{"id":5383,"date":"2024-07-26T15:39:26","date_gmt":"2024-07-26T15:39:26","guid":{"rendered":"https:\/\/www.brightmine.com\/us\/?post_type=resources&p=5383"},"modified":"2025-07-21T19:55:30","modified_gmt":"2025-07-21T19:55:30","slug":"what-happens-when-an-employee-goes-on-long-term-disability","status":"publish","type":"resources","link":"https:\/\/www.brightmine.com\/us\/resources\/hr-compliance\/employee-leaves\/what-happens-when-an-employee-goes-on-long-term-disability\/","title":{"rendered":"What happens when an employee goes on long-term disability?"},"content":{"rendered":"\n
\n
\n
\n
\n

by Natasha K. A. Wiebusch<\/strong>, JD<\/strong>, Brightmine Marketing Content Manager<\/p>\n\n\n\n

When an employee goes on long-term disability, HR and managers must navigate several decisions to support the employee and stay in compliance<\/a>. HR teams also need to follow specific processes and procedures.<\/p>\n\n\n\n

Even with processes and procedures in place, however, questions will inevitably arise. Employees may begin receiving other benefits or want to return part-time. In some cases, layoffs or changes in the business may impact the employee’s job.<\/p>\n\n\n\n

In this article, we provide guidance to help you navigate common issues that arise when an employee goes on long-term disability.<\/p>\n\n\n\n

What is long-term disability insurance?<\/h2>\n\n\n\n

Long-term disability insurance provides benefits in the form of income replacement to people who are unable to work due to a long-term injury or illness. Employees can purchase long-term disability coverage on their own or through their employer.<\/p>\n\n\n\n

Long-term disability benefit amounts vary. On average, benefit amounts are 50%-80% of the claimant’s lost wages. <\/p>\n\n\n\n

\n

Example: Long term disability amount<\/h4>\n\n\n\n

If an employee earned $2,600 per month at the time they filed their disability claim, and the policy benefit is 70% of their lost wages, they would receive $1,820 per month in benefits:<\/p>\n\n\n\n

$2,600 \u00d7 0.7 = $1,820<\/p>\n<\/div>\n\n\n\n

Short-term disability vs long-term disability<\/h3>\n\n\n\n

The primary difference between short-term disability and long-term disability coverage is the duration of coverage. That is, the length of time a covered person can receive benefits through their policy for their disability.<\/p>\n\n\n\n

The duration of short-term disability benefits varies depending on the insurance company and the policy. However, coverage typically last anywhere from a few weeks to six months. Long-term disability benefits, on the other hand, can last anywhere between one and 10 years.<\/p>\n\n\n\n

Another key difference between the two is the waiting period. A covered person can usually obtain short-term disability benefits almost immediately to cover their needs. Long-term disability claimants, however, must generally comply with a much longer waiting period.<\/p>\n\n\n\n

When can an employee use long-term disability benefits?<\/h2>\n\n\n\n

Employees can usually use long-term disability benefits once they’ve exhausted paid sick leave and short-term disability benefits. They will also need to file a claim and meet the plan’s eligibility requirements.<\/p>\n\n\n\n

Eligibility requirements<\/h3>\n\n\n\n

Eligibility requirements for long-term disability benefits will depend on the terms of the policy. You can expect policies to have the following basic requirements:<\/p>\n\n\n\n

\n

1. Meet the period of employment requirement<\/h4>\n\n\n\n

Plans typically require covered individuals to work for a minimum period for their employer to qualify for benefits. The minimum period of employment will depend on the policy.<\/p>\n\n\n\n

2. Have a qualifying disability<\/h4>\n\n\n\n

Each policy defines what a qualifying disability is. Generally, a qualifying disability is an illness or injury that prevents the covered plan member from performing their occupation. Some policies state that the plan member must be unable to perform their own occupation, while others state they must be unable to perform any occupation.<\/p>\n\n\n\n

Additionally, plans typically won’t allow an employee to receive benefits if they’re able to work at all. Others, however, provide long-term disability benefits for partial disability. Depending on the policy, employees may receive partial disability benefits if they’re unable to work full-time or if they need to work a different job.<\/p>\n\n\n\n

3. The disability lasts for an extended period<\/h4>\n\n\n\n

The plan member’s disability must last for an extended period. For example, if an employee’s injury heals within four weeks, they won’t qualify for long-term disability.<\/p>\n\n\n\n

4. Complete the elimination period<\/h4>\n\n\n\n

Long-term disability insurance plans usually have an elimination period that employees must complete before they can receive benefits. The policy determines the duration of the elimination period, however, they usually last between three and six months. Employees generally use their short-term disability benefits during this time.<\/p>\n<\/div>\n\n\n\n

Documents employees need<\/h3>\n\n\n\n

During the claims process, claimants need to provide certain documents to their insurance provider. This includes:<\/p>\n\n\n\n