How to Get Short-Term Disability Approved While Pregnant 2025
What Is Short-Term Disability Insurance?
Short-term disability insurance provides temporary income to an insured worker who cannot perform job duties due to a medical condition, illness, or non-work-related injury. Depending on the policy, coverage may come as an employer benefit or a standalone policy, affecting premiums, deductibles, and co payments. Some policies offer direct payments, while others require out-of-pocket expenses before compensation begins. The amount received typically depends on a percentage of the employee’s salary and varies by jurisdiction. To qualify, workers must submit medical records and documentation supporting their claim, often backed by medical opinions. However, certain exclusions apply, and employment protection laws determine whether a work absence due to a covered condition ensures job protection.
Employers and insurance companies set different coverage options, making communication essential when applying for short-term benefits. Some policies coordinate with paid leave programs, while others focus solely on income replacement. If an employee qualifies, temporary benefits can ease the financial risk of missing work, but understanding legal rights is key. Workplace policies may require a transition from disability insurance to another form of support after a set period. Missing deadlines or failing to submit the right paperwork can delay approval, making early planning essential. Whether the policy is employer-sponsored or individual, knowing how treatment, policy details, and employment protection laws interact can make a significant difference in securing benefits.
Coverage of Disability Insurance
What Does Short-Term Disability Insurance Cover?
A few months ago, my cousin Lisa assumed her short-term disability insurance would fully cover her leave after childbirth, but she quickly discovered that policy details can be confusing. Here’s what she learned the hard way:
Doctor’s approval is essential—without it, an insurance company may reject a disability claim, even for pregnancy or post-delivery complications.
Certain illnesses and injuries, like a broken bone, may qualify for benefits, but the timeline is limited—nothing close to 102 weeks, which applies to long-term disability.
Treatment plans and recovery expectations impact approvals, so consulting an insurance professional beforehand can help avoid surprises.
Lisa eventually received benefits but wished she had understood these factors before applying. Her biggest takeaway? Knowing the rules early can save a lot of stress.
Short-Term Disability and Pregnancy
Does Short-Term Disability Insurance Cover Pregnancy?
Some plans consider conditions like severe morning sickness or hyperemesis gravidarum valid reasons for a claim, while others set a strict legal threshold for approval. The elimination period—the waiting time before benefits begin—can be tricky, especially if a policy has high deductibles and co payments.
Many employers offer sickness leave or employer accommodations, but that doesn’t always mean job protection. Programs like Family and Medical Leave may help, but they’re unpaid, leaving many to rely on personal savings or supplemental maternity insurance. Speaking with an insurance professional or financial advisor can clarify options before making a claim.
Some provinces have stronger protections. The Human Rights Commission of Newfoundland and Labrador, for example, addresses discrimination cases related to pregnancy. However, not all claims qualify for long-term disability insurance, so understanding coverage limits ahead of time is essential.
Eligibility for Short-Term Disability During Pregnancy
Medical Eligibility
Last year, my friend Sarah had to fight for her short-term disability benefits when her high-risk condition made standing, walking, and even basic daily activities unbearable. Her insurance provider initially denied her disability claim, saying her symptoms weren’t severe enough. But her physician pushed back, providing extensive medical documentation to prove that her pregnancy-related complications significantly limited her major life activities. The process wasn’t simple—she had to go through an appeal and wait several months before approval.
Policy and Workplace Considerations
Here’s the problem: Many policy terms require that an employee be completely unable to perform their work duties before qualifying. Some insurers may approve claims for severe morning sickness, but only if it lasts beyond a few weeks and disrupts the ability to work. Others may expect an employer to offer reasonable accommodations, like modified work hours or reduced lifting requirements, before considering benefits.
Legal Protections and Challenges
Laws like the ADA and ADAAA protect against discrimination, but in Canada, eligibility depends more on policy coverage and whether the condition meets the insurer’s definition of an impairment. Sarah eventually got her claim approved, but without legal protections, it was a real challenge.
Laws like the ADA and ADAAA protect against discrimination, but in Canada, eligibility depends on policy coverage and whether the condition meets the insurer’s definition of an impairment. For a comparison of maternity leave policies and benefits between Canada and the U.S., read Living in Canada vs. USA: A Quick Guide to the Pros and Cons.
