Short-term disability insurance replaces part of your income when a temporary medical condition prevents you from working, but many people, including federal government employees, USPS employees, and VA employees, aren’t always sure what conditions actually qualify. Eligibility for federal employee disability insurance and short-term disability depends on your specific policy, medical documentation, and how your condition affects your ability to perform your job. Below, we outline the most common medical situations that qualify for short-term disability.
8 Medical Conditions That Qualify for Short-Term Disability Benefits
- Recovery from Surgery
- Pregnancy, Childbirth, and Postpartum Recovery & Complications
- Severe Illness or Medical Treatment
- Mental Health Conditions & Treatment Programs
- Non-Work-Related Injuries or Accidents
- Hospitalization or Inpatient Treatment Programs
- Chronic Conditions with Acute Flare-Ups
- Neurological Conditions
If your condition falls into one of these categories and is supported by medical documentation, you may be eligible for short-term disability benefits. The sections below explain how coverage works, the required documentation, and what to expect when applying for benefits.
Medical Situations Typically Covered by Short-Term Disability
If short-term disability feels overwhelming, you’re not alone. Here’s a clear breakdown of the conditions most often approved, along with the reasons they qualify.
1. Recovery from Surgery
Recovery from surgery is one of the most common reasons someone goes on short-term disability. If your surgery makes it hard to do your job because of pain, limited movement, tiredness, or medical instructions, you may be eligible to receive benefits while you recover.
Common surgeries include orthopedic procedures, back or spinal surgeries, joint replacements, and other operations that require time off work to heal. Approval typically depends on the documentation from your medical provider outlining the procedure, expected recovery time, and any work restrictions (such as lifting limits, inability to stand or sit for long periods, or cognitive side effects from medication).
Once the waiting period ends, benefits are paid until your doctor clears you to return to work or until the plan’s maximum benefit period is reached.
2. Pregnancy, Childbirth, and Postpartum Recovery & Complications
Short-term disability often covers pregnancy, childbirth, and recovery if medical reasons prevent you from working. While pregnancy itself is not always seen as a disability, many policies do cover the recovery period after childbirth and any complications related to pregnancy.
Short-term disability policies can cover recovery from vaginal or cesarean delivery, postpartum healing, and conditions such as preeclampsia, gestational diabetes, severe nausea, bed rest, or other high-risk pregnancy issues. Your healthcare provider typically needs to certify that your leave is medically necessary, and coverage may vary depending on whether the leave is for routine recovery or complications.
The duration and benefits differ depending on your policy. Some federal employees will also use paid leave or FMLA alongside short-term disability to extend their time off.
3. Severe Illness or Medical Treatment
You may qualify for short-term disability if a serious illness or its treatment prevents you from working for an extended period of time. This includes conditions that require ongoing medical care, cause a lot of pain or fatigue, or make it unsafe for you to perform your job.
Examples include chemotherapy or radiation treatment for cancer, heart conditions, severe respiratory illnesses, autoimmune disorders, and other illnesses that require extended recovery or frequent medical appointments.
Approval usually comes down to your medical paperwork—specifically, how your condition or treatment affects your ability to work, how long your doctor expects you to be out, and any limits you need to follow. Benefits continue until you’re cleared to return to work or you hit your plan’s maximum coverage period.
4. Mental Health Conditions & Treatment Programs
You might be eligible for short-term disability benefits for mental health conditions if your symptoms or treatment make it difficult or unsafe to perform your job. As long as your provider documents the condition, many policies treat mental health and physical conditions the same.
Coverage can include conditions such as severe anxiety, depression, PTSD, or acute stress disorders. It may also apply if you are in a structured treatment program, such as an intensive outpatient program (IOP) or a partial hospitalization program (PHP). To get approved, you’ll need a licensed mental health provider to document your diagnosis, treatment plan, and how your symptoms affect your ability to work. The duration of benefits and eligibility depends on your policy, with some plans requiring additional documentation or limitations for mental health claims.
*Available options on federal government employee disability insurance can be very limited for mental illness.
5. Non-Work-Related Injuries or Accidents
Short-term disability insurance provides support for injuries or accidents outside the workplace that temporarily prevent you from performing your job. This coverage is often used when an injury affects your movement, strength, coordination, or ability to do tasks safely.
Some examples are car accidents, falls, sports injuries, or other incidents that cause fractures, sprains, concussions, or soft tissue injuries. To qualify, you must submit medical evidence that shows how the injury affects your ability to work, along with any restrictions or recovery times you may have. Injuries that happen at work usually aren’t covered by short-term disability and are handled through workers’ compensation instead.
Not sure if you have short-term disability coverage? Fill out our short form to review your options as a federal, USPS, or VA employee and plan ahead before you need coverage.
6. Hospitalization or Inpatient Treatment Programs
Hospitalization or inpatient treatment programs usually qualify for short-term disability when they require time away from work for recovery. Extended hospital stays or medically necessary inpatient programs typically show a level of impairment that prevents you from performing your normal job duties.
This may include surgical hospitalizations, serious illness requiring inpatient care, or admission to medical or psychiatric facilities for stabilization and treatment. Approval typically relies on discharge documentation, physician certification, and any ongoing recovery or work restrictions after release. Benefits generally continue through the recovery period as long as medical documentation supports the need for continued time off.
