A Primer on Disability Terminology
The terms short-term disability, temporary disability, long-term disability, and permanent disability can cause confusion. What follows is a brief introduction designed to help clear up some of the uncertainty regarding what these terms mean, and in what circumstances they apply.
In California, people who cannot work due to physical or mental impairments are eligible for state disability benefits, provided they have contributed to the program via regular payroll deductions. This type of state-provided benefit is called short-term disability or temporary disability. If someone has a disability that is likely to affect him or her for at least one year, that person can apply for federal Social Security disability benefits. These are called long-term disability or permanent disability benefits. Just as in the case of state disability benefits, in order to be considered for federal benefits, the individual must have contributed to the program via regular payroll deductions.
If a person becomes disabled due to a workplace injury, he or she can receive temporary disability payments until the condition stabilizes. Once that happens, the individual can apply for permanent disability benefits. Some companies offer their employees group short and long-term disability insurance policies, which provide a benefit safety net should their employees suffer workplace injuries and become disabled as a result.
Permanent disability benefits are available to veterans who have become disabled (physically or mentally) as a result of their military service. These are called veteran service-connected disability benefits and are provided for under federal law.
There can be overlap in an individual’s eligibility for benefits. For example, if someone is injured at work and, as a result, will not be able to work for at least a year, that person is eligible for worker’s compensation temporary disability, worker’s compensation permanent disability, Social Security disability, and IF his or her employer provides it, short or long-term disability insurance.
Another example of overlapping eligibility would be in the case of a cancer patient, who would be eligible for short-term disability (through the state), long-term disability (through the federal Social Security disability program), and, IF his or her employer provides it, short or long-term disability insurance.
It is important to note that when it comes to overlapping eligibility, offsets apply. In other words, for someone who receives multiple benefits, the amount of one or more of the benefits the individual receives will be reduced. This offset rule also applies to benefit amounts paid by employer-provided group short-term and long-term disability insurance policies when an individual is also receiving other types of disability benefits.
One exception to benefit offsets applies to disabled veterans who receive service-connected disability payments. These individuals can collect all Social Security disability payments without being subject to benefit reductions.
Just because someone is receiving long-term disability payments does not mean he or she will be eligible to receive them indefinitely. Nearly all Social Security disability beneficiaries are subject to periodic case reviews. If the Social Security Administration examines a case and decides, based on the evidence, that an individual’s condition has improved, or even resolved, then that person’s benefits may be reduced or even eliminated completely. However, an individual receiving Social Security disability benefits has the right to present evidence of his or her disability in order to try and maintain benefits.
Individuals receiving employer-provided group long-term disability benefits are also subject to periodic reviews. They, too, can present evidence of a continuing disability in an effort to keep receiving benefits if the insurance company has reviewed the case and decided to reduce or terminate disability payments. The Veterans Administration also conducts reviews of cases in order to determine whether individuals receiving service-connected benefits are still eligible for those benefits, or if it is appropriate that those benefits be reduced or terminated.
Certain types of disability shelter other types from benefit reduction or termination. For example, a Social Security disability recipient has a solid argument against the claim that he or she is ineligible for group long-term disability. In other words, an insurance company would have to argue against the Social Security Administration’s finding that the person in question was disabled. It would be a difficult argument to make. This goes both ways, meaning that if the Social Security Administration determines that an individual’s condition has improved enough to justify eliminating benefits, a group long-term insurance provider also has a solid argument in favor of terminating that individual’s benefits.
When it comes to understanding and applying disability terminology, context is key. An experienced attorney can provide a great deal of clarification, and help a claimant maximize the benefits to which he or she is entitled under applicable state and federal laws.