How to Get Short-Term Disability Approved While Pregnant
Understanding Short-Term Disability Coverage
In 2023, the Bureau of Labor Statistics reported that only 27% of civilian workers had access to paid family leave, while others had to rely on unpaid family leave through the Family and Medical Leave Act (FMLA). Without insurance coverage, the lack of pay can make the childbirth recovery period financially stressful. Since approval isn’t automatic, understanding the process and gathering proper documentation from a healthcare provider is key.
Employment Insurance (EI) sickness benefits provide financial help for up to 26 weeks, paying 55% of average weekly earnings up to a government-set maximum. To fully understand how EI contributions and benefits work, check out When Does EI & CPP Max Out? Find Out Before It's Too Late!
Meeting Eligibility Requirements
Most insurance companies require proof that symptoms, an illness, or a pregnancy-related injury affect the ability to work. Some state and local laws expand eligibility, but policies vary. In Canada, provincial programs may offer better income replacement, but private short-term disability benefits still depend on employer plans. Applicants must follow strict state laws, ensuring they meet the right criteria before filing a claim. Knowing the system and available tools can increase approval chances.
Maximizing Benefits and Compensation
While some policies offer coverage for 12 weeks, others extend up to 90% of wages for a limited time. A comprehensive guide on workplace policies and regulations can help employees demystify the claims process. If a standard plan doesn’t cover enough, exploring additional options—like alternative insurance coverage for pregnancy or adoption—might be necessary.
Medical Considerations and Benefits for Pregnancy-Related Disability
Understanding Disability Coverage and Eligibility
Many Canadian women don’t realize that short-term disability can provide monthly income during pregnancy and postpartum recovery. For instance, severe nausea like hyperemesis gravidarum, preeclampsia, or gestation-related hypertension may meet the criteria, but mild complications might not. Policies often require medical proof of complications, such as low iron levels from iron-deficiency anemia, abnormal glucose levels indicating diabetes, or extreme fatigue due to thyroid disorders.
Medical Documentation and Legal Aspects
Employers may require verification of medical intervention, like hospitalization for preterm labour, severe vomiting, or even a miscarriage or stillbirth. If approved, the benefit period typically lasts three to six months, depending on the policy. The Public Health Agency of Canada reports that 8.46% of pregnancies involve birth defects, while 8.69% result in pregnancy loss—factors that may influence disability coverage decisions.
Postpartum Challenges and Support
Recovery after childbirth isn’t just physical. The National Institute of Mental Health recognizes major postpartum depression, anxiety, and baby blues as qualifying mental health conditions for disability payments. Postpartum depression requiring medical attention may justify time off work, especially if compounded by chronic conditions like autoimmune diseases or infections such as rubella. Employers may offer greater benefits, but without proper medical care and documentation, securing income during recovery can be challenging.
Long-Term Disability and Pregnancy in Canada
Understanding Long-Term Disability (LTD) for Pregnancy
Long-term disability (LTD) coverage provides monthly income for Canadian women who are unable to work due to serious pregnancy complications, postpartum recovery, or chronic medical conditions. However, mild complications may not qualify.
To receive disability payments, applicants must provide medical evidence from doctors, proving the condition prevents them from working. The Public Health Agency of Canada reports that 8.46% of pregnancies involve birth defects, while 8.69% result in pregnancy loss, which can significantly impact eligibility.
Applying for LTD Benefits
Step 1: Check Policy Details
Review policy details, including deductibles, benefit duration, and income replacement terms.
Understand the transition from short-term disability or maternity leave to LTD coverage.
Step 2: Gather Medical Documentation
Submit records of medical intervention, hospital stays, or complications like preterm labour, hypertension, or iron-deficiency anemia.
Obtain statements from healthcare providers confirming the medical condition prevents a return to work.
Step 3: File an LTD Claim
Complete the application process through the insurance company or employer benefit plans.
If the claim is denied, a disability lawyer can assist with an appeal using additional medical evidence.
Financial and Workplace Considerations
Some benefit plans include life insurance, parental leave benefits, and greater benefits for severe conditions.
Payroll deductions may cover LTD premiums, but financial security depends on insurance coverage.
Employers may require medical proof for continued job protection.
Pregnancy and Disability Leave Interactions
Pregnancy, Sick Leave, and Disability: Understanding Leave Interactions
Maternity, Parental, and Sick Leave
Maternity leave is job-protected and lasts up to 17 weeks in Ontario.
