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Can you receive disability for pregnancy?

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βˆ™ 2012-03-05 17:39:13

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Thanks to the Pregnancy Discrimination Act (PDA) of 1978, all GROUP disability insurance policies for employers with at least 15 employees must treat pregnancy as if it were an injury or illness, subject to the other terms of the policy (in other words, pre-existing condition exclusions, waiting periods, elimination periods, the contract's particular definition of "disability", and proof of loss provisions all still apply). It does not matter who pays the premiums as long as it is a group contract. Furthermore, it has become the industry standard for group disability policies for employers with less than 15 employees is to also treat pregnancies as illnesses.

On the other hand, individual (non-group) disability policies, even those purchased through payroll deduction and "sponsored" by an employer (but are individually "owned" by the employee) typically exclude benefits for disabilities caused by routine pregnancy and deliveries. This may vary from contract to contract and is subject to state insurance laws.

It should be noted that disability benefits due to pregnancy are UNRELATED to whatever MATERNITY LEAVE an employee may be entitled to: Maternity Leave is a type of Family and Medical Leave which allows employees to miss work for a certain amount of time without fear of loosing his or her job, but it is typically unpaid (which employees then supplement with unused vacation time, sick pay, or their own personal savings). This is usually available also for adoptions or for the fathers (called PATERNITY LEAVE). Disability Benefits, when applicable, are only payable for the period of time the mother is physically or mentally unable to work due to the pregnancy and/or delivery (e.g. 6-weeks postpartum for a normal delivery). The amount of maternity leave and the duration of disability benefits available to a new mother are unrelated to each other and should not be confused.

Therefore, it is possible for an employee to have leave available without disability benefits; disability benefits without leave available (for example when leave has been exhausted earlier in the year and/or when FMLA or State leave laws do not apply); or both leave and disability benefits of differing durations.

So for example, the Family and Medical Leave Act (FMLA) of 1993 (for larger employers) as well as state FMLA-like laws may allow an employee to miss work for twelve weeks, while the disability benefit may only be through the sixth week postpartum. This leaves the employee without any pay for the "extra" time off when she would be physically and mentally able to work following her recovery from the delivery but has chosen not to return to work to spend more time with the baby.

When preparing for a leave from work due to pregnancy, the employee should always discuss both maternity leave AND any disability benefits available with their employer to avoid any surprises once the leave/disability begin.

2012-03-05 17:39:13
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