If medical conditions have rendered you disabled for any period of time, you need to understand the types of disability benefits available and how to access them.

A Columbus, Ohio short-term/long-term disability insurance attorney can help you understand what options you have to make it through a period of not working.

Short-Term vs. Long-Term Disability

If you are disabled it means that you cannot work. The designation of short-term or long-term depends on the length of your disability period. A short-term disability generally persists for less than one year. A long-term disability lasts longer than one year.

Disability Insurance

Both short-term and long-term disability insurance describe private insurance benefits. That means you or your employer purchase short-term and long-term disability insurance from a private insurance company. Some employers provide group disability insurance policies as part of their benefits packages. If your employer does not offer short-term or long-term disability benefits, or if you want additional coverage, you can buy an individual policy from an insurance agent. Private insurance is different from a government benefit like workers’ compensation or Social Security disability.

Can You Receive Both Workers’ Compensation and Short-Term Disability?

It’s important to understand that workers’ compensation and short-term disability insurance operate under different rules, and they rarely overlap. Workers’ compensation is designed to help if you are injured or become ill as a direct result of your job—let’s say you slip at the office or develop carpal tunnel from repetitive work tasks. In contrast, short-term disability insurance covers situations where you’re unable to work due to reasons unrelated to your job, such as an injury from a weekend soccer game or a medical condition like pregnancy complications.

You usually cannot receive benefits from both workers’ compensation and short-term disability for the same incident. If your absence from work is attributed to a work-related event, your claim typically falls under workers’ compensation. Most insurance policies prohibit “double-dipping,” meaning you won’t be able to collect payouts from both types of coverage for a single accident or illness. Instead, you will generally receive one or the other based on the cause and location of your injury or illness.

Understanding which coverage applies—and when—is key to ensuring you receive the benefits that best match your circumstances. If you have questions about your specific situation, it’s always wise to consult with your HR department, insurance carrier, or a qualified attorney.

The Value of Voluntary Benefits

Voluntary benefits, including disability insurance, dental, vision, and life coverage, add meaningful value to a benefits package. By offering these options, employers provide employees with an extra layer of security and peace of mind that extends beyond basic health insurance.

Providing access to voluntary benefits allows employees to tailor their coverage to fit their individual needs and family situations. For instance:

  • Disability insurance helps replace income if a medical condition prevents someone from working.
  • Dental and vision insurance cover crucial services often excluded from standard health insurance—and can make preventative care more accessible.
  • Life insurance offers important financial protection for loved ones in case of the unexpected.

When employers include these voluntary benefits, they not only support the financial well-being of their team but also demonstrate a deeper investment in their employees’ overall health and security. This can lead to higher job satisfaction, increased retention, and a more attractive workplace.

Should Employers Offer Short-Term, Long-Term, or Both Types of Disability Insurance?

Because no one can predict when illness or injury might strike, employers are wise to consider disability insurance as a critical part of their benefits package. Offering both short-term and long-term disability coverage ensures a safety net for employees facing any length of work absence due to health issues.

By providing both types of policies, employers not only help protect their staff from the sudden financial strains that come with being unable to work, but also foster a sense of security and loyalty within the workforce. When employees know they’ll be supported—whether they need just a few weeks to recover or are facing a long-term health challenge—it can reduce stress and demonstrate genuine care for their wellbeing.

Beyond the benefit to employees, this approach can also help businesses minimize disruption and maintain productivity, as team members are more likely to return to work when they feel valued and protected. Ultimately, a combination of short-term and long-term disability insurance offers the most comprehensive support for both employees and employers alike.

What Are Coverage Levels in Disability Insurance?

Coverage levels in disability insurance determine how much of your regular income you can expect to receive if you become disabled and are unable to work. This percentage—sometimes called the “replacement rate”—reflects how much of your gross wages the policy will pay out during a qualifying disability.

