Short Term Disability Insurance (STD) and Benefits Q&A, Part 2

(Note: the following is geared towards the State of California. Your state will likely have something very similar, but be sure to check your state regulations and your policy's terms and conditions.) Click here for California state disability details

As readers of my blog and website, most people know that I like to keep things light and fun. Unfortunately, the subject doesn't really have a light side and it's certainly not fun. I mean who really wants to talk about getting injured, right? So I apologize to this article is a little bit dry and boring, but I think that you'll find it very informative.

(Continued From Previous Page) You must enroll during the initial enrollment to meet the pre-existing conditions exclusionary period for short term disability coverage (which can last between six and 12 months.) Then you must continue to be an employee (or member of a professional group or association) and continuously remain enrolled in coverage during the service wait and pre-existing conditions exclusionary period. Upon the passing of the exclusionary period, you will then be covered for any pre-existing disability. Essentially this is to protect employers from hiring previously injured employees, having those employees then claim that they were injured again and have the employer pay out benefits.

Does short term disability insurance cover health coverage?

Many people think that disability insurance covers health coverage. This is not true, as it only provides income replacement, although as this money is paid to you directly, you may use it for health expenses. However, in employer-sponsored coverage, your employer may use your eligibility for short term group disability to determine continued eligibility for other benefits such as health and life coverage. Basically what this means is that if you suffer from a short term disability that would severely affect your future health, they may choose to raise your health benefit premiums.

It's important to know that if you have individual short term disability coverage that you are responsible for all of the costs... not your employer. Your employer is not required to offer short term group disability because it protects you from off the clock injuries and illnesses. However, since your coverage is offered by your employer, your premium payments will be deducted from your paycheck on a pretax basis and will therefore save you a great deal of money versus purchasing it on your own. So, be grateful that your employer is offering short term group disability insurance even though they don't have to.

On the other hand, if you have group short term disability coverage, you may be responsible to pay nothing, to pay a percentage of the cost or to pay a set premium. Concerning employer-sponsored short term group disability coverage, you will be responsible for paying the amount above what you're employer has chosen to pay and is determined by agreements between the insurance company and your employer. For an explanation of your benefit details, your employer, human resources department or personnel staff can explain these benefit details.

What kind of requirements, do I need to meet for enrollment and eligibility?

The type of short term disability coverage do you have, whether it's a group or individual determines their requirements for enrollment and eligibility. If your short term disability coverage is set up through your employer, there are active work requirements that need to be met, including working a minimum number of hours per week. Disability coverage can be used to replace part of your income if you suffer from a disability that makes it impossible for you to work as long as you met the service wait and pre-existing condition exclusionary periods. You will also be required to retain membership to continue to be eligible for benefits through a professional group or association.

What restrictions are there with the short term disability coverage?

When it comes to disability coverage, a lot of people believe that there are restrictions based on their income. This is not really true. The amount money you make does not determine whether or not you can purchase disability coverage. However, many insurance policies determine the amount of money that you can receive per month by setting the top dollar amount paid out along with the percentage amount to be paid.

For instance, if you earn $5,000 per month, your insurance policy might state that you can only receive a maximum of 70% which would equate to $3500 per month. Another policy might state that you can receive 60% of your income up to a certain amount, for example, $2000 per month. And yet another policy might state that they will cover the difference between 70% of your income minus what the state will pay. For example, if you qualify for California disability insurance, you can receive 55% of your income up to $500 per week. If you are paid $1000 per week by your employer normally, this type of policy will pay $200 per week (70% times $1000 -$500 equals $200.) This is why it's very important to know how much your particular, short term disability policy will pay in case you are disabled. If it is not enough for you to cover your expenses, you should seriously consider purchasing supplemental disability insurance from a company such as Aflac.

Here's more Q&A about short term disability insurance:

• What is STD coverage?
• How does one become eligible for STD insurance?
• How much do I get paid if I cannot work due to injury or sickness?
• Does STD insurance cover health coverage?
• What kind of requirements, do I need to meet for enrollment and eligibility?
• What restrictions are there with the STD coverage?
• What's the difference between private STD coverage and federal and state programs?
• What happens if I am laid off or fired?
• How long does STDlast?
• I am on STD and I was recently terminated because I have no more sick time. I pay $20 a week through payroll and I would like to know if my employer has to pay the premium?
• I purchased a Aflac STD policy seven months ago because I was told that it covers pregnancy since it can be used for maternity. I am now pregnant and am due to deliver in seven months. What are the steps I need to take to receive my benefits?
• I have a Doctor's note stating not to lift weights heavier than 15 lbs for a period of 5 weeks. Human Resources has approved the doctor's note and says I have to be on STD because my job description requires me to lift 50 lbs. However, my department head is thinking about putting me in a different role for those 5 weeks that would not require me to do heavy lifting. My questions are: 1) Can I choose STD over the desk job or is that up to my department head? 2) Is he legally allowed to keep me in the office and pay me a lower wage just to avoid paying me STD? 3) What if the desk job pays me even less than I would have gotten for STD payments?
• I was in a car accident and my neck and back suffered a sprain. I have been doing physical therapy and have not been working since for the past two months. My employer does not want to pay for anything else after four weeks of being off so if I go back to work now and still suffer from pain would my whole STD process start over?
• When I first applied for my insurance I did not apply for STD. I am now 8 months pregnant and I have already been put on leave and discovered that my employer mistakenly cancelled my insurance. They have re-enrolled me and I opted for STD as well. Then my paycheck did not have the premiums deducted so I brought it to the attention of my employer. They said I will have to be reinstated once again. Well, I may have this baby at any time, so what are my rights? If the insurance goes through, will I get paid for my maternity leave?
• I pay for my STD through work which covers me for 6 months in the event of a disability but could get additional months coverage to compliment my long-term policy which kicks in after 6 months. Does the premium you pay for a Short-Term group plan cost more if you choose a plan when applying for coverage with a longer duration of coverage, since the insurance company would be taking a greater financial risk having to pay you for additional months?
• My employer does not offer STD insurance. Anybody know of good insurance companies that offer INDIVIDUAL STD insurance? I want to purchase my own, personal disability insurance before I have my baby in six months. Do you have any recommendations?