Individuals hoping to get short-term disability benefits must have suffered a workplace injury, be an employee of the Texas state government, or have disability coverage through private insurance. The Texas Income Protection Plan (TIPP) application process is easy to follow and can be done online or by phone.
What Are Short-term Disability Benefits in Texas?
Short-term and long-term disability coverage are offered via the Texas Income Protection Plan (TIPP). Both benefits replace a portion of an active employee’s income should they suffer a disability or otherwise can’t work due to injury, illness or pregnancy.
Short-term disability insurance provides an employee with 66 percent of their monthly salary (capped at $6,600 a month for claimants making more than $10,000 a month) for a benefit period of up to five months after completion of the waiting period. To file a short-term disability claim, employees must show:
- An approved practitioner has certified them as totally disabled.
- They have fulfilled the waiting period.
- Approved by third-party administrator for disability benefits.
Individuals can enroll in the state's disability insurance plan during their hire or rehire event. They do not need to show evidence of insurability (EOI) for their disability plan to begin. Coverage would start the first day of the following month.
Short-term Disability and Preexisting Conditions
If a claimant has a condition for which they’ve received medical advice, services, treatment or prescription drugs in a three-month period before disability benefits begin, benefits for that specific condition are not covered for the first six months of the enrollment period. After that time, the claimant must fulfill the waiting period to receive benefits.
If claimant receives disability payments from other sources such as Social Security disability or Workers’ Compensation, benefit payments will be smaller.
How to File a Disability Claim in Texas
To file a short-term disability claim, the claimant must provide certain information:
- First day they missed work as a result of the disability.
- Medical condition.
- Primary care physician or specialist’s name, phone and fax number.
- First and last dates of hospitalization, if applicable.
- Balance of sick leave on the first day of the disability.
- Expected work date return.
- Any additional disability benefit payments they may receive or expect to receive.
The claimant should file their disability claim within the first 90 days after the first day of their disability. They can do this via TIPP’s self-service option or call the agency’s customer care line toll free 855-604-6230, Monday through Friday 7 a.m. to 7 p.m. CST. A claim manager will contact the claimant within 24 hours for additional information.
Receipt of Claim Approval
The TIPP administrator will send the claimant an acknowledgement packet with a claim form to be filled out within 10 business days. If their claim is approved, the initial check will be issued on the first business day of the month.
Before the plan begins, the claimant must use up their sick leave balance or complete a waiting period of 30 days, whichever period is longer. Waiting periods and use of sick leave run concurrently.
Michelle Nati is an associate editor and writer who has reported on legal, criminal and government news for PasadenaNow.com and Complex Media. She holds a B.A. in Communications and English from Niagara University.