policies will even pay 100% of your weekly wages for a period.) These benefits provide stability and peace of mind, giving you space to focus on your health and recovery.
RELATED: Disability Insurance in a Nutshell
Pro: Most Short-Term Disability Policies Are “Own Occupation” Plans
Disability insurance plans define “disability” in one of two ways:
- Own occupation: You are disabled if you cannot do your actual job.
- Any occupation: To get disability insurance benefits, you must prove that you cannot do any type of work.
For many professionals, it’s a lot simpler to prove you’re unable to do your actual occupation than any job. For example, suppose you’re a respected neurosurgeon who develops an essential tremor. You cannot safely operate on patients due to your health condition, so you’re eligible for short-term disability under an own occupation plan. However, under an any occupation plan, the insurance company may argue that you’re still capable of teaching, managing a medical practice, or working as a telehealth physician.
Thankfully, most short-term disability policies use the easier own occupation standard. To understand your policy’s precise definition of disability, you should review your Plan Document or Summary Plan Description (SPD). If you need help understanding these documents, contact an experienced short-term disability lawyer.
However, even if you have an “own occupation” short-term disability policy, you’re not out of the woods. Many long-term disability insurance policies use the “any occupation” definition. So, suppose your illness or injury takes a while to heal, or you are permanently disabled. In that case, the insurer may try to argue that you’re ineligible for long-term disability because you can still do other work—even though your short-term disability claim was quickly approved.
Con: Your Policy Might Not Cover All Health Conditions
Most short-term disability plans have exclusions and limitations. It’s a good idea to understand this fine print before choosing a private disability plan or applying for benefits. Look out for these common exclusions and limitations:
- Pre-existing conditions: Many employer-funded plans have waiting periods that you must complete before the plan will cover a pre-existing condition.
- Self-inflicted injuries: Many policies will not cover self-inflicted injuries.
- Normal pregnancy: While many short-term disability policies will cover your recovery time after labor and delivery, some plans limit your benefits unless you’ve undergone a C-section or suffered complications.
- Workers’ compensation: Some short-term disability policies will not cover claims involving an occupational illness or injury. Other plans have specific limitations. For example, the insurance company may offset your monthly benefits dollar-for-dollar with anything you receive in workers’ compensation benefits.
Insurance companies sometimes read these exclusions and limitations too broadly, denying valid claims. If the adjuster tries to limit your short-term disability claim or deny it completely, consult a lawyer as soon as possible.
Con: Waiting Periods Are Common in Short-Term Disability Plans
While most short-term disability exclusion periods aren’t as long as their long-term disability counterparts, you’ll still have to wait a bit before you’re eligible for a monthly benefit. For short-term disability claims, the elimination period can be between 0–90 days, although a seven-day waiting period is most common. Some policies have different elimination periods for illnesses and injuries, so make sure you review your plan’s terms and conditions carefully.
You should also pay close attention to how elimination periods and limitations interact. Many policies treat these waiting periods like a deductible—you lose out on benefits during the elimination period regardless of your claim’s length.
For example, UNUM often limits short-term disability benefits for a normal pregnancy to six weeks. Suppose you have a one-week elimination period. In this case, you may only receive five weeks of benefits, because UNUM will “deduct” your waiting period from your maximum period of disability.
Looking for Personalized Advice From an Insurance Lawyer?
Contact a Short-Term Disability Lawyer and Get Your Questions Answered
Every short-term disability policy has its own quirks and challenges. If you have questions about your policy’s specific terms, it’s best to consult an experienced disability insurance lawyer. That way, you’ll know you’re getting honest, reliable advice from a professional.
Our attorneys help people at every stage of the disability insurance process:
- Identifying the best policy for their unique needs and goals
- Deciding whether it’s time to apply for short-term disability
- Navigating the application process
- Appealing a wrongly denied disability insurance claim
- Filing a state or federal lawsuit
Unlike an adjuster, who represents the insurance company, our team is committed to helping and educating professionals throughout Chicago and Illinois.
Bryant Legal Group: Chicago’s Trusted Short-Term Disability Lawyers
At Bryant Legal Group, we focus our practice on disability and other insurance claims. If you have questions about your short-term disability options, contact us today. We can help you interpret your policy’s terms and conditions and decide whether you should file or appeal your claim.
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