Short-term disability insurance (STD) is designed to help workers by replacing a portion of their salary if they become unable to work due to an illness or injury.
However, unlike some other states, Washington doesn’t have a state-mandated program for short-term disability insurance.
Washington does offer Paid Family and Medical Leave (PFML), which can provide some income replacement when you need to take medical leave. However, STD insurance can supplement PFML, especially for higher-income earners.
In this article, we’ll take a comprehensive look at Washington State short term disability, how it works, and how it interacts with the state’s PFML program.
Understanding Short-Term Disability Insurance (STD) in Washington
If you’re temporarily unable to work due to illness, injury, or another medical condition, short-term disability insurance can replace a portion of your income while you recover. Depending on the policy, benefits can last for up to six months and replace anywhere from a portion of your wages to your full paycheck.
How Does STD Differ from Washington’s Paid Family and Medical Leave (PFML)?
Washington’s PFML program offers 12 weeks of medical leave per calendar year. Short-term disability insurance can supplement those benefits by covering the waiting period before PFML kicks in or by providing additional income replacement.
It’s worth noting that employees who earn more than $87,000 a year may not be fully covered by PFML, making STD a valuable supplement for higher earners in Washington state.
Types of short-term disability coverage in Washington
In Washington, you’ll typically find two main ways to get short-term disability coverage: employer-sponsored group plans and individual STD policies.
Employer-sponsored (group) STD plans
With these plans, your employer arranges for coverage, usually through a private insurance company or a policy they provide directly.
Group plans are often more affordable than individual policies, because the risk is spread across the entire group of employees. Plus, they usually cover all eligible employees, regardless of their current health status.
Individual STD policies
If you’re self-employed or your employer doesn’t offer short-term disability, you may need to purchase an individual policy.
Because the insurance company is insuring you alone, you’ll typically have to go through a health screening. Individual policies also tend to be more expensive than group plans.
Are you eligible for short-term disability? How do you apply?
If you think you might need to use Washington’s short-term disability benefits, here’s how to figure out whether you’re eligible and how to apply.
Eligibility requirements
There are a few common requirements you should know about. First, most policies require a waiting period before the benefits kick in. You’ll also need to provide medical documentation to show that you’re truly unable to work.
The medical certification is a must-have. Without it, your claim will likely be denied.
How to apply for STD benefits
Start by contacting your HR department. They’ll give you the specifics of your company’s policy.
Make sure you fill out those claim forms completely and accurately. Any mistakes or missing information can delay the process.
Finally, get your medical documentation in as soon as possible. The sooner you provide it, the faster your claim can be processed.
Navigating the Claims Process and Potential Issues
Once you’ve filed your claim, what can you expect? Here’s a quick look at processing times, payment details, and what to do if your claim is denied.
Processing Time and Payment
Claims are usually processed in about four weeks, but that can vary. Once your claim is approved, you’ll typically have access to your funds within 1 to 14 days.
Claim Denials and Appeals
If your claim is denied, the first thing to do is carefully read the denial letter. You’ll want to understand why your claim was turned down before you decide on your next steps.
If you believe the denial was in error, you can appeal the decision. But again, it’s important to understand the reason for the denial before you start the appeals process.
Choosing the Right Short-Term Disability Plan (for Employers)
If you’re an employer thinking about offering short-term disability insurance, here are some things to keep in mind:
- Affordability, employee benefits, and talent acquisition. Can you afford the premiums? Will a short-term disability plan help you attract and retain employees?
- Insurance brokers. Brokers can help you find the right group STD plan for your business.
- Employee needs. Take the time to understand what your employees need from a short-term disability plan.
In Closing
Whether you’re an employee or an employer in Washington State, it’s essential to understand how short-term disability insurance works.
Short-term disability coverage can fill gaps in the state’s programs, providing income protection if you can’t work due to a temporary illness or injury. It can also offer peace of mind.
For personalized advice on whether short-term disability coverage is right for you or your employees, be sure to talk with your HR professional or a qualified insurance broker. They can help you understand your options and make the best choice for your specific situation.