Where should you turn if you are sick or injured and cannot work in Illinois?
Your answer depends on the incident location (on or off the job) and how long you might be without an income.
Short-term disability covering off-the-job sicknesses and injuries lasting less than one year is voluntary. The state does not require employers to provide the benefit, so you must sign up for a private insurance policy before you need it.
Meanwhile, the government mandates coverage for two temporary disability programs. Most people can apply for benefits for occupational losses and off-the-job medical conditions lasting twelve months or longer.
Optional Short-Term Disability
The State of Illinois does not require all employers to provide short-term disability insurance to its employees to protect their incomes from non-occupational (off-the-job) accidents and illnesses lasting less than one year. It is optional.
Therefore, most people will need to purchase a policy proactively to address this coverage hole – although there are some exceptions.
How to Apply
The number one rule when applying for short-term disability benefits in Illinois is that you must have an insurance policy in force before becoming sick, hurt, or pregnant.
Apply for Expense Benefits
If you did not purchase short-term disability before your need, you could not apply for benefits because you lack coverage. However, the lost income could make you eligible for other government benefits to help with expenses.
Government benefits to help pay personal bills go to low-income families based on their projected earnings, not what they made in the past. You might get immediate help with housing, grocery, energy, internet, medical, repair, and water bills.
Apply for Income Benefits
You can apply for short-term disability income benefits in Illinois by filing a claim with the issuing insurance company or governing agency if you already have coverage in force.
State Employees
Illinois State Government employees with at least eighteen months of accredited service automatically have short-term disability covering non-occupational accidents and illnesses through the State Employee Retirement System (SERS).
Apply for SERS disability benefits by completing the claim form.
Federal Employees
Federal government employees working in Illinois do not automatically have short-term disability insurance, but they have a partial substitute: the Federal Employee Paid Parental Leave Act (FEPFLA).
Apply for FEPFLA benefits by completing the claim form after the birth of a newborn baby.
Apply for Coverage
You can apply for short-term disability coverage by completing a new policy application at work or through a licensed insurance agent outside your employer.
To start the process, ask for a personalized insurance quote. An agent licensed in Illinois may contact you to present monthly premium estimates for various feature configurations: monthly benefit, elimination period, and benefit period.
The agent will help you complete the new policy application by asking you medical history questions and submitting the document to the insurance company for underwriting review. You must show evidence of good health to purchase the coverage.
Qualifying Conditions
For those with coverage already in force, it may help to know what medical conditions qualify for short-term disability in Illinois.
Pregnancy
Pregnancy qualifies for short-term disability when the coverage begins before conception, and a valid medical reason prevents the mother from performing the full-time duties of her job.
Do not wait until after conception to buy coverage. Any new policy will exclude your pre-existing condition for at least twelve months. In other words, you can obtain coverage for accidents and illnesses unrelated to your current pregnancy.
Illinois does not have paid maternity leave benefits outside the Federal and Chicago municipal governments. Therefore, purchasing a policy from a private insurance company is the best way to protect your income from this foreseeable event.
Mental Health
Mental health sometimes qualifies as a valid reason, depending on the type of coverage you have, such as group or individual plans.
Group policies cover mental health issues more frequently than individual plans. Therefore, people concerned about protecting their income in case of anxiety and depression or substance abuse treatment should sign up at work – if offered.
Covid-19
COVID-19 is a qualifying medical reason when the covered individual cannot perform their full-time job duties, and the illness continues beyond the elimination period.
Caring for family members does not make you disabled. Therefore, workers who take off from work to watch over a sick spouse or child are not eligible.
The policy elimination period defines how quickly benefits begin. Most people recover from COVID-19 within two weeks, but depending on their policy features, some might be ineligible for claim payments.
- 7 days
- 14 days
- 30 days
- 3 months
How It Works
Short-term disability insurance in Illinois works no differently than in other parts of the country. For instance, the features you choose at enrollment determine the amount and length.
Amount
Unless they work for the Illinois state government, each person determines how much their insurance policy pays because the monthly benefit is a critical input on the premium cost.
The claim payment amount is stated in your policy documents. When buying coverage, you can select up to 66% of your income or a monthly maximum, whichever is smaller.
Since higher pay amounts lead to higher monthly premiums, many people cover a lower percentage of their earnings.
Length
Unless they work for the Illinois state government, each person determines how long their insurance policy honors claims because the monthly period is another critical input on the premium cost.
In Illinois, short-term disability lasts as long as you cannot perform the duties of your full-time occupation or until the benefit period expires, whichever is less.
When signing up, people can choose from 3, 6, 12, or 24-month benefit periods. Many prefer the cheapest option since more extended benefit periods mean higher monthly premiums.
Termination
The Family Medical Leave Act (FMLA) provides job protections for disabled employees. However, it covers only about 56% of workers and does not last forever.
If the FMLA does not protect your job, you can be fired while on disability in one of two ways.
- You stay out of work beyond the twelve weeks of FMLA job protections
- You belong to the 44% of employees that do not qualify for FMLA
- You work for an uncovered employer
- You are an ineligible employee
Mandatory Temporary Disability
Temporary disability benefits are more abundant in Illinois because separate government entities require coverage for two additional qualifying reasons.
- Occupational (on-the-job) accidents and illnesses of any duration
- Off-the-job injuries and illnesses lasting twelve months or longer
Social Security
The federal government requires employers and employees to fund the premium cost of Social Security Disability Insurance (SSDI) through payroll taxes, meaning most people have temporary disability benefits for non-occupational conditions lasting more than one year.
Start your SSDI application early while remembering that your medical condition does not have to be permanent or last until age 65. You could be eligible even if you might return to work in the future.
- The Social Security Administration publishes its definition, which could be temporary (lasting a limited period) or permanent (continuing indefinitely).
You must not be able to engage in any Substantial Gainful Activity (SGA) because of a medically determinable physical or mental impairment(s) that is either:
- Expected to result in death
- Has lasted or is expected to last for a continuous period of at least 12 months
Worker’s Compensation
The state government in Illinois requires employers to purchase Worker’s Compensation Insurance, meaning most personnel have temporary disability benefits for occupational injuries and illnesses.
Apply for temporary disability benefits through the Worker’s Compensation insurance plan purchased by your employer. Contact the Human Resources department immediately after an on-the-job accident. They should assist you in completing the paperwork.