The specifics will depend on your individual policy, but both short-term and long-term disability insurance typically replace somewhere between 40% and 80% of your pre-disability earnings. For example, one policy might cover 60% of your salary, while another could go as high as 70%. This replacement rate helps ensure you can continue to meet your financial obligations even while you’re recovering and unable to work, but it rarely covers your full paycheck.

It’s important to review your policy documents or consult your human resources department or insurance agent to understand exactly how much coverage your plan offers.

How Disability Insurance Protects Employers and Employees

Offering short-term and long-term disability insurance isn’t just about providing a safety net for employees—it can be a smart move for your business as well. By including disability coverage in your benefits package, you help ensure your team members are protected if they’re unable to work due to illness or injury. This safeguard means employees can focus on recovery without unnecessary financial stress, which in turn can improve workplace morale and productivity.

From the employer’s perspective, disability insurance can help reduce turnover and minimize interruptions in workflow. When employees know their income is secure during difficult times, they’re more likely to remain loyal, reducing the cost and hassle of finding and training replacements. You can enhance your package by seeking advice from experienced agents, or by comparing well-known providers such as Guardian, MetLife, or The Standard to find the right mix for your staff’s needs.

In short, disability insurance creates a win-win: employees are protected from unforeseen setbacks, and employers maintain a more stable, committed workforce.

Short-Term Disability Insurance

Short-term disability insurance replaces some of your income for a period of a year or less when you cannot work at all or can only work part-time because of a disability. Short-term disability benefits start after you run out of leave or sick days. To obtain coverage, you or your employer must pay a monthly premium. When an illness or injury prevents you from working, you apply for benefits through your human resources representative or your insurance agent.

If your insurance grants benefits, under a typical policy you will receive around 60% of your previous income. For instance, if you earned $1,000 per week, short-term disability insurance would pay you $600 per week while receiving benefits.

What Is Considered Fraud in Short-Term Disability Claims?

Fraudulent claims in short-term disability insurance occur when someone intentionally provides false or misleading information to obtain benefits they are not entitled to receive. This can take several forms, such as:

  • Submitting fake medical documentation or altering existing records to exaggerate the severity or existence of a medical condition.
  • Misrepresenting your ability to work—claiming you are unable to perform job duties when you are actually capable of working part-time or in another capacity.
  • Failing to disclose income from other sources or continuing to work while collecting disability benefits.

Insurance companies, including well-known providers like MetLife and The Hartford, take fraud seriously and may launch investigations if fraudulent activity is suspected. Penalties can include repayment of benefits, cancellation of coverage, and, in severe cases, legal action. Always provide accurate, honest information when filing your claim to ensure compliance with your policy.

Are Short-Term Disability Insurance Benefits Taxable?

Whether your short-term disability insurance benefits are taxable depends primarily on how your policy was paid for. If your employer pays the entire premium or you pay your portion with pre-tax dollars through payroll deductions, any benefits you receive are generally considered taxable income. This means you’ll need to report these payments on your tax return, and taxes will be owed on the amount you receive.

On the other hand, if you purchased your own short-term disability policy independently—outside of your employer’s plan—and paid the premiums using after-tax dollars, the benefits you receive typically are not taxable. In this case, since you’ve already paid taxes on the money used to buy the policy, the income replacement you receive is tax-free.

Short-term disability policies usually pay between 40% and 70% of your regular earnings while you’re unable to work. If your benefits are taxable, you may have the option to have taxes withheld from each check to avoid a larger tax bill at the end of the year. It’s a good idea to consult your human resources department or a tax professional for guidance on your particular situation.

Does Short-Term Disability Insurance Cover Pregnancy?

Yes, short-term disability insurance typically covers pregnancy and childbirth, treating them much like any other medical condition that prevents you from working. Most policies provide a portion of your income—often between 50% and 70%—during your recovery period, which usually lasts six to eight weeks following delivery.

It’s important to review your specific policy since the length and amount of coverage can vary. Also, keep in mind that you generally cannot receive short-term disability benefits and paid family leave at the same time; you will need to choose which benefit to use during your leave. Be sure to talk with your HR representative or insurance agent to understand exactly how your coverage applies to maternity leave.

