If you or your loved one is dealing with a short term disability in the state of Pennsylvania, you may be wondering what steps you should take in order to receive the necessary financial support to best support the situation. In this guide, we will help you go through all of the necessary information you need to know and steps to take to best deal with short term disability in Pennsylvania.
What is Short Term Disability?
Short term disability refers to a kind of insurance you can receive if you cannot work because of a medical condition or accident for a short period of time. In order to qualify for short term disability, you will need the approval and certification of a medical professional certifying your condition makes you unable to work.
Once you have submitted your short term disability claim, the Bureau of Disability Determination (BDD) will review and determine whether your submission makes you eligible for short term disability insurance. There are several requirements which need to be met in order to qualify for short term disability in Pennsylvania. According to the state governmental website, these include:
● The condition must be a physical or mental impairment that affects your personal and work life significantly
● You must be unable to perform the tasks required by your work because of your condition, and this must be demonstrable
● The inability to perform work duties “due to a continuous, incapacitating serious health condition, caused by an illness, injury, impairment, or physical or mental condition”
Short term disability allows you to receive financial compensation even if you are unable to work because of a justified physical or mental cause. There are a variety of short term disability causes which may apply, ranging from car accidents, concussions, to pregnancy, but it is important to inform yourself about the specific kinds which qualify for such help before applying.
What Conditions Qualify Short Term Disability in PA?
Unlike long term disability coverage, which applies to sicknesses or handicaps which last for at least one year or are predicted to lead to death, short term disability coverage applies to situations where a physical or mental impairment is predicted to last for a short period of time.
Short term disability coverage is not an obligation on the part of the employer. A short term disability coverage is considered a benefit to employment, meaning non-compensation related benefits you may receive as an employee. These may include health insurance and vacation time-off as part of your contract. These may also include short and long term disability insurance coverances.
What is the Process for Getting My Short Term Disability Approved?
According to the official Pennsylvania government website, there are five main aspects considered in the process of applying for short term disability in PA. They will be based on the information you will submit as part of your application for short term disability coverage. These include:
● The definition of the medical condition you are suffering from (physical, mental, type of injury, etc)
● The date at which your disability or impairment began
● A demonstration of how said disability or impairment negatively affects your capability to perform necessary tasks for work
● Proof or certification of a medical professional certifying your condition handicaps your ability to work
● The kinds of treatments and/or medications you have received (if any) in light of said disability or handicap
If you qualify for all of the necessary requirements, you should be able to submit your application worry-free. The requirements include both those listed in the earlier section on “What is Short Term Disability?” as well as the requirements listed in this section above. If your application is rejected, keep reading below to see what you can do and how you can appeal.
How to Qualify for Short Term Disability in PA
As stated above, to qualify for short term disability in Pennsylvania, you must have proof of an incapacity to perform required tasks as part of your job due to a recoverable physical or mental ailment. There are a few more requirement to be eligible for short term disability insurance which are important to keep in mind as you go through the application process:
● You must be low income or lack fundamental resources
● You must have a United States citizenship or qualify as a non-citizen who is allowed to receive such aids
● You must be eligible to meet the criteria of a person in need of short term disability insurance
● You must not be active in any other kind of labor for which you receive compensation that would be in contradiction with your disability claim
If there are several of these categories you do not fall under, it may make it difficult for you to receive approval for your short term disability coverage application. That being said, if it is rejected, there are ways to appeal, and fight, the decision. We will go over these possibilities further down.
What Documents Do I Need for My Application?
There is a long list of documents which are either necessary or recommended for your application. Once you have decided to apply, make sure to start gathering up documentation on the list so the process can be expedited. Some of the records required include:
● Social Security Number
● Contact and residential information (address)
● List of any and all medications and doses you are taking
● Medical records from medical institutions and professionals
● Medical test results (scans, X-rays, lab tests, etc)
● Photocopy of W-2 Wage and Tax Statements form
● Bank deposit form if applicable
Remember, this is only a part of what you may need for your application. You can find the rest of the necessary documents here. It may also be the case that the office dealing with your particular case asks for additional documentation, justification, or evidence of some kind to continue the application process.
