How Does Short-Term Disability Work? All Your Questions, Answered

Picture this: You’ve been dealing with chronic back pain for years, and you’ve finally decided to go in for surgery to get it taken care of. Your doctor is honest: The recovery is going to be pretty brutal. It’s going to take a long time (we’re talking several months) for you to feel remotely back to normal. Sitting at your desk five days a week is going to be next to impossible while you’re getting better.

Your mind is already cranking through all of the numbers. How are you supposed to cover your expenses when you’re physically unable to work for that period of time?

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Or maybe you’re in a situation like Meaghan Tiernan, a senior copywriter for a marketing agency in San Francisco, who knew she needed time off for maternity leave.

Luckily, you can use short-term disability to recover from surgery or take time off after childbirth. You can also use it for any number of other medical issues that’ll keep you from doing your job.

Here are some of the most common questions people have about short-term disability benefits—with answers to help you navigate the process.

Short-term disability pays you a portion of your salary in situations when non-job-related injuries, illnesses, or other medical issues prevent you from working for a limited time period. (Note: “Non-job-related” is an important phrase there. Injuries sustained while you’re on the clock will typically be covered by workers’ compensation rather than short-term disability.)

Many U.S. employers offer a short-term disability plan as an employment benefit. However, only a few states and territories—including California, Hawaii, New Jersey, New York, Rhode Island, and Puerto Rico—require that employers offer a short-term disability plan to their employees. (No matter where you’re located, you can search for jobs at companies that offer short-term disability on The Muse.)

Well, that depends on your specific plan: “By definition, it’s short-term, but it can range in duration. I’ve seen [coverage] be as short as 30 days and as long as one year,” says Chicago-based attorney Michael Bartolic, whose firm focuses on employee benefits and deferred compensation.

Your time off also depends on your specific health problem. “The medical field has guidelines as to how long recovery should take,” Bartolic says. That provides a roadmap for your employer or plan provider to establish a reasonable amount of time for you to be out of work.

As the names imply, short-term disability is used to cover injuries or illnesses that persist for a shorter amount of time (usually less than six months or one year, depending on your plan). In contrast, long-term disability insurance comes into play for issues that will take you out of work for longer than that.

If your disability will render you unable to work in any sort of occupation beyond what even your long-term disability insurance covers, “The insurer paying your long-term disability benefit is typically going to recommend that you apply for Social Security disability, which can be a very lengthy process,” says Joseph McDonald, a partner at McDonald and McDonald, an Ohio-based law practice specializing in disability insurance.

There isn’t one standard definition for a disability that applies across the board.

“It’s all plan- or policy-specific,” Bartolic says. “As a general observation, it’s any sort of injury or illness that renders one unable to do their job.” That could include things like a major surgery with a long recovery period, a chronic illness that requires frequent treatment, or an injury sustained in some sort of accident.

Short-term disability may also cover COVID-19, but only if a doctor has verified that the virus is keeping you from performing your job and/or you can’t do your job from home. Additionally, some places, such as New York, have policies around workers being paid if they need to quarantine. So check your local laws for any COVID-related leave.

What if it’s not something physical that takes you away from the demands of your job? What if you’re struggling with depression or another mental health issue that makes it impossible to fulfill your work responsibilities?

Mental health leave is covered by some short-term disability plans (again, it’s important to check your own plan documents). You should be talking with a qualified mental health professional (such as a psychiatrist, psychologist, or therapist) before your leave, McDonald says, so that they can provide you with support as well as the necessary documentation.

You’ve probably heard of circumstances (like Tiernan’s, as just one example) where people use their short-term disability for pregnancy and maternity leave.

“We actually see a lot of short-term disability policies that specifically address maternity leave,” Bartolic says. These plans also will explain how much time off is offered for maternity leave, which can vary based on things like whether the birthing parent had a vaginal delivery or a C-section.

Some employers exclude maternity leave from their short-term disability plan, however, and may have an entirely separate program to address paid leave for childbirth. If you don’t have coverage for maternity leave under either of these benefits, you may be eligible for unpaid leave under the Family and Medical Leave Act (FMLA).

If your company offers short-term disability, it can generally be structured in two ways:

• Self-funded or self-administered: Your employer provides and funds this benefit themselves.
• Insurance: Your employer works with an insurance company to provide this benefit.

Some companies may blend these two models, with the company funding the part of your paycheck that the insurer doesn’t cover for a given amount of time.

When you take advantage of your short-term disability benefit, your time off is paid—but that doesn’t necessarily mean you’ll be getting your full paycheck. Some plans offer full salary replacement, but most don’t. Instead, they offer a percentage of compensation (usually 50% to 60% of your weekly earnings) with a dollar amount cap.

“There are also programs that award you different amounts based on your longevity with the company,” McDonald says. For example, “If you are there for 10 years and have a 26-week disability period, you might get three months at 100% and then three months at 50%.”

If you live in one of the five states where short-term disability benefits are mandated, then the amount you’ll be compensated is regulated as well.

