Are You Eligible for Short-Term Disability in Florida if Your Condition Is Work-Related?

An illness or an injury can easily cause short-term disability and leave you financially stranded. As someone who lives and works in Florida, what can you do? 

If you are injured on the job and your employer has offered you a short-term disability policy or coverage through a disability plan, you might be eligible for both short-term disability and workers’’ compensation benefits  However, some short-term disability policies or plans don’t allow you to collect both at the same time but may allow you to collect long-term disability benefits and workers’ compensation benefits at the same time. 

While you may qualify for both the short and long-term disability policy or plan, it may offset or reduce your benefits by whatever you get in workers’ compensation money benefits. This can be complex. You should seek guidance to understand your benefits and the interaction of both short and long-term disability benefits and workers’ compensation benefits.

Short-Term Disability vs. Workers’ Comp

Florida law does not require employers to carry short-term disability (STD) insurance, although they may offer it as a benefit. Individuals can also apply for disability insurance policies. 

Although policies vary in what they cover, short-term disability is generally intended to cover injuries and illnesses that arise outside of work, such as slips and falls, car accidents, pregnancy-related conditions, and other diseases or ailments that are not related to the job. 

For job-related injuries and illnesses, an employee can claim workers’ compensation benefits as provided by state law.

Differences in Compensation

Short-term disability policies or plans typically pay out up to 70% of pre-disability income for a limited period. The time and amount offered will depend on the policy or plan terms. Most state workers’ compensation laws provide for the payment of lost wages and causally related medical care. On the other hand, short-term disability payments do not cover medical care—that is a matter for health insurance or self-payment. 

Florida workers’ comp benefits are set by law. If a doctor finds that you are “temporary total”  (TTD) and cannot work at all, you should receive a benefit of  66 ⅔% of your average weekly wage, or 80% if you were critically injured, until you reach maximum medical improvement (MMI). If you are able to work and lose 80% of your AWW and are not at maximum medical improvement, you can be paid temporary partial disability benefits (TPD). These temporary benefits end when the authorized doctor says you are at MMI. 

You may then become eligible for permanent impairment benefits or permanent total disability benefits.

Workers’ comp also covers authorized medically necessary treatments for the injury or illness, including prescription drugs and transportation to medical care, but the insurance carrier or servicing agent chooses the doctor.

Short-term disability insurance has an “elimination period”—usually 7 to 21 days, depending on the policy. After your disability begins, you cannot collect insurance until this period has passed. Workers’ comp does not offer payment for the first 7 days of disability unless you are disabled for 21 days or more. 

Neither will cover pre-existing conditions, and both require a doctor’s determination of disability. Short-term disability typically requires a doctor to find that you cannot perform the “material and substantial duties” of your job. Workers’ comp requires a doctor’s finding of temporary total or partial disability.

Which Coverage Is Right—and Who Will Tell You?

It is not against the law to receive both short-term disability and workers’ compensation payments, but your insurance payments can be reduced by the amount you received from workers’ compensation. If the illness or injury had a complicated cause, you may find yourself in a situation where the workers’ compensation carrier denies your claim, leaving you in the cold.

Often it’s clear when an injury resulted from the job and that is easy but employers and insurers can make workers’ compensation hard to receive. Unscrupulous employers do not want their employees to make claims on workers’ comp insurance. They may encourage filing a short-term disability claim instead. Otherwise, they may resort to refusals, threats, and retaliation—unlawful behavior, which is  not uncommon. 

On the other hand, doctors authorized by workers’ compensation have an incentive to downplay your injury or deny your claim, since the workers’ compensation carrier or servicing agent pays the doctor’s bill. The short-term disability carrier or plan and the workers’ compensation carrier or servicing agent can put you in the middle. 

How Do You Protect Yourself?

Start by finding the professional who can protect you—a Florida attorney who handles both short and long-term disability and workers’ compensation claims. 

An experienced disability attorney will know how to manage your case from the beginning and throughout. It is far wiser to have an attorney present during any discussions or interviews with insurance company representatives. Even the doctors at independent medical examinations (IMEs) are anything but independent, and you may find innocent statements used to undermine your claim.

For over four decades, Attorney Nancy L. Cavey has brought Florida short-term disability claims for clients with heart disease, spinal injuries, fibromyalgia, and other complex medical issues. If the short-term disability insurance company denies your claim, the Cavey law team can prepare a strong, detailed appeal, and you don’t have to pay unless you get your benefits.

Attorney Nancy L. Cavey is also a board certified workers’ compensation attorney who can help you with your workers’ compensation claim and help you maximize both your workers’ compensation and short term disability benefits.   

Contact our St. Petersburg office today at 727-477-3263 to get started on your consultation with us.