Health Coverage For People With Disabilities
If you have a disability, you have three options for health coverage through the government.
Medicaid provides free or low-cost medical benefits to people with disabilities. Learn about eligibility and how to apply.
Medicare provides medical health insurance to people under 65 with certain disabilities and any age with end-stage renal disease . Learn about eligibility, how to apply and coverage.
Affordable Care Act Marketplace offers options to people who have a disability, dont qualify for disability benefits, and need health coverage. Learn about the .
Who Pays For Short
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 doesnt cover for a given amount of time.
How Do You Apply For Short
Your first step is to make sure that your illness or injury is well-documented, as youll have to provide some medical evidence or backing. Consult with your doctor and find out what youre 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, Im 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 disabilityits called an elimination period. You dont 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 . Dont 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 theyre consistent with your disability claim. Contact your healthcare providers office to find out the best way to send those records over.
Disability Insurance And Paid Family Leave Benefits
The California State Disability Insurance program provides short-term Disability Insurance and Paid Family Leave wage replacement benefits to eligible workers who need time off work.
You may be eligible for DI if you are unable to work due to non-work-related illness or injury, pregnancy, or childbirth.
You may be eligible for PFL to:
- Care for a seriously ill family member.
- Bond with a new child.
- Participate in a qualifying event because of a family members military deployment to a foreign country.
To file for benefits, read messages from the EDD, submit online forms, or manage your profile, access your SDI Online account.
Note: It may be necessary to send some documents via U.S. mail.
To provide feedback about the SDI information available on the EDD website, take our SDI Survey.
New:On February 9, 2022, Governor Newsom signed Senate Bill 114 which requires employers with 26 or more employees to provide Supplemental Paid Sick Leave for specific COVID-19 related reasons. The law is retroactive to January 1, 2022, and will end September 30, 2022.
Benefits For Your Divorced Spouse
If you are divorced, even if you have remarried, your ex-spouse may qualify for benefits on your record.
To qualify on your record, your ex-spouse must:
- Have been married to you for at least 10 years.
- Be at least 62 years old.
- Be unmarried.
- Not be eligible for an equal or higher benefit on their own Social Security record, or on someone else’s Social Security record.
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What Happens If The Dac Gets Married
If the child receives benefits as a DAC, the benefits generally end if they get married. However, some marriages are considered protected.
The rules vary depending on the situation. Contact a Social Security representative at 1-800-772-1213 to find out if the benefits can continue.
To speed up the application process, complete an Adult Disability Report and have it available at the time of your appointment.
Is Short Term Disability Insurance Worth It
Whether a short term disability policy is right for you is a decision only you can make. But considering that over 1 in 4 of todays 20-year-olds will become disabled before they retire,3 having a short term disability policy in place can help you feel confident that youre protected, whatever challenges life may bring. If youre not sure how a short term disability policy will fit into your overall financial plan, talk with a financial professional who can help you figure out how to best protect yourself.
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Is Your Job Protected While You Take Short
Unfortunately, short-term disability doesnt offer any direct job protection. You can legally be fired from your job while on leave, and you also arent entitled to the exact same position when you return.
However, the Americans With Disabilities Act protects people who meet the ADAs definition of disabilitywhich may be different from the definition in your short-term disability planand makes it far more challenging for companies that are covered by the ADA to fire an employee because of their disability.
State And Local Disability Programs
If you live in California, Hawaii, New Jersey, New York, and Rhode Island, you may have state-funded disability programs available to you, dependent upon your circumstances. Some other states have assistance programs that offer monetary support to low-income residents who are also faced with serious medical issues. Paid medical leave is available in Washington, D.C., and other locations have unique programs as well. The exact resources available to you vary by state, but you should investigate all your options.
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Apply For Benefits Online
You should apply for disability benefits as soon as you become disabled. Follow these easy steps to apply online for disability:
- To start your application, go to our Apply for Benefits page, and read and agree to the Terms of Service. Click Next.
- On that page, review the Getting Ready section to make sure you have the information you need to apply.
- Select Start A New Application.
- We will ask a few questions about who is filling out the application.
