Under Oklahoma law, short-term disability insurance (STD insurance) is defined as insurance that replaces part of a worker’s regular income when the worker cannot perform their duties due to suffering an illness or injury.
Short-term disability is different from workers’ compensation (WC) insurance, which replaces income only for individuals who have suffered an injury or illness while performing their job.
Short-term Disability Plans
A worker is typically offered short-term disability insurance as an optional insurance plan made available by their employer. The employee pays for the plan through payroll deduction. The plan may be offered only as an after-tax deduction.
Injuries or illnesses that qualify for STD insurance usually include those that last for less than a year, such as a broken arm or a bout of meningitis. There is no average or typical duration for a short-term disability because the length that it takes a worker to recover depends on the specific illness or injury.
Disability benefits typically have a maximum benefit period based on the disability, the employee’s years of service and the employee’s age at the onset of their disability.
Amount of Short-term Disability Payments
The insurance policy determines the amount that a short-term disability plan pays to a worker. For employees of the University of Oklahoma, for example, disability benefits are 60 percent of their weekly salary up to a maximum of $1,500 per week.
A benefit begins the first day of an accident or on the 15th day of an illness, with a maximum duration of 26 weeks. A City of Tulsa employee will be paid 60 percent of basic weekly earnings, up to $1,250 a week.
For a state of Oklahoma worker, short-term disability has a maximum monthly benefit of $2,500. A state STD insurance plan provides up to 150 days of paid disability benefits after a 30-day elimination period.
Long-term Disability Insurance
Long-term disability (LTD) insurance is for workers with a long-term disability, such as severe carpal tunnel syndrome. The maximum monthly benefit differs according to the terms of the policy. For a state of Oklahoma worker, long-term disability pays a maximum monthly benefit of $3,000.
This type of insurance begins after 180 days from the date of disability. Oklahoma City’s LTD insurance plan also has a 180-day waiting period and covers 60 percent of an employee’s monthly salary.
Preexisting Condition Clause
An STD plan may have a preexisting condition clause, which means that a worker may not be eligible for benefits if they received treatment for a condition prior to the date the policy took effect. A worker’s eligibility is dependent on the terms of the policy.
The University of Oklahoma’s STD insurance policy provides that a worker may not be eligible if they received treatment for a condition within three months prior to their effective date until the worker has been covered under the policy for six months.
The state of Oklahoma’s STD insurance policy provides no benefits for an illness or injury that results from a preexisting condition.
Social Security Disability Benefits
The U.S. Social Security Administration (SSA) provides disability benefits to individuals through two programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
In order to qualify, individuals must meet a program’s requirements for disability. The SSA typically defines disability as the inability to engage in substantial gainful activity because of a medically determinable physical or mental impairment that has lasted or is expected to last at least one year or result in death.
Social Security Is Not STD Insurance
The SSDI and SSI programs are not STD insurance. A worker does not pay into a private plan to get these types of benefits. SSDI pays disability benefits to individuals who are insured because they made contributions to the U.S. Social Security trust fund through Social Security tax on their earnings.
SSDI also pays certain individuals with disabilities who are dependents of insured persons. SSI pays persons, including children under the age of 18, who have disabilities and limited income and assets.
Determinations for SSI and SSDI benefits are based on federal rules and regulations. An individual should apply for benefits online or through their local Social Security Administration office. The Oklahoma Department of Rehabilitation Services has a disability determination services office that makes the medical eligibility determination on applications for SSDI and SSI.
Information Needed to Apply for Benefits
Applicants for SSDI or SSI must provide:
- Date of birth.
- Place of birth.
- Social Security number.
- Name, Social Security number and date of birth or age of current spouse and any former spouses.
- Dates and places of marriage and dates of divorce or death, if appropriate.
- Names and dates of the births of applicant’s minor children.
- Bank or other financial institution’s routing transit number and account number, if benefits will be electronically deposited.
Necessary Medical Information for a Disability Claim
The applicant also will need to provide information to the SSA about their medical condition, including:
- Name, address and phone number of contact person who knows about the applicant’s medical conditions and can help with the application process.
- Detailed information about the applicant’s medical illnesses, injuries or conditions.
- Names, addresses, phone numbers, patient ID numbers and dates of treatment for doctors, hospitals and clinics.
- Names of medicines the applicant is taking or has taken and who prescribed them.
- Names and dates of medical tests the applicant has had and who referred the applicant for the tests.
Necessary Employment Information
Additionally, the applicant will need to share information about their employment, including:
- Amount of money applicant earned in the last year and the current year.
- Name of applicant’s employer/s for last year and current year.
- Copy of applicant's Social Security statement, which provides information on the individual’s personalized benefits from SSA.
- Beginning and ending dates of any active U.S. military service the applicant had before 1968.
- List of up to five jobs the individual worked in the last 15 years before they became unable to work and the dates of those jobs.
- Information about any worker's compensation, black lung or similar benefits for which the applicant filed or intends to file.
- University of Oklahoma: Human resources, Short-term Disability Insurance
- State of Oklahoma: HealthChoice, Disability Plan Handbook
- U.S. Social Security Administration: Disability Benefits
- Blue Cross/Blue Shield of Oklahoma: STD Insurance for City of Tulsa Employees
- Oklahoma Department of Rehabilitation Services: Disability Determination Services
- City of Oklahoma City: 2022 Benefits Guide
- U.S. Social Security Administration: Apply Online for Disability Benefits
Jessica Zimmer is a journalist and attorney based in northern California. She has practiced in a wide variety of fields, including criminal defense, property law, immigration, employment law, and family law.