How Short-Term Disability Insurance Works with Paid Family Leave

When it comes to pregnancy, short-term disability insurance typically covers a portion of your income during your recovery period—often between 6 to 8 weeks following childbirth, depending on your medical provider’s certification and the details of your policy. Most short-term disability plans pay about 50% to 70% of your regular wages during this time.

However, it’s important to understand how these benefits interact with paid family leave programs. In most cases, you cannot collect short-term disability benefits and paid family leave for the same period—they generally cannot be “stacked” together. You may be eligible to receive both, but not at the same time; for example, you might first use short-term disability for your own medical recovery, then transition to a paid family leave program if you wish to take additional bonding time with your child.

If you have questions about sequencing these programs, speak with your human resources representative or an experienced attorney, as state rules and private policy terms can differ. This way, you’ll make the most of your available benefits during parental leave.

Preexisting Conditions and Short-Term Disability Coverage

A key factor to understand when evaluating short-term disability insurance is how your policy treats preexisting conditions. Many insurance companies have specific rules about medical issues you experienced or were diagnosed with before your coverage began. These are considered “preexisting conditions.”

In many cases, if your disability arises from a condition you had before your policy’s effective date, your claim may be denied. For example, if you were receiving treatment for a back injury before obtaining coverage, and that injury prevents you from working after your policy starts, the insurer may decide you are ineligible for benefits under their preexisting condition exclusion.

It’s important to review your plan documents, as some policies will cover preexisting conditions after you have been enrolled and symptom-free or treatment-free for a certain period—often called a “look-back period” or “waiting period.” This detail varies from one insurer to another, so make sure you know how your particular policy addresses these situations. If you have questions about your eligibility, a disability insurance attorney or your insurance agent can clarify your rights and options.

Exclusions and Limitations for Short-Term Disability Coverage

Not every situation that keeps you away from work will be covered by short-term disability insurance. Most policies come with specific exclusions and limitations you should be aware of.

Generally, you must be unable to perform your job duties due to a documented medical condition, as confirmed by your doctor. Common qualifying scenarios include recovering from surgery, managing a serious illness, or medical restrictions related to pregnancy.

However, there are important restrictions:

  • Work-Related Injuries: Injuries that happen at work are usually not covered by short-term disability insurance, since these fall under workers’ compensation, which all employers in Ohio are required to provide.
  • Preexisting Conditions: Many policies exclude benefits for disabilities resulting from preexisting medical conditions, especially if you became disabled shortly after enrolling in coverage.
  • Intentional or Foreseeable Injuries: Disabilities that arise from injuries caused intentionally, or while engaged in criminal activity, are often not eligible for benefits.
  • Caring for Others: If you need to take time off to care for a sick family member, short-term disability insurance generally does not provide benefits. While you may be entitled to job protection under the Family and Medical Leave Act (FMLA), disability insurance is reserved for your own medical condition.

Understanding these limitations can help you plan ahead and avoid surprises when you need support the most.

Does Short-Term Disability Insurance Protect Your Job?

While short-term disability insurance provides important income replacement, it generally does not guarantee job protection during your leave. In most cases, these benefits allow you to continue receiving a portion of your pay while you recover, but your employment status is not automatically safeguarded by the insurance itself.

To address job security while on short-term disability, other legal protections may apply. For instance, the federal Family and Medical Leave Act (FMLA) may entitle eligible employees to up to twelve weeks of job-protected leave, though this is separate from disability insurance and has its own requirements.

It’s important to review both your disability insurance policy and applicable federal and state laws to fully understand your rights regarding job protection while on leave.

The Role of State and Federal Laws in Job Protection

While short-term disability insurance provides partial income replacement during a period you cannot work, it’s important to understand how your employment status is protected. In most cases, employees remain on the payroll while receiving short-term disability benefits. However, actual job protection depends on the specific laws of your state and applicable federal regulations.