- You will then sign into your mySocial Security account, or you will be prompted to create one.
- Complete the application.
You can use the online application to apply for disability benefits if you:
- Are age 18 or older.
- Are not currently receiving benefits on your own Social Security record.
- Are unable to work because of a medical condition that is expected to last at least 12 months or result in death and
- Have not been denied for disability in the last 60 days.
Note: If your application was recently denied, our application is a starting point to request a review of the determination we made.
You may be able to file online for SSI at the same time that you file for SSDI benefits. Once you complete the online process above, a Social Security representative will contact you if we need additional information.
Eligibility Requirements For State Temporary Disability
State temporary disability benefits are usually easier to get than Social Security disability. In the states that provide for short-term disability, here are some general requirements that apply to all of the states.
- The worker must have worked a certain length of time before being eligible for benefits30 days to six months, depending on the state.
- Some states have a minimum earnings requirement.
- There is a one-week waiting period before benefits are payable.
- The illness or injury must be non-work related.
- Benefits last no more than 26-30 weeks .
- The weekly benefit is approximately 60% of your wages.
- Pregnant women can receive short-term disability for several weeks for delivery and recovery.
- You will need to submit medical records or go to a medical exam to prove your disability.
For information on your state’s specific eligibility rules, see our article on eligibility for state temporary disability benefits.
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For Persons With Disabilities
The Department of Health and Community Services provides policy direction, funding, and operational standards to the four Regional Health Authorities who deliver programs and services to individuals with disabilities and their families. In some instances individuals and families access the programs and services of other departments. The following will define the major programs and services funded by the Department of Health and Community Services and provide information on those that are available from other government departments or agencies.
What Is Short Term Disability Insurance
Disability insurance is sometimes referred to as income replacement because it pays you benefits to replace a portion of the income you lose if youre unable to work due to a prolonged illness or injury. Short term disability insurance typically starts paying benefits within two weeks of a qualifying illness or injury and covers you for a benefit period thats usually between 13-26 weeks. Youll continue to receive benefits until youre able to return to work or until you reach the end of your benefit period.
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What Conditions Qualify For Short Term Disability
Cancer, pregnancy, mental health issues, injuries and musculoskeletal diseases are among the top reasons for disability claims. Coverage varies by policy, but your plan should outline if there are any conditions that would be exempt from coverage under your policy. Unlike Workers Compensation, short term disability insurance pays benefits for an injury or illness unrelated to your job. You can also purchase additional cancer, accident or critical illness insurance to supplement your short term disability benefits if youre unable to work for one of those reasons.
Is Your Condition Found In The List Of Disabling Conditions
For each of the major body systems, we maintain a list of medical conditions we consider severe enough to prevent a person from doing SGA. If your condition is not on the list, we must decide if it is as severe as a medical condition that is on the list. If it is, we will find that you have a qualifying disability. If it is not, we then go to Step 4.
We have two initiatives designed to expedite our processing of new disability claims:
- Compassionate Allowances: Certain cases that usually qualify for disability can be allowed as soon as the diagnosis is confirmed. Examples include acute leukemia, Lou Gehrigs disease , and pancreatic cancer.
- Quick Disability Determinations: We use sophisticated computer screening to identify cases with a high probability of allowance.
For more information about our disability claims process, visit our Benefits for People with Disabilities website.
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Whats The Difference Between Short Term And Long Term Disability Insurance
As the name indicates, short term disability insurance is intended to cover you for a short period of time following an illness or injury that keeps you out of work and is usually offered through an employer. While policies vary, short term disability insurance typically covers you for a term somewhere between 13-26 weeks and can replace anywhere from 40-70% of your income during that benefit period. If you have both short term and long term disability policies in place, short term disability will pay you benefits during the waiting period before your long term disability coverage begins, at which point youll transition from one policy to the next to receive benefits. For that reason, it makes sense to have both policies to help ensure an unexpected illness or injury wont derail your financial confidence for a few months or for several years.