Be aware that if your employer works with an insurer to offer short-term disability benefits, then payments will often be administered by the insurance company. That means they might arrive in a different form or on a different schedule than you’re used to. For example, when Tiernan used short-term disability, she was given a debit card that her short-term disability payments were added to. “It was typically every 14 days that I was paid,” she says. “Then you’d have to transfer the funds from that debit card to your bank account if that was your preference.”

You can purchase insurance for disability privately, but for a pretty high price. The cost can vary based on your age and the level of benefits, but some estimates state that you should expect to pay between one and three percent of your annual gross income. So, if you’re earning a $50,000 salary, purchasing your own short-term disability policy could cost between $500 and $1,500 each year. “The biggest barrier to securing private coverage is cost,” McDonald says. “Shop around to get the best deal.”

Unfortunately, short-term disability doesn’t offer any direct job protection. You can legally be fired from your job while on leave, and you also aren’t entitled to the exact same position when you return.

However, the Americans With Disabilities Act (ADA) protects people who meet the ADA’s definition of disability—which may be different from the definition in your short-term disability plan—and makes it far more challenging for companies that are covered by the ADA (those who employ 15 or more workers) to fire an employee because of their disability.

Your first step is to make sure that your illness or injury is well-documented, as you’ll have to provide some medical evidence or backing. “Consult with your doctor and find out what you’re up against first. Make sure you speak honestly about your symptoms,” McDonald says. “That medical record will be reviewed by an insurance company, so start out with a strong pronouncement of, ‘Hey, I’m having this problem.’”

Be aware that short-term disability plans have a requirement for how many days you need to be out of work before you can claim disability—it’s called an elimination period. You don’t want to claim short-term disability for something that could be covered by sick days, Bartolic says.

To get the ball rolling with your employer, approach your HR department to file an initial claim (which usually involves a fairly standard form). Don’t have an HR department? Connect with your manager or look at your plan overview to get the necessary documents. Your physician will need to sign off on your claim form before you even submit your application, to vouch for the fact that your injury or illness prevents you from working.

After you submit your claim, your employer or the insurance company that administers your short-term disability plan will request that you submit your medical records so that they can review them and verify that they’re consistent with your disability claim. Contact your healthcare provider’s office to find out the best way to send those records over.

If you find yourself confused about any of the documents or applications, you can ask for help—whether it’s from your company’s HR department or even people at your doctor’s office. “I actually found the team at my physician’s office to be extremely helpful,” says Tiernan, who admits her own leave process was slightly more complicated, as she took advantage of both short-term disability and FMLA for the birth of her child. “They have a whole team dedicated entirely to filling out forms and navigating this process, so I was on the phone with them a lot. They helped me figure out the best forms to fill out, what the dates would be, and any follow-ups that I needed. They even spoke to my HR team directly here at the office.”

“The first thing to do is to carefully read the correspondence that’s saying it’s not being approved,” Bartolic says. “That will tell the person a lot, and will tell them what to do if they disagree with the decision.”

Most disability plans in America are covered under the Employee Retirement Income Security Act (ERISA), which means claims are reviewed through the lens of this federal law. “If your plan is covered by ERISA, the law requires that the denied individual be presented with a right to appeal that decision,” McDonald says. So be sure to take advantage of the appeals process within the designated time frame.

Depending on your disability, you and your employer will need to sort out different logistical elements when you’re ready to get back to work. But that’s not the only factor at play here—there’s also an emotional and relational element involved when you return to the office after an extended amount of time off.

Companies aren’t stagnant and, while you’re on leave, there might be employees leaving and new team members being added as well as adjustments to strategy or workflow. “There were shifts that occurred during my time gone, so I needed to readjust to the changes that had happened,” Tiernan says.

In her case, however, “Most of it was just emotional and mental fatigue after having spent four months not really on a computer every day or using my brain in that kind of way,” she says. But she felt there was an expectation that she’d jump back in full force. “Looking back, I appreciate that now because I don’t think I would’ve been able to transition as well as I had if it had been slow.”

Every person and situation is different, though, and you may find that easing back into work is best for you physically and psychologically. So communicate with your employer and your medical team to ensure a smooth transition.

Your first day onboarding at a new job, when you typically receive all the paperwork about short-term disability and other benefits, can be “kind of a firestorm,” McDonald says. While it’s not exactly a fun topic to think about, it’s important that you familiarize yourself with the details of your plan—so you don’t have to get up to speed when you’re already dealing with a medical setback.

Ideally, you’ll never have to take advantage of your short-term disability benefits. But in the event that the unexpected happens, you’ll be glad that you took the time to understand what’s offered to you. This explainer is a good place to start, but you also need to read through the details of your specific plan.

So often, people are hesitant to take longer leaves. “We gain some sense of identity from our work,” McDonald says. When you’re out for more than a few days, “Not only is there a fantastic disruption in your income, but there is really a disruption in your identity and in your ability to contribute to your family, to your organization, and to your peers.” Your short-term disability benefit can ease at least some of these concerns, so you can focus on healing.

Regina Borsellino also contributed writing, reporting, and/or advice to this article.