People applying for short-term disability benefits in Oregon often learn the hard way of the gaping hole in the three government-mandated programs covering most people.
First, the Oregon Paid Leave program covers non-occupational short-term disabilities for twelve or fourteen weeks before ending abruptly.
Second, Social Security covers non-occupational temporary disabilities lasting twelve months or more – per their rules.
Third, Worker’s Compensation covers temporary disabilities occurring on the job.
What if you are disabled for thirteen to fifty-two weeks from an off-the-job accident or illness? That is where a supplemental insurance policy steps in to save the day if you act in time.
Short-Term Disability in Oregon
Oregon workers may want to purchase a private short-term disability policy to supplement the state program’s biggest weakness: the benefits end after only twelve weeks for most off-the-job (non-occupational) medical conditions.
State Disability
Oregon mandates state short-term disability insurance through a program with a different name: Paid Family Leave, which covers the serious health condition of an employee.
Application
Apply for Oregon State short-term disability benefits through Frances Online. Prepare to complete and submit at least two documents to process your claim.
- Verification of Serious Health Condition Form
- Family and Medical Leave Health Care Provider Certification
Eligibility
The Oregon State short-term disability program has two primary eligibility criteria. You cannot apply for benefits unless you meet both requirements.
- Have a severe medical condition that involves a period of incapacity.
- The employee must have funded Paid Family Leave premiums.
- Earned at least $1,000 in the previous twelve months
- Not a federal government employee
- Self-employed or independent contractor voluntarily contributing
- Work for a tribal government that chose coverage
Amount
The Oregon State short-term disability program pays benefits based on a sliding scale using the wages you earned during the previous twelve months.
Use the disability pay amount calculator to estimate your weekly benefits, which might look similar to the following chart.
| Annual Income | Weekly Benefit | % Replaced |
|---|---|---|
| $40,000 | $769 | 100% |
| $60,000 | $989 | 86% |
| $80,000 | $1,181 | 77% |
| $100,000 | $1,374 | 71% |
| $150,000 | $1,523 | 53% |
Duration
The benefit duration of the Oregon State short-term disability program is its Achilles heel. Many workers cannot return to work when the claims payments stop.
- 12 Weeks: For a severe medical condition unrelated to pregnancy
- 14 Weeks: Have given birth or have health needs because of childbirth
Survival assistance while waiting for disability through Social Security are sparse if you cannot work for an extended period. Also, you do not qualify unless your medical condition lasts twelve months or longer.
Private Disability
Buying private short-term disability insurance is the ideal way to supplement the Oregon State-mandated program. Choose a three-month elimination period to keep the premiums affordable and close the nine-month gap before Social Security becomes viable.
Buy short-term disability outside your employer if not available at your workplace. With a state-mandated program, fewer companies will offer a voluntary option. Avoid the nine-month donut hole and enjoy peace of mind by purchasing coverage before getting sick, hurt, or pregnant.
- The Oregon Health Plan (OHP) does not provide short-term disability to Medicaid recipients.
- The Public Employees Benefits Board offers a voluntary short-term disability program to Oregon state government workers.
Temporary Disability in Oregon
Workers in Oregon have a second one-step process when applying for temporary disability benefits mandated by the state. In these cases, you do not have to act proactively to purchase coverage for two types of losses.
- Occupational (on-the-job) incidents of any duration
- Non-occupational losses lasting at least twelve months
Social Security
Social Security covers non-occupational temporary disabilities lasting twelve months or longer. The federal government requires most Oregon workers to contribute to the system via FICA payroll taxes.
You do not need a permanent disability to get Social Security benefits. Do not be fooled into thinking that your medical condition must last until age 65. Trust the federal government’s definition.
“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 a continuous period of at least 12 months.”
Workers’ Compensation
Workers’ compensation covers temporary occupational disabilities. Oregon requires most employers to purchase a policy for their employees, so coverage should be automatic.
Apply for temporary disability benefits through Workers’ Compensation.
- Tell your employer about any injury or illness immediately.
- Fill out Form 801, “Report of Job Injury or Illness,” and submit it to your employer
- Your employer should send the form to its workers’ compensation insurance carrier within five days of your notice.
- Inform your physician that you suffered a work-related injury or illness.
- The staff should help you complete Form 827, “Workers’ and Health Care Provider’s Report for Workers’ Compensation Claims.”
- The staff should forward the form to the insurer within 72 hours of your visit.
You might be eligible for several types of benefits.
- Medical treatment
- Transportation expenses
- Temporary wage replacement