The Family and Medical Leave Act (FMLA) is a key federal law that can protect your job during a qualifying medical leave, including periods when you’re receiving short-term disability. Under FMLA, eligible employees may take up to 12 weeks of unpaid, job-protected leave per year for certain medical reasons, ensuring you can return to your position—or an equivalent one—after your leave ends.

In summary, while short-term disability insurance pays partial wages, federal laws like FMLA determine whether your job will be protected during that leave period. Always check both Ohio law and your employer’s policies to fully understand your rights.

Long-Term Disability Insurance

Long-term disability insurance helps replace some of your income when you cannot work at all or can only work part-time because of a disability for an extended period of over one year.

You apply for benefits by speaking with your human resources representative or your insurance agent.

What Qualifies as a Long-Term Disability?

Long-term disability coverage typically applies if you are unable to work due to serious or ongoing medical conditions lasting at least six months. Common qualifying conditions include:

  • Chronic pain that makes it difficult or impossible to perform your job duties for an extended period
  • Cancer treatments that require you to take prolonged time away from work
  • Major illnesses, such as heart disease, multiple sclerosis, or severe respiratory conditions
  • Serious injuries from accidents, whether at work or elsewhere, that prevent you from returning to your position

It’s important to note that most long-term disability insurance policies coordinate benefits with other sources of income replacement. For example, if you become eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), your insurer may reduce or end your long-term disability benefit based on the amount you receive from these programs. This avoids “double-dipping” and ensures that your total income replacement does not exceed your pre-disability earnings.

Qualifying for Long-Term Disability Coverage

To qualify for long-term disability insurance benefits, you typically must show that your condition prevents you from working not just in your current job, but in any occupation suited to your education, experience, and training. These policies usually set a higher standard than short-term disability insurance, which may only require proof that you’re unable to perform your specific job duties.

Every long-term disability insurance policy clearly defines what counts as a qualifying condition and how long your disability must last to meet eligibility requirements. Common qualifying circumstances include:

  • Extended illnesses or injuries, such as those that persist for more than six months
  • Chronic conditions (e.g., severe back pain, cancer treatments, or progressive diseases)
  • Any mental or physical impairment that significantly limits your ability to work in any occupation

It is also important to note that if you become eligible for other types of income replacement—like Social Security Disability Insurance (SSDI)—your long-term disability benefits might be reduced or even replaced, depending on the policy’s rules. Always review your policy details or consult with an attorney to understand which situations are covered and how benefits might coordinate with other programs.

Long-term disability requires a waiting period between the date you leave work and the date you actually get your benefits. Depending on your plan, you may wait anywhere between 90 days and a year before benefits are paid. Like short-term disability, long-term disability insurance usually pays a percentage of your income—usually 80% for the first few weeks then a lower percentage in the weeks that follow.

Many people choose to apply for Social Security Disability and or Supplemental Security Income benefits from the government while receiving long-term disability insurance benefits.

Understanding Elimination Periods in Disability Insurance

Elimination periods, sometimes called waiting or qualifying periods, are an important feature of both short-term and long-term disability insurance policies. The elimination period is the length of time you must wait after becoming disabled—meaning the date you can no longer work—before your insurance benefits begin.

For many short-term disability policies, the elimination period is typically about 14 days. In contrast, long-term disability policies often require a longer waiting period, commonly around 90 days. This means you’ll need to be unable to work for that specified amount of time before the insurance company starts paying your benefits.

It’s worth noting that the elimination period begins on the first day you are unable to work due to your disability, not the date you actually file your claim. Understanding and planning for this waiting period is important so you can manage your finances until your benefits start.

Are Long-Term Disability Insurance Benefits Taxable?

Whether or not your long-term disability benefits are taxable depends on who paid the premiums and how they were paid. If you pay the full cost of your long-term disability insurance with after-tax dollars, your benefit payments are generally tax-free. However, if your employer pays all or part of your premiums, or if the premiums are paid with pre-tax dollars, some or all of your disability benefits may be subject to income tax.