Parental leave is for bonding with a newborn or adopted baby, lasting up to 61-63 weeks.
Sick leave applies to temporary medical conditions, including pregnancy complications.
Disability and Sickness Benefits
Short-term and long-term disability benefits support those unable to work due to severe conditions.
EI sickness benefits provide financial help for up to 26 weeks.
CPP disability benefits cover prolonged disabilities beyond sick leave.
Approval Process & Coverage
Private insurance and government programs offer different coverage options.
Human rights tribunals handle disputes over eligibility and exclusions.
Proper notification and documentation help avoid delays and maximize benefits.
Applying for Sickness and Disability Benefits During Pregnancy
How to Apply for Sickness Benefits During Pregnancy
Eligibility Requirements
Need at least 600 insurable hours in the past 52 weeks or since the last EI claim.
A medical certificate from a doctor confirming complications and required recovery time.
Application Process
Apply online through Service Canada with required documents:
Social Insurance Number (SIN)
Record of Employment (ROE) from your employer
Medical documentation supporting your inability to work
There is a one-week waiting period before payments begin.
Benefits & Coverage
EI sickness benefits cover up to 26 weeks, paying 55% of average weekly earnings up to a government-set maximum.
Can transition to EI maternity benefits or parental benefits after sickness benefits.
Short-term disability insurance may offer additional coverage.
Appeal Process
If your claim is denied, you can appeal with additional medical documentation.
Government of Canada determines maximum benefit periods and weeks of leave based on your current condition.
Getting Approved for Disability While Pregnant
Getting Approved for Short-Term Disability While Pregnant: A Step-by-Step Guide
Check Eligibility
Must have pregnancy-related complications that affect your ability to work.
Conditions like severe nausea, preterm labor, gestational diabetes, preeclampsia, and hyperemesis gravidarum may qualify.
Review your STD policy for legal exclusions, pre-existing conditions, and minimum required hours.
Gather Medical Documentation
Schedule a doctor’s appointment to discuss symptoms, treatments, and medications.
Obtain a doctor’s note, medical certificate, functional abilities form, and other medical documentation.
Consider a second opinion from a specialist if needed.
Understand Your Insurance Options
Check if you qualify for Employment Insurance (EI) sickness benefits, private disability insurance, or provincial disability programs like ODSP.
Confirm with your employer or insurance provider about extended benefits.
Prepare and Submit Your Claim
Gather policy documents, medical data, personal data, and workplace policies related to your disability claim.
Submit a disability benefit application with supporting forms and correspondence.
Ensure all details match your doctor’s certification of essential work function limitations.
Follow Up and Appeal If Needed
Communicate with your HR department, legal team, or attorney if issues arise.
If your claim is denied, review the claims process, policy exclusions, and fight for reconsideration if necessary.
Keep a symptom journal and provide additional medical notes to strengthen your case.
Eligibility and Requirements
Eligibility and Requirements for Short-Term Disability Plans
A doctor must certify the condition. The applicant must be employed and may receive benefit payments for up to 15 weeks. Some policies have a short service period requirement, especially for public servants. Eligible individuals may switch to EI maternity benefits or EI sickness benefits after 17 weeks. Medical documentation and a clear understanding of policy details are essential.
EI Premium Reduction Guide Annex 1: Requirements for Short-Term Disability Plans
For employers to qualify for an EI premium reduction, their short-term disability plans must meet strict requirements. These include conditions for both weekly indemnity plans and cumulative paid sick leave plans, ensuring alignment with government regulations for benefit distribution.
Requirements That Apply to All Short-Term Disability Plans
To access short-term disability benefits, an employee must be part of an eligible plan and meet the employment duration requirements. In most cases, an employee must have at least three months of continuous employment. Payments typically start after a seven-day waiting period, covering 55% of the employee's average insurable earnings, with a yearly maximum of $65,700 in 2025. Employers may integrate additional benefits based on overtime, bonuses, or shift differentials. Specific exclusions apply, including criminal offenses, strikes, cosmetic procedures, or disability resulting from drugs or alcohol.
