Skip to main content
Disability Insurance

Reasons for Short-Term Disability Denial in BC

Short term disability plans are available to many workers in British Columbia through their employers, with the province mandating minimum coverage requirements for all plans. Short term disability is an intended financial safety net for employees experiencing a temporary inability to work due to illness, injury, or chronic medical condition. Short term disability has certain eligibility requirements that, if not met, can result in short term disability denial.

Learn more about the common reasons for short-term disability denial, reapplying for short-term disability, and how short-term disability can be one step along the road to receiving long term disability benefits.

What Is Short Term Disability?

Short term disability provides temporary benefits for ill or injured employees for up to sick months. You must be actively and gainfully employed to receive short term disability benefits through your employer. Monetary benefits are determined by length of work service and employee type. In general, short term disability provides recipients between 60 to 85 percent of their regular pay, up to $650 weekly. Benefit rates vary depending on factors such as the recipient’s number of dependents and current income.

Short Term Disability for Government Workers

The Short Term Illness and Injury Plan (STIIP) provides temporary benefits for all government workers.

Stage 1
Employees who have worked less than three months will receive benefits for a maximum of six days per calendar year at 75% of their regular pay rate.

Stage 2
Employees who have worked between three and six months will receive benefits for a maximum of 15 weeks* at 75% of their regular pay rate for the first six days and 66 percent rate for the days remaining.
*Cannot exceed the maximum weekly sickness benefit set by employment insurance.

Stage 3
Employees who have worked six months or more will receive benefits for a maximum of six calendar months at 75% of their regular pay rate.

If you are a regular employee and are unable to go back to work following your maximum benefit period, you must apply for either general leave without pay or for long term disability benefits.

Short Term Disability for Auxiliary Workers

Auxiliary workers who have benefits have a maximum benefit period of seven months at 75% of the regular pay rate. Those who do not have benefits must have worked at least 400 hours in the same ministry and have not lost seniority to earn short term disability benefits. These employees earn a 60% benefit reward of normal average straight-time earnings for up to 15 weeks.

Reasons Short Term Disability Can Be Denied

There are a few short term disability disqualifiers that you should be aware of if you are planning to apply for benefits.

1. Failure to Meet Eligibility Requirements

Employees must wait an interim period prior to the activation of their policy benefits. This is called an “elimination period” and it is the minimum amount of time one must work in a job prior to accessing benefit plans. Typical elimination periods are three months, however, eligibility is likely to involve working a minimum number of hours in jobs with irregular schedules. Employees must meet the requirements of their job, adhere to their employment contract (if applicable), and be employed at the time they become disabled. Both part-time and full-time workers can be eligible for short term disability benefits. Those in non-traditional roles such as temporary contractors can be eligible under certain circumstances.

2. Incomplete Application

Short term disability applications require three components:

  1. A completed application form
  2. An Employee Statement (this form can be provided by your employer)
  3. An Attending Physician’s Statement

If any of these elements are absent from your short term disability application, you will be denied. However, you can appeal and reapply up to three times.

Additionally, you’ll want to alert your employer of your intention to apply for short term disability benefits. Firing employees for seeking short term disability benefits constitutes wrongful dismissal.

The Attending Physician’s Statement acts as proof of your condition. This is in contrast to long term disability benefits applications, which require more extensive medical documentation, including medical records and lab test results.

3. Your Symptoms or Diagnosis Aren’t Serious Enough

On the whole, short term disability benefits have a lower medical threshold than long term disability benefits and can cover a range of conditions that impact your mental and physical mental health in ways that prevent you from working your current job.

Fortunately for many benefits recipients, insurance companies no longer use a specified list of approved conditions and symptoms to determine medical eligibility for short term disability. Applicants can receive benefits for just about any valid medical reason, as long as its severity is confirmed by a doctor. Generally, the Attending Physician’s Statement is enough to get approved for short term disability benefits, but not always. Challenging a previous decision may take some modification of your original application, including seeing another doctor.

This can be especially important for those whose illness or injury may be enough to require long term disability benefits. Being approved for short term benefits isn’t a requirement for long term disability but it can help build your long term disability case.

4. You Are Currently on BC’s Employment Insurance

BC’s Employment Insurance (EI) is a government-run safety net that permits workers to take up to six weeks away from work for a number of valid reasons. You cannot receive both EI benefits and short term disability benefits at the same time. However, previously receiving EI benefits does not prevent someone from being eligible for or receiving short term disability benefits. Those who attempt to collect both benefits may be required to return the illegitimately awarded funds and be made ineligible for future benefits.

5. You Fail to Fully Participate in Recommended Medical Treatment

One key—and sometimes overlooked—factor of disability benefits occurs after receiving approval. With several check-in points throughout the three- to six-month benefits period requiring records documenting your medical progress, you’ll be expected to follow up with the doctor’s recommended treatments for your condition.

While benefits can last for six months, this is dependent on your medical progress. During this time, if your condition improves enough that the insurance company feels you can return to work, they may rescind benefits. On the other hand, if the insurance company suspects you are not fully participating in treatment to maintain your disability benefits (sometimes referred to as malingering), they may accuse you of trying to receive those benefits in an unauthorized or fraudulent way and discontinue them.