For example, if your employer provides disability coverage as part of your benefits and pays the premiums out of pre-tax income, any benefits you receive will likely be taxed as regular income. On the other hand, if you purchase an individual disability policy and pay the premiums yourself with money that’s already been taxed, the benefits you receive should not be taxed.

You may also have the option to have taxes withheld from your disability payments, or you can plan to resolve any tax liability when you file your annual tax return. It’s a good idea to consult your tax advisor or accountant to understand the tax implications for your specific situation.

Denial of Benefits

Applications for short-term and long-term disability insurance require the submission of medical records. Often times, insurance companies deny disability benefits applications based on the medical records you submitted.

If your insurance company denies benefits, it might be time to hire an Ohio short-term/long-term disability insurance lawyer. A disability attorney can help your through the appeals process. Generally, an appeal requires building a record and submitting additional medical documents to your insurance provider. In order to build a record you should ask your doctors for written opinions, get any objective testing that reveals the extent of your disability, request letters or expert testimony, and track down any missing records. A short-term/long-term disability insurance lawyer can help build the record and can communicate and negotiate with insurance companies.

Appealing an insurance company’s decision may not always result in granting of benefits. If an insurance company sends a final letter of denial, this ends what lawyers call the administrative process. You could still get benefits, even after an insurance company denies your appeal.

The next step is to file a lawsuit against the company. Claims for denial of benefits arise under a statute called the Employee Retirement Income Security Act of 1974, or simply ERISA. If you file an ERISA lawsuit, a federal judge will review the administrative record to decide whether the insurance company violated its own policy or any part of ERISA.

Can Short-Term Disability Benefits Be Denied for Not Following Treatment?

Yes, your short-term disability benefits can be denied if you do not follow your doctor’s prescribed treatment plan. Insurance companies expect you to take reasonable steps to recover from your condition. If you ignore medical advice, skip appointments, or refuse recommended treatments without a valid reason, your insurer may view this as a lack of cooperation and deny your claim. To avoid jeopardizing your benefits, stick closely to your healthcare provider’s instructions and keep a record of your appointments and treatments. This shows both your commitment to recovery and helps support your claim.

Meeting Deadlines When Applying for Long-Term Disability Benefits

When applying for long-term disability benefits, it’s essential to pay close attention to the deadlines set by your insurance policy and your insurer. Missing a required deadline can result in an automatic denial of your claim—even if you otherwise qualify for benefits.

Most long-term disability policies have strict timelines you must follow. These typically include:

  • Notification Deadline: You generally must notify your insurance company—or your employer’s HR department—about your disability within a certain number of days after you stop working. This period commonly ranges from 30 to 90 days.
  • Proof of Loss Deadline: After notifying your insurer, you must submit all required forms and detailed medical documentation by the deadline outlined in your policy, which may be anywhere from 30 days to a few months from the date you first miss work.
  • Responding to Requests: If the insurance company requests additional records or information, respond promptly, as insurers usually set specific timeframes for each request.

Carefully review your policy’s terms, and make sure to submit every required document before the listed due dates. If you aren’t sure about a particular deadline or requirement, talk to your human resources representative or consult with a disability attorney. Being proactive with deadlines is one of the most effective ways to protect your right to benefits.

Finding A Short-Term & Long-Term Disability Insurance Attorney

The short-term/long-term disability insurance attorneys at Agee, Clymer, Mitchell & Portman have significant experience representing clients with disabilities throughout Ohio. We know exactly how to handle short-term and long-term disability insurance matters. In addition, our experience in all areas of disability law allows us to ensure clients avail themselves of all possible avenues to receive benefits. Our highly sophisticated team has the capability to file and represent clients in multiple overlapping claims. With offices in Columbus, Circleville, Jackson, Chillicothe, Cincinnati, Dayton, Delaware, and Galion, we are among Ohio’s premiere disability law firms.

If you are experiencing problems getting short-term or long-term disability insurance benefits, contact Agee, Clymer, Mitchell & Portman today online or call at 1-800-678-3318.