Four programs in Massachusetts cover momentary disabilities, making it challenging to know where to apply for coverage and benefits.
The Paid Family Medical Leave (PFML) program covers off-the-job accidents and illnesses for up to twenty weeks. Social Security helps with similar disabilities lasting at least fifty-two weeks. Workers’ Compensation pertains to on-the-job incidents of any duration.
Meanwhile, private insurance companies market policies that fill gaps, but you must apply for coverage proactively first.
For the sake of simplicity, we group PFML and private policies into the short-term disability section and Social Security and Workers’ Compensation into the temporary disability insurance segment.
Short-Term Disability In MA
In this section, we address how to apply for short-term disability in Massachusetts, covering off-the-job (non-occupational) accidents and illnesses lasting less than one year.
Application Requirements
The short-term disability application requirements in Massachusetts vary based on whether you helped fund the PFML program and if you have a pregnancy-related medical condition.
State Program
Apply for benefits from the Massachusetts state-sponsored program provided you meet the primary requirement: you worked in the Commonwealth and contributed via payroll taxes.
Apply for short-term disability benefits through MA Paid Family Medical Leave (PFML). PFML covers a severe health condition that prevents you from doing your job for three consecutive days with at least one of the following:
- Overnight stay in a medical facility
- Two or more treatments by a healthcare provider within 30 days
- At least one treatment by a healthcare provider within 30 days with plans for continued treatment or prescriptions
Pregnancy
Short-term disability in Massachusetts for pregnancy has additional application requirements because new mothers often qualify for two reasons: giving them extra time off with pay.
Massachusetts maternity leave laws under PFML allow for twenty-six weeks.
- Up to 20 weeks to manage a personal serious health condition
- Pregnancy complications before birth
- Recovery from labor and delivery
- Postpartum health-related problems
- Up to 12 weeks to care for a family member or to bond with a child
Other Programs
Many people do not meet the primary requirement for short-term disability in Massachusetts because they did not contribute to the PFML program. If you fall into these categories, you must apply with the appropriate entities.
Many workers are exempt from making PFML contributions, making them ineligible to file benefits claims.
- Federal government employees
- USPS postal workers
- Self-employed and 1099 contract workers
Other Massachusetts residents commute across borders to work in neighboring states, making them exempt from PFML contributions but possibly eligible for benefits sponsored by these states.
- Rhode Island
- New York
- Connecticut
- New Hampshire
Pay Components
Short-term disability pay in Massachusetts has two components: the monthly amount and duration of the benefits. Consider both elements when deciding whether to apply for additional coverage.
Purchasing individual coverage is an intelligent choice for people concerned about two possible holes in the state PFML program: the amount and duration.
Amount
The amount that short-term disability pays in Massachusetts might motivate high-income earners to apply for supplemental coverage to insure a more significant percentage of their income.
Calculate your weekly benefit by inputting your earnings from the last four quarters. You will notice that the PFML program is progressive and subject to a cap.
| Income Range | % Replaced |
|---|---|
| Low | 80% |
| Medium | 73% |
| High | 50% or less |
Length
The length of time short-term disability pay lasts in Massachusetts should concern you, as the state-sponsored program ends after only twenty weeks.
People out of work for twenty-one to fifty-two weeks have no income insurance to replace lost wages. Consider purchasing a supplemental policy to fill this glaring hole.
The monthly premiums are lower with a more extended elimination period, making it affordable to address this risk in advance.
Temporary Disability in MA
This section addresses how to apply for temporary disability insurance in Massachusetts, covering on-the-job (occupational) accidents and illnesses of any duration and non-occupational conditions lasting more than one year.
Social Security
Social Security provides temporary disability insurance in Massachusetts, covering off-the-job accidents and illnesses expected to last one year or longer. Workers fund the premiums through FICA payroll taxes.
You can get Social Security benefits without having a permanent disability. As their definition indicates, your medical condition does not have to last until you reach age 65 to qualify!
“To meet our definition of disability, 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 at least 12 months.”
Workers Comp
Workers’ Compensation provides temporary disability insurance in Massachusetts, covering on-the-job (occupational) accidents and illnesses of any length. The Commonwealth requires employers to purchase coverage for their employees.
File a Workers’ Compensation claim through the Department of Industrial Accidents if an insurer denied your benefits, your employer refused to help, or it’s been more than thirty calendar days since your injury.
In addition to partial wage replacement, you might qualify for medical care and vocational rehabilitation services.