Special Rules For People Who Are Blind Or Have Low Vision
We consider you to be legally blind under Social Security rules if your vision cannot be corrected to better than 20/200 in your better eye. We will also consider you legally blind if your visual field is 20 degrees or less, even with a corrective lens. Many people who meet the legal definition of blindness still have some sight and may be able to read large print and get around without a cane or a guide dog.
If you do not meet the legal definition of blindness, you may still qualify for disability benefits. This may be the case if your vision problems alone or combined with other health problems prevent you from working.
There are several special rules for people who are blind that recognize the severe impact of blindness on a person’s ability to work. For example, the monthly earnings limit for people who are blind is generally higher than the limit that applies to non-blind workers with disabilities.
In 2022, the monthly earnings limit is $2,260.
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Can I Apply For Temporary Social Security Benefits
Disability benefits through the Social Security Administration are only available to people who are disabled for 12 months or longer and who have an impairment that meets severity level requirements.
Your temporary disability may last a year or may be shorter in duration. The type of disability benefits for which you should apply depends on how long your medical condition is expected to be out of work.
Free Computers And Medical Equipment
Free or low cost internet and computers may be provided by some cable companies. Some will offer Internet access at a reduced cost or free to low-income and/or disabled individuals and families. As a couple examples, students that are eligible for the federal government National School Lunch Program may obtain a computer and a low cost internet through Comcast’s Internet Essentials program. Learn more on .
Another option is a program known as Connect2Compete. Various non-profit agencies, companies and corporate entities participate. They may offer discounted high speed Internet, free digital literacy training and low-cost computers.
People with a disability can get free medical equipment. Charities, Medicare, government programs and other agencies provide a wide variety of items based on their need. Whether it is for mobility issues, a mental or physical disability, serious illness or health care needs, assistance is offered. Find
Assistive technology offices are located in most states. If you need access to a computer for a critical task, such as searching for a job or other activities that are essential to the disabled living independently, this government agency may be able to help. There are also non-profits that can offer the disabled or their caregivers access to durable medical equipment.
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Whats It Like To Return To Work After Short
Depending on your disability, you and your employer will need to sort out different logistical elements when youre ready to get back to work. But thats not the only factor at play heretheres also an emotional and relational element involved when you return to the office after an extended amount of time off.
Companies arent stagnant and, while youre 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 shed jump back in full force. Looking back, I appreciate that now because I dont think I wouldve 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.
Regina Borsellino also contributed writing, reporting, and/or advice to this article.
Benefits For Your Spouse
Benefits are payable to your spouse:
- Age 62 or older, unless your spouse collects a higher Social Security benefit based on their earnings record. The benefit amount for your spouse is permanently reduced by a percentage, based on the number of months up to their full retirement age.
At any age if they are caring for your child under age 16 or who was disabled before age 22, and is entitled to benefits.
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When Its A Good Option
Private disability insurance is always a good option if you are covered. The biggest problem is that most people dont know about it and so often are not covered. If you are not covered and recently became disabled, you probably wont be able to start getting disability insurance coverage because of your pre-existing condition, unless you sign up through an employer or other group plan.
Information You Need To Apply
Before applying, be ready to provide information about yourself, your medical condition, and your work. We recommend you print and review the . It will help you gather the information you need to complete the application.
Information About You
- Your date and place of birth and Social Security number.
- The name, Social Security number, and date of birth or age of your current spouse and any former spouse. You should also know the dates and places of marriage and dates of divorce or death .
- Names and dates of birth of children not yet 18 years of age.
- Your bank or other and the account number.
Information About Your Medical Condition
- Name, address, and phone number of someone we can contact who knows about your medical conditions and can help with your application.
- Detailed information about your medical illnesses, injuries, or conditions:
- Names, addresses, phone numbers, patient ID numbers, and dates of treatment for all doctors, hospitals, and clinics.
- Names of medicines you are taking and who prescribed them.
- Names and dates of medical tests you have had and who ordered them.
Information About Your Work:
- Award letters, pay stubs, settlement agreements, or other .
We accept photocopies of W-2 forms, self-employment tax returns, or medical documents, but we must see the original of most other documents, such as your birth certificate.
Do not delay applying for benefits because you do not have all the documents. We will help you get them.
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