7. Chronic Conditions with Acute Flare-Ups
Chronic medical conditions may qualify for short-term disability when symptoms temporarily worsen and interfere with your ability to work. While the condition itself may be ongoing, coverage is typically tied to acute flare-ups that result in functional limitations.
Examples include migraines, multiple sclerosis, Crohn’s disease, lupus, fibromyalgia, or other conditions that cause a sudden increase in pain, fatigue, or mobility issues. Approval usually requires documentation from a medical provider confirming the flare-up, its impact on your job duties, and the expected duration of limitations. Short-term disability benefits generally apply only for the period when symptoms prevent you from working, not for ongoing symptom management.
8. Neurological Conditions
Neurological conditions may qualify for short-term disability when they temporarily impair physical movement, coordination, cognition, or sensory function. These conditions often require time away from work for treatment, recovery, or stabilization.
Examples include concussions, seizures, stroke recovery, nerve disorders, or other neurological events that affect concentration, memory, balance, or motor skills. Eligibility depends on medical documentation that shows how the condition limits your ability to perform job tasks and whether the restrictions are temporary. Benefits will continue until symptoms improve, you are medically cleared to return to work, or you reach your plan’s maximum coverage period.
Conditions That Are Generally Excluded from Short-Term Disability
Not every medical situation is covered by short-term disability, even if you need to take time off work. Coverage depends on whether your condition temporarily prevents you from performing your job and whether it is included in your policy. Knowing what’s typically excluded can help you understand what to expect before filing a claim.
Usually, short-term disability does not cover minor or brief illnesses that do not seriously affect your ability to work, such as colds, mild flu, or common infections. Elective or cosmetic procedures are also not covered unless they result in complications that lead to documented medical restrictions.
Another common reason claims are denied is missing or incomplete medical documentation. Most claims require a note from a licensed healthcare provider that explains your diagnosis, treatment plan, how your condition affects your ability to work, and how long recovery is expected to take. Without this paperwork, the insurer may decide your condition does not qualify.
Short-term disability generally covers temporary, non-work-related conditions. Work-related injuries are handled through workers’ compensation, and long-term or permanent conditions may fall under other programs.
Finally, some insurance policies may exclude coverage for specific situations based on timing or the terms outlined in the policy. This can include pre-existing conditions, failure to meet waiting periods, or noncompliance with treatment plans. Because every plan is different, it’s worth reviewing your policy details ahead of time.
When a Medical Condition Becomes a Disability
Short-term disability coverage is designed to replace income when a temporary medical condition prevents you from working, but eligibility depends on having the right coverage in place before a medical event occurs. Commonly covered situations include surgery recovery, pregnancy complications, serious illnesses, mental health treatments, injuries, and hospitalization—provided you meet the policy’s requirements.
Federal government employees, including USPS and VA employees, do not automatically receive short-term disability insurance through their jobs, so it’s important to plan ahead. Learning about your options and signing up for coverage before you need it can protect your income if a medical issue arises.
If you’d like help reviewing your benefits or exploring short-term disability options for federal employees, you can schedule a 30-minute consultation to walk through your options and plan ahead.
Frequently Asked Questions About Short-Term Disability Eligibility
Below you’ll find the answers to common questions about which medical conditions qualify and who’s eligible for short-term disability.
Getting approved for short-term disability is usually not difficult if you have the right coverage and provide clear medical records. Your claim is more likely to be approved when a healthcare provider confirms that a temporary medical condition prevents you from doing your job and your policy covers it.
People often use short-term disability for things like recovering from surgery, pregnancy and postpartum recovery, serious illness or medical treatment, mental health conditions that require time off, or injuries and accidents that happen outside of work. You usually qualify if your doctor confirms that your condition will temporarily prevent you from working.
Short-term disability is usually approved for conditions that have clear medical records and a set recovery time. Common examples include recovering from surgery, childbirth or pregnancy complications, serious illnesses or treatments, mental health issues with a treatment plan, injuries from accidents, and hospital stays that prevent you from working.
You typically do not need to share medical details with your employer when requesting short-term disability. In most cases, you can simply tell your supervisor or HR department that you have a medical condition requiring time off and that you are applying for short-term disability. Medical documentation will be handled through your insurance provider.
When it comes to short-term disability claims, proving your condition isn’t simply a matter of whether the diagnosis is considered “hard” or “easy.” Approval relies primarily on the medical documentation provided and the limitations you experience. Claims can be more difficult to support when symptoms are based mostly on how you’re feeling rather than clear test results, such as pain, fatigue, or certain mental health conditions. To strengthen your claim, it’s important that your healthcare provider thoroughly documents how these symptoms impact your ability to perform your job and provides a clear treatment and recovery plan.
For short-term disability purposes, conditions that do not temporarily prevent you from performing your job duties are typically not considered disabilities. This includes minor or short-term illnesses, elective procedures that do not have medical restrictions, and situations excluded by the policy terms. Examples of exclusions include work-related injuries covered by workers’ compensation and conditions that existed before your coverage began.
Yes. Short-term disability claims usually require medical documentation from a licensed healthcare provider. This documentation typically includes a diagnosis, treatment plan, work restrictions, and an estimated return-to-work date.