January 10, 2001 |
2001-R-0050 | |
TEMPORARY DISABILITY BENEFIT PROGRAMS | ||
By: Lynn Marx, Research Attorney | ||
You asked about the temporary disability benefits that certain states provide for individuals who are accidentally injured or incur an illness that is not related to their employment.
SUMMARY
Five states and Puerto Rico mandate that employers provide temporary disability benefits for their employees. Temporary disability benefits provide partial wage replacement to employees who are temporarily disabled for non-work related reasons, including pregnancy and childbirth.
Rhode Island was the first state to pass a temporary disability law. Most of the states and Puerto Rico do not require coverage for government workers. Most states and Puerto Rico allow employers to obtain alternative insurance plans.
In general, all the states and Puerto Rico define disability in terms of the inability of an individual to perform regular or customary work because of the individual's physical or mental condition. Two of the programs do not require employer contributions. All of the programs provide benefits for at least 26 weeks and all have a 7-day waiting period.
All of the programs cover most pregnancy related disabilities.
PROGRAM COVERAGE
Table 1 shows the year the states and Puerto enacted their temporary disability benefit programs, the employers and employees covered, the qualifying wages or employment necessary to be covered by the program, and the types of plans available.
Table 1: Year of Enactment, Employers and Employees Covered, Qualifying Wages or Employment, and Types of Plans
State-Commonwealth |
Year Enacted |
Employers-Employees Covered |
Qualifying Wages or Employment |
Types of Plans |
California |
1946 |
Most private |
Must have earned $300 during previous 12-month base period |
Private and state plans (private plan has to be better than state) |
Hawaii |
1969 |
Most private and state |
In covered employment at least 14 weeks (at least 20 hrs/week) + earned at least $400 during previous 52 weeks |
Private plans, self-insurance, or collective bargaining agreement |
New Jersey |
1948 |
Most private and certain state educational institutes; some government entities may elect coverage |
20 base weeks of employment in which wages are 20% of statewide weekly wage |
Private and state |
New York |
1949 |
Most private |
4 consecutive weeks of employment or unemployed <4 weeks |
Private, state, and self-insurance |
Puerto Rico |
1968 |
Most private and state entities operating as private enterprises |
$150 in base period |
Private and state |
Rhode Island |
1942 |
Most private; state and local entities exempt but may elect coverage |
200 x min. hourly wage in 1 qtr. and, base period, wages of 1- ½ x highest quarter (base period wages must be at least 400 x min. hourly wage) or 400 x min. hourly wage |
State plan only |
BENEFITS
Table 2 shows how the state programs are funded, the weekly benefit amount and duration, and the waiting-period requirements.
Table 2: Funding Mechanism, Weekly Benefit Amount, Benefit Length, and Waiting Period
State-Commonwealth |
Funding Mechanism |
Weekly Benefit Amount |
Benefit Length |
Waiting Period |
California |
Employee only: 0.9% of first $46,327 annual earnings |
Two-thirds of gross wages, up to a maximum of $490 /week; if gross wages < $189/week, % of gross wages is > two-thirds |
Up to 52 weeks |
7 days |
Hawaii |
Employer may share cost w/ workers; can't charge worker > half the premium or > 0.5% of weekly taxable wages |
58% of average weekly wage, maximum $372 (2000) |
Up to 26 weeks |
7 days |
New Jersey |
Employee pays 0.5% of first $21,200; capped at 80.53/year; Employer pay varies according to claims experience |
Two-thirds of a worker's weekly wages, up to a maximum of $401 (2000) |
Up to 26 weeks |
7 days (compensable after benefits have been paid for 3 consecutive weeks) |
New York |
Employer may share cost with worker; worker contribution 0.5% earnings; capped at $.60/week |
50% of average weekly wage, maximum $170 a week |
Up to 26 weeks |
7 days |
Puerto Rico |
Employers and employees pay 0.5% of the worker's wages up to $9,000 |
Same as unemployment (by schedule), except maternity which is 100% of wages |
Up to 26 weeks |
7 days (unless, if hospitalized) |
Rhode Island |
Employee only: 1.4% of first $40,600 |
4.62% of total wages in highest quarter (maximum $504) plus dependence allowance |
Up to 30 weeks |
7 days (compensable if disability lasts > 28 days) |
PREGNANCY
All of the state programs allow pregnancy-related disabilities. Puerto Rico allows all pregnancy-related disabilities except those arising from an abortion that is not induced for medical reasons. Usually pregnancy is payable 4 to 6 weeks before the baby is due and 6 to 8 weeks after delivery.
LM:ts