Short-term disability allows workers who suffer illness or injuries outside of work to support themselves through weekly payments during recovery, but it does not cover on-the-job accidents or injuries, unlike temporary disability insurance.
Short-term disability leave benefits are relatively new to the commonwealth of Massachusetts. On January 1, 2021, this program was added to the state's Paid Family and Medical Leave (PFML) program. The income replacement payments continue for 20 weeks, but if the applicants remain disabled, they can reapply when their benefits end.
Massachusetts Short-term Disability Insurance
On January 1, 2021, short-term disability benefits became part of the Massachusetts Paid Family and Medical Leave program (PFML). Individuals can receive a replacement of some of their wages if they suffer a serious health problem that has no connection to their job. PFML covers workers who earned at least $5,700 over the last four calendar quarters.
Most workers in the state have this type of coverage, with some exceptions:
- Small businesses that did not opt-in.
- Self-employed workers who go through MassTaxConnect.
- Residents of Massachusetts who commute to another state for work.
- Employees of exempt employers.
Defining Serious Health Condition Under Massachusetts Law
Most employees in Massachusetts can take leave from their job and receive short-term disability payments if they have a qualifying reason. This event or cause must be a serious health condition, such as injury, illness, or pregnancy as certified by a healthcare provider, and which makes them unable to work.
A "serious health condition" is a mental or physical ailment that prevents an individual from working for more than three consecutive days and requires one of these eligibility factors:
- Overnight treatment in a medical facility.
- At least two treatments from a healthcare provider within 30 days of the event or cause that made them unable to work.
- One or more treatments from a healthcare provider within 30 days of the event or cause that made them unable to work with plans for that treatment to continue, including prescriptions.
- Some pregnancy-related medical conditions may be covered by short-term disability, including complications occurring before the due date, labor and delivery recovery, and postpartum disorders that keep an employee from returning to work.
Applying for Short-term Disability in Massachusetts
Applicants will first create an online account. When completing their application, they need to include:
- Reason for taking leave.
- Date they told their employer of their need to leave.
- Date when their leave started or when they were planning to stop working.
They will then:
- Upload government-issued identifying documents such as driver's license, state-issued ID, or passport.
- Upload their bank information.
- Upload information from their medical provider about their condition.
- Fill out a Certification of Serious Health Condition form (PFML-FORM-0001-Cert-SHC-V1.0.0).
- Upload their company's Federal Employer Identification Number (FEIN).
Short-term Disability Benefit Amount
In Massachusetts, the amount of short-term disability payments an individual will receive depends on how much they earn. Short-term disability payments are progressive – those who make more receive a lesser percentage of replaced wages. There is a per-week cap for those earning greater than $78,000 a year. For example:
- If a worker's annual income is $26,000, their weekly benefits would be $400 or 80 percent.
- If a worker's annual income is $52,000, their weekly benefits would be $708 or 71 percent.
- If a worker's annual income is $78,000, their weekly benefits would be $850 or 57 percent.
- If a worker's annual income is $104,000, their weekly benefits would be $850 or 43 percent.
Massachusetts short-term disability payments will continue for 20 weeks through the Paid Family and Medical Leave program. Applicants who remain disabled can re-apply after their benefits end.
When to Apply for Short-term Disability
Applicants can apply for short-term disability beginning 60 days before their leave starts. However, in the case of illness or injury, they may need to leave work immediately. In that instance, they can apply for retroactive leave after taking time off, but they'll need to know when their departure from the job began.
With retroactive leave, they may see a benefit reduction if:
- They applied for benefits more than 90 days after they started the leave.
- During leave, their employer was still paying their salary.
- They used their vacation time or sick leave.
- They received benefits through another wage replacement program.
Processing a Short-term Disability Application
The state Department of Family and Medical Leave (DFML) will notify the individual's employer of the employee's application within five days of its submission. The employer then has 10 business days to review the worker's application and provide any necessary additional information to the DFML.
After the DFML decides whether the applicant will receive benefits, that individual has 10 days to appeal the department's decision or any aspect of that decision. The department may ask the applicant for additional information during the appeal process. Applicants can appeal online or mail the appeal form they received with their notice. They may also request a hearing.
Short-term Disability vs Temporary Disability Insurance
Employees sometimes confuse Temporary Disability Insurance (TDI) with short-term disability, but the programs are different. TDI offers workers partial wage replacement for illnesses and accidents they incur while working.
TDI benefits are more significant than short-term disability payments, as they cover healthcare and rehabilitation as well as wage replacement. These employee benefits may also last longer. Employees should contact their employer regarding any questions about this coverage. They can then apply for TDI through the insurance company issuing the policy.
- Growing Family Benefits: Short-Term Disability Insurance in Massachusetts [TDI]
- Mass.gov: Paid Family and Medical Leave (PFML) Overview and Benefits
- Mass.gov: Opt in and Contribute to Paid Family and Medical Leave as a Self-employed Individual
- Mass.gov: Certification of Your Serious Health Condition
- Mass.gov: Request an appeal for Paid Family and Medical Leave
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.