Requirements Specific to Weekly Indemnity Plans
Weekly indemnity plans provide coverage for employees unable to work due to illness or injury. Benefits last between 15 and 52 weeks, with provisions for reinstatement if a recurring disability arises. Employees must meet minimum work-hour requirements, typically 150 to 400 hours. Some provincial and territorial employers offer special weekly indemnity plans.
Requirements Specific to Cumulative Paid Sick Leave Plans
These plans allow employees to accumulate paid sick leave credits based on continuous employment. Credits can be used for pregnancy, newborn or adopted child care, medical appointments, or critically ill family members. Employers offering enhanced paid sick leave plans may qualify for an EI premium reduction. The benefit duration ranges from 72 to 125 days, depending on employment status and initial application. Some plans allow employees to accumulate 12 to 20 sick leave days per year, ensuring continued income support during medical absences.
Employment Protections and Rights During Maternity or Sick Leave
Protections in Non-Unionized and Unionized Workplaces
In unionized settings, rights are outlined in a collective agreement, while non-unionized employees rely on employment standards laws and the Human Rights Act for protections during maternity or sick leave.
Legal Protections and Employment Standards
Each province in Canada has its own Employment Standards Act, covering maternity leave, parental leave, and sick leave. Employers must comply with these laws, ensuring approved leaves do not lead to wrongful dismissal under Section 53 of the Act.
Reinstatement and Job Security
Employees on maternity leave or sick leave have the right to reinstatement in their previous role or a comparable position upon return. Employers cannot terminate or penalize an employee for taking approved leave due to disability, pregnancy complications, or childbirth.
Disability and Employment Status
Employees receiving short-term or long-term disability benefits retain employment protections, but eligibility may depend on jurisdiction and employer policies. Employees facing disputes over termination or denied benefits should consult a legal professional for guidance.
Privacy and Communication
Employers must respect employee privacy regarding medical conditions. Employees should stay informed about their employment status, EI sickness benefits, maternity leave benefits, and disability benefits while on leave.
Insurance and Benefits During Maternity Leave
Employees on maternity or sick leave may receive benefits through their employer or insurance provider. Coverage includes short-term disability insurance, pension programs, and vacation entitlements, depending on policy details and workplace rules.
The HR department can clarify premiums, deductibles, copayments, and exclusions related to pregnancy and childbirth. Consulting an insurance professional helps navigate coverage options and ensure continued benefits and reinstatement rights after leave.
Benefits and Pension Plans
Employees in Canada may be eligible for short-term disability benefits during pregnancy and leave periods. These benefits, along with pension plans, depend on insurance policies, employer guidelines, and employment standards acts.
Key Considerations:
HR Department & Insurance Provider – Clarifies coverage, limitations, and reinstatement rights.
Pension Contributions – Lost contributions during leave may impact retirement savings.
Medical Documentation – Required for a disability claim to access benefits.
Legal Advice – Helps address policy violations and ensure rights are upheld.
Understanding definitions, withdrawal options, and claim processes ensures employees receive the benefits they are entitled to.
Disability Insurance and Maternity Leave
Do I Need Disability Insurance While I’m on Maternity Leave?
Some employers suspend coverage, while personal disability insurance may continue. If sick or injured, coverage options vary for long-term disability and parental benefits.
What Do I Need to Consider Before Purchasing Disability Insurance for Maternity Leave?
When buying disability insurance for maternity leave, check coverage through your employer or partner. Review benefits administrator policies, defined benefits, and percentage of regular income. Compare premiums, length of coverage, retirement age, and waiting periods. Some policies require a medical exam, blood test, or questionnaire. Get quotes from multiple providers and compare standalone policies with life insurance options.
Does Long-Term Disability Insurance Cover Pregnancy?
Long-term disability insurance may cover pregnancy-related complications but not routine pregnancy. Short-term disability is usually the primary coverage for maternity leave. Policies vary by employer and insurance company, so check benefits, claim processes, and coverage levels. Some plans allow a transition from short-term to long-term disability if complications persist.
Can I Get EI Maternity Benefits and Disability Benefits Like EI Sickness at the Same Time?
You cannot receive EI maternity benefits and EI sickness benefits at the same time. However, if you develop a medical condition before or during maternity leave, you may qualify for EI sickness benefits first and then switch to maternity benefits. The total benefit period cannot exceed 102 weeks. Eligibility depends on medical documentation, qualifying criteria, and the maximum weeks allowed under special benefits.