How Long Will it Take to Get Approved for Short Term Disability in Pennsylvania?
If you are wondering how long it will take for your short term disability request to get approved in Pennsylvania, the answer is upto two weeks. If you are in a tight situation and need to receive short term disability coverage fast, make sure you submit your request as soon as possible. This will help mitigate possible delays and stress you may experience if you do not receive an answer right away.
As a general rule of thumb, it is always a good idea to get started on the bureaucratic process of your application right away after your accident or ailment arises. As much as it can be a stressful situation to deal with all of the paperwork, especially if you are dealing with a physical or mental injury, it will benefit you in the long run to submit your application as soon as possible.
How Much Can You Make on Short Term Disability in PA?
According to the Disability Rights of Pennsylvania (DRP), you can earn up to “½ and ⅔ of your salary between 13 and 26 weeks.” It is absolutely crucial to check exactly what percentage of your salary you are allocated and for how many weeks you are eligible to receive it so you can budget accordingly. Considering that it does represent a significant cut in pay, it is important to budget around having less income during your time off from work.
Here is an example: let’s say you are making an average of $2,000 per month working full time. This means you are making roughly $500 per week. If you are granted short term disability at ⅔ your salary for 20 weeks, this means that you would be making an average of $300 per week (instead of $500) and in total would receive $6,000 in total (instead of $10,000).
Along with the cut in salary, you may accumulate additional expenses due to your ailment such as medication costs, doctor visit fees, and any other medical services you may require. Taking the necessary time off to recover is absolutely crucial, and to reduce possible unnecessary financial stress, it is best to create a budget as you take time off to avoid any more difficulties.
Getting Denied for Short Term Disability in PA
You may get denied for short term disability in Pennsylvania after you submit your application. This may be the case even if you answer all of the questions properly and that you feel you qualify for all of the requirements. If this is the case, do not give up hope: you can appeal the decision, and fight for your right to receive short term disability coverage.
Can I Appeal a Rejected Short Term Disability Application?
Yes, absolutely. You can appeal to any decision made on behalf of your request for short term disability coverage. That being said, the process of appeal can be long and strenuous, and can be a cause of additional stress in your life. This is why taking the time to do the proper research and making sure you have all of the necessary documentation properly filled out. This help help avoid the hassle of having to re-send incomplete paperwork, which can prolong the process.
How Do I Appeal?
To appeal, you will need to request a court hearing to review your case. It is important to note that this must be done within 60 days of receiving the rejection notice. If you do not make you request in time, it may be dismissed. If you have legitimate cause for the delay, you can send documentation to the court and they may grant you an extension for your appeal.
To request a hearing, you, or your representative if you have hired one, will need to submit either a written or online form properly filled out with all of the required information. It may be the case that after receiving your request for a hearing, the office asks for additional documentation or evidence. You will then be contacted to schedule a hearing date. It is important to submit any and all information regarding your disability no later than 5 business days before the hearing.
At the hearing, a judge may ask for a medical professional to testify for your disability. We recommend seeking out a representative to help defend your case. Once the hearing has been completed, you will receive a written response by the judge regarding your appeal. If you still disagree with the decision, you can file a request to have the court decision reviewed.
Additional Resources for the Disabled
Whether or not you are granted short term disability, there are many great resources available to help you live with your disability. The Pennsylvania government website has an entire list of online resources you can access designed to support disabled people.
If you have questions regarding the application process, your rights as a disabled person in the state of Pennsylvania, or believe you may be facing a form of discrimination based on your disability, you can check out the Disability Rights Pennsylvania (DRP) website which is ful of resources to help you.
If you are looking for specific information regarding the rights of and laws surrounding disabled people in the United States, you can check out the Americans with Disabilities Act (ADA) website which details everything you may want to know and more.
Conclusion
Short term disability coverage can make worlds of a difference if you are dealing with a severe, short term physical or mental injury in Pennsylvania. If you do not take the necessary time off, the accumulation of stress and fatigue may end up worsening your condition in the long run. That being said, remember to carefully look through everything required and all of the qualifications needed in order to have a smooth and hassle-free application process.