People applying for short-term disability benefits in Washington State often learn the hard way of the gaping hole in the three government-mandated programs covering most people.
First, the Paid Family Medical Leave program covers non-occupational short-term disabilities for twelve 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 Washington State
In Washington State, short-term disability insurance has public and private components that complement each other. To keep our analysis simple, we focus on the two primary distinctions.
- The mandatory program lasts twelve weeks
- A voluntary plan covers fewer individuals
- Begins at week thirteen
- Continues twelve months (or longer)
Government Benefits
First, the public short-term disability program in Washington State is known as Paid Family and Medical Leave (PFML). PFML replaces a portion of income when a “serious health condition prevents you from working.”
PFML Application
Apply for short-term disability benefits in Washington State through the PFML web portal, following the steps to avoid unnecessary delays in processing your claim.
- Submit the documentation via the online application portal
- Have proof of your identity ready
- Complete the Certification of a Serious Health Condition form
PFML Pay Amounts
How much does Washington State short-term disability pay? The weekly amount is quite generous, but the duration of claim payments is the gaping hole you want to close if possible.
- The amount is 90% of your income up to a weekly maximum of $1,437 as of the publication date of this article.
- The benefits end after twelve weeks, leaving you without support if you cannot work after this point.
PFML Qualifications
What qualifies you for Washington State short-term disability under the PFML umbrella? The most critical criterion is whether you have coverage.
The government requires employers to collect and disperse SDI premiums for all workers, meaning more people are eligible. However, several groups are exempt from these requirements.
- Federal government employees
- Businesses located on tribal lands
- Self-employed individuals who did not opt into a voluntary plan
- Union members subject to older collective bargaining agreements
Private Insurance
Second, buying short-term disability insurance from a private company operating in Washington State is the only way to extend benefits past the brief twelve-week period for the government-run program.
Private Applications
Applying for short-term disability from a private insurance company in Washington State is a two-step process. To qualify for benefits, you must buy a policy before getting sick, hurt, or pregnant.
Purchase a Policy
Receive a quote tailored to your circumstances. A licensed agent will provide a cost estimate for specific policy features before helping you complete an application to purchase coverage.
- Select the three-month elimination period so that benefits begin just as the government claim checks stop at twelve weeks.
- Choose at least a 12-month benefit period to carry you through until you meet the Social Security criteria.
File a Claim
Apply for short-term disability benefits by filing a claim with the private insurance company that issued the policy. Download the paperwork and follow the instructions precisely to avoid delays or denials. The form may require three separate signatures.
- The insured individual verifying the statements are valid
- Your licensed physician documenting your medical condition
- Your employer confirming that you are no longer working
Private Qualifications
Short-term disability covers pre-existing conditions after one year if you are healthy enough to purchase the coverage. The new policy application will ask a series of in-depth medical questions.
Therefore, the primary qualification for short-term disability purchased through a private insurance company in Washington State is that coverage must be in force before one becomes sick, hurt, or pregnant.
Private Pay Amounts
How much does short-term disability pay when you purchase a policy through a private insurance company? It depends on your choices when enrolling because better benefits translate into higher premiums.
However, we can boil the answer down to two critical comparison points to keep things simple.
- Pays less than PFML for people earning below $83,000 annually (90% versus 66% of income)
- Pays much more than Social Security for most people ($1,400 per month average versus up to $6,500)
Temporary Disability in Washington State
Two temporary disability insurance programs in Washington State fill other holes in Paid Family Medical Leave (PFML). To simplify our analysis, we focus on the two primary distinctions of these mandatory benefits covering most people.
- Occupational or on-the-job accidents and illnesses
- Medical conditions lasting twelve months or longer
Social Security
Social Security provides temporary disability in Washington State for non-occupational accidents and illnesses expected to last at least twelve months. Hence, a supplemental policy from a private insurance company is needed.
- PFML: Ends after twelve weeks even if you remain disabled
- SSDI: Begins after five months only if you meet two conditions
- Social Security approves the claim quickly
- Your condition is expected to last 12 months or longer or result in death
Submit your SSDI claim application now, even if you believe you can return to work in the future. To qualify, you do not have a permanent or long-term medical condition. The rule is twelve months, not twelve years, or the remainder of your life.
Most people have Social Security disability coverage because the federal government requires participation. You fund the mandatory premiums through FICA payroll taxes.
Worker’s Compensation
Worker’s Compensation insurance provides temporary disability benefits for occupational injuries and illnesses in Washington State. The mandatory coverage kicks in if you hurt yourself while on the job.
You can apply for temporary disability through Worker’s Compensation by seeking immediate medical attention and informing your employer immediately. Your doctor will help with the next steps.
- Certify whether your injury is work-related
- Help you file a workers’ compensation claim
- Decide when you can return to work
- Recommend any further treatment you may need
Most people have Worker’s Compensation because the Department of Labor and Industries government requires employers to purchase coverage through them or a private carrier. The only possible exceptions are specific independent contractors, real estate agents, gig economy workers, and remote employees.
