Short-Term Disability (STD) is a temporary wage replacement benefit that provides a portion of your income if you are unable to work due to a non-work-related illness or injury. The required length of time an employee must be at a job to qualify varies significantly based on the specific plan offered by the employer and whether the coverage is private or state-mandated. Eligibility can range from the first day of employment to many months later.
How Short-Term Disability Coverage Works
Short-Term Disability (STD) protects an employee’s income during a temporary period of non-work-related medical incapacity. The benefit typically replaces 50% to 70% of the employee’s pre-disability earnings. This income replacement is paid out for a limited duration, often between 9 and 52 weeks, with 26 weeks being a frequent maximum benefit period.
The temporary nature of STD distinguishes it from Long-Term Disability (LTD), which covers more severe conditions for longer durations. STD also differs from Workers’ Compensation, which covers only injuries or illnesses sustained while working. STD applies only to health issues that happen outside of the workplace, such as major surgery, an accident at home, or complications from a pregnancy.
The Primary Eligibility Factor: Employment Tenure
Most employer-sponsored programs impose a mandatory service requirement, known as employment tenure. This is the amount of time an employee must be on the payroll before they become eligible to enroll in the STD plan. Common waiting periods for private plans are 30, 60, 90, or 180 days of continuous full-time employment.
While some plans offer immediate enrollment, most require a new employee to wait a specified time before coverage takes effect. This specific rule is outlined in the plan’s Summary Plan Description (SPD). Reviewing the SPD or the employee handbook is the only way to confirm the required waiting period. A claim filed before the tenure requirement is met will be denied, regardless of the medical condition.
Other Eligibility Requirements
Beyond the employment tenure requirement, the “elimination period” is a separate factor. This is the mandatory period after you become disabled but before benefits begin to be paid. For most STD policies, the elimination period is 7 to 14 days, though some can be as long as 30 days.
Employees will not receive benefit payment during this initial period, even if they meet the tenure requirement. Employees often use accrued sick leave or vacation time to cover lost wages during this time. Another eligibility measure is the “actively-at-work” clause, which prevents enrollment if an employee is already disabled or hospitalized on their eligibility date. This clause ensures the insurance covers only new, unforeseen disabilities that occur while the employee is actively performing their job duties.
Understanding State Mandated Disability Programs
A handful of states and one territory—California, Hawaii, New Jersey, New York, Rhode Island, and Puerto Rico—mandate their own short-term disability programs, often called Temporary Disability Insurance (TDI) or State Disability Insurance (SDI). These state-level programs usually have different, often shorter, tenure requirements that can supersede or supplement a company’s private plan. Some state programs require only a minimum amount of earnings over a specified period, making coverage nearly immediate for a new employee.
For example, in New York, an employee must have worked for a covered employer for at least four consecutive weeks. California’s program requires an employee to have earned at least $300 in the 12 months before the last complete quarter prior to filing a claim. Employees in these regions must understand that state program requirements apply regardless of the specific terms of their company’s private plan.
The Application and Claims Process
The claims process begins with the employee notifying their employer’s Human Resources department or benefits administrator of their impending leave. The administrator provides the necessary claim forms, which typically include three sections: the Employee’s Statement, the Employer’s Statement, and the Attending Physician’s Statement. The employee must complete their section accurately, detailing their medical condition and the date they became unable to work.
The process requires coordination with the medical provider, who must complete and sign the Attending Physician’s Statement. This document provides the medical evidence, including the diagnosis, treatment plan, and the expected duration of the disability. Filing all components of the claim package quickly is important, as many policies have strict deadlines for submitting initial notice and final proof of loss.
What to Do If Your Short-Term Disability Claim Is Denied
If your claim is denied, first review the denial letter, which must state the specific reason for the decision. Common reasons include insufficient medical evidence, not meeting the elimination period, or failing to satisfy the required employment tenure. The denial letter will also outline the internal appeals process, which is the mandatory first course of action for most employer-sponsored plans governed by ERISA.
The appeal should involve submitting new and more detailed medical documentation, such as a letter from your doctor linking your condition to your inability to perform job duties. If the internal appeal is unsuccessful, you may pursue an external review or consult with an attorney specializing in disability claims.