TEMPORARY DISABILITY LAWS : Eligibility & Benefits

TEMPORARY DISABILITY LAWS
At their inception, state unemployment insurance programs were usually designed to cover only unemployed persons who were both willing and able to work. Benefits were denied to anyone who was unable to work for any reason, including disability. Some states amended their unemployment insurance laws to provide coverage to the unemployed who subsequently became disabled. However, five states—California, Hawaii, New Jersey, New York, and Rhode Island—and Puerto Rico went one step farther by enacting temporary disability laws under which employees can collect disability income benefits regardless of whether their disability begins while they are employed or unemployed. While variations exist among the states, these laws (often referred to as nonoccupational disability laws because benefits are not provided for disabilities covered under workers' compensation laws) are generally patterned after the state unemployment insurance law and provide similar benefits.

In the six jurisdictions with temporary disability laws, most employers are required to provide coverage for their employees. In most jurisdictions, except Rhode Island, which has a monopolistic state fund, coverage may be obtained from either a competitive state fund or private insurance companies. Self-insurance is also generally permitted. Private coverage must provide at least the benefits prescribed under the law, but it may be more comprehensive. Depending on the jurisdiction, the cost of an employer's program may be borne entirely by employee contributions, entirely by employer contributions or by contributions from both parties.

Eligibility
Before an employee is eligible for benefits under a temporary disability law, the employee must satisfy (1) an earnings or employment requirement, (2) the definition of disability, and (3) a waiting period.

Earnings or Employment Requirement
Every jurisdiction requires that an employee must have worked for a specified time and/or have received a minimum amount of wages within some specific period prior to disability to qualify for benefits.

Definition of Disability
Most laws define disability as the inability of the worker to perform his or her regular or customary work because of a nonoccupational injury or illness including maternity. As with workers' compensation laws, certain types of disabilities are not covered. In most jurisdictions, these include disabilities caused by self-inflicted injuries or by illegal acts.

Waiting Period
The usual waiting period for benefits is seven days. However, in some jurisdictions the waiting period is waived if the employee is hospitalized.

Benefits
Benefits are a percentage, usually ranging from 50 percent to 66⅔ percent, of the employee's average weekly wage for some period prior to disability, subject to maximum and minimum amounts. Benefits are generally paid for at least 26 weeks if the employee remains disabled that long.