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What Qualifies As A Short Term Disability?

April 18, 2018

By: Theresa Semple | April 17, 2018

Life happens to all of us.

Illnesses, surgeries, accidents, are all a part of life. Fortunately, there is disability insurance to help us get through.

It can be confusing trying to understand disability policies, so here’s a breakdown of which medical conditions qualify as a short-term disability in terms of insurance.

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Medically Necessary Procedures

Most surgeries are covered by short-term disability as long as your doctor certifies them as medically necessary.

In addition to the procedure itself, any side effects from prescription medications that make it difficult to work are also included in coverage.

Weight-loss surgery is often covered by disability policies, but not always. For bariatric surgeries, you will need to check the terms of your individual plan.

Surgeries for purely cosmetic reasons are not covered.

Maternity

Pregnant women are generally eligible for a few weeks to several months of maternity leave. This includes the end of their pregnancy and a period of recovery after delivery.

Although, be aware that the maternity coverage doesn’t begin until the policy has been active for nine months. Pregnancy is considered a pre-existing condition. So, if you are pregnant before you get the policy, it may not cover your maternity leave.

And while we’re on the subject, there have been new rules and guidelines to help assist new moms in the workplace. Because no woman should ever feel like her career is on the line for having a baby.

Pre-Existing Conditions

Unlike regular health insurance that is forced to cover all conditions, short-term disability insurance does not cover pre-existing conditions.

Pre-existing conditions are the most frequent reason why carriers deny claims. It can get confusing because of disability policies there is no clear-cut definition of what a pre-existing condition is.

Most often they are defined as an illness or medical condition that was in existence 12 months prior to the policy date.

Mental Illness

Most disability insurance policies do not cover episodes of mental illness. However, you can purchase a small policy rider that will cover side effects of medications.

If mental illness is a concern for you, consider looking into some government-based programs that may provide financial assistance.

Workers Comp vs Short Term Disability

If an injury happened at work or is related to the current job, filing for workers’ compensation benefits, not short-term disability benefits, is the way to go.

But if the condition is non-work-related and prevents an employee from performing the material duties of the job, then this is where disability benefits kick in.

Find Out More

Nothing is more frustrating than not being able to earn an income because of an illness or injury.

There are ways to protect yourself if working is not an option anymore. Disability can cover that gap until you are back on your feet.

Remember, every policy is a little different, so don’t hesitate to contact us with any questions. We’re here for you every step of the way.