Documentation and Red Flags
Red Flags and Documentation for Maternity Leave and Disability Benefits
Applying for maternity leave and disability benefits involves various legal exclusions and potential red flags that can affect your approval process. Missteps related to pension contributions, incorrect medical documentation, or confusion with Service Canada may cause delays or denials. It's important to understand the terms of your insurance policies, employer requirements, and eligibility criteria before applying.
Key Red Flags to Watch For
Unclear or missing medical documentation: Your doctor’s statement should include an estimated delivery date, details of any disability, and how your condition affects work duties.
Incorrect pension contributions: Errors in records may affect future benefits and require consultation with your employer or financial advisor.
Unrelated conditions impacting eligibility: Some insurance providers may deny claims if they determine your disability is unrelated to your pregnancy.
Gaps in communication with the insurance provider: Lack of clarity with your insurer, HR representative, or support team may result in misunderstandings about coverage, waiting periods, or benefit terms.
Misinterpretation of policy terms: Always review policy details to avoid reliance on guesswork regarding your insurance plan provider’s coverage limits, disability leave duration, and claim procedures.
Essential Documentation for a Smooth Process
Doctor’s certification confirming medical necessity for leave.
Medical records detailing the condition, diagnosis, and treatment plan.
Employer verification outlining your job duties and how your condition prevents you from performing them.
Insurance policy documents specifying coverage limits, exclusions, and waiting periods.
Financial records confirming pension contributions and past earnings for benefits calculation.
Consultation records with a legal advisor, HR representative, or insurance provider to clarify rights and policies.
Taking the time to gather complete documentation, maintain clear communication, and consult with experts when needed will improve your chances of a successful claim approval for maternity leave or disability benefits in Canada.
Alternatives and Choices
Choosing Between FMLA and Short-Term Disability (STD): Alternatives and Considerations
Selecting between FMLA (Family and Medical Leave Act) and Short-Term Disability (STD) requires understanding their job security, cost implications, and coverage differences. Employees dealing with maternity leave, severe health conditions, or other medical leave needs must weigh these options carefully.
Key Differences
FMLA: Provides job protection for eligible employees but is unpaid. It covers maternity leave, adoption, paternity leave, and serious health conditions.
STD: Offers paid leave for a medical condition, covering a portion of lost wages through insurance plans. However, it may have premiums, deductibles, and coverage limitations.
Alternative Options
Vacation Days & Paid Leave: Some employers allow using vacation days or extended health coverage to bridge financial gaps.
Parental Benefits & Maternity Benefits: Available through insurance plans or government programs, these can provide additional financial support.
Unpaid Leave: If FMLA or STD are unavailable, some employers offer leave of absence policies, though this may impact pensions and job security.
Insurance Claims & Financial Planning: Consulting an insurance professional or financial advisor can help in selecting the best policy for coverage.
Understanding policy details, eligibility criteria, and employer benefits can help employees make informed decisions about their leave options.
Conclusion
Understanding the process, meeting requirements, and exploring coverage options are key to a smooth application. While maternity leave provides time for recovery, disability benefits can offer additional support in case of medical issues. Weighing alternatives like long-term disability or employer-provided plans helps address financial concerns and ensures stability during childbirth and recovery.
FREQUENTLY ASKED QUESTIONS
FAQs and Community Questions
Is pregnancy considered a disability in Canada?
Pregnancy itself is not considered a disability in Canada, but complications such as gestational diabetes, Hyperemesis Gravidarum, severe morning sickness, or chronic conditions may qualify for short-term disability or long-term disability benefits if they impact work eligibility.
Can you go from maternity leave to sick leave?
A transition from maternity leave to sick leave depends on eligibility, disability benefits, policy terms, and coverage. To qualify, an employee must be disabled, provide medical documentation, and meet the approved leave requirements, including the actively at work requirement before illness or disability.
How do I qualify for short-term disability benefits as a pregnant woman in Canada?
To qualify for short-term disability benefits in Canada, a pregnant individual must meet employment insurance (EI) requirements, provide medical documentation from a healthcare provider, and prove they are unable to work due to medical reasons covered by their insurance plan.
Is short-term disability available for the entire duration of pregnancy in Canada?
Short-term disability coverage for pregnancy in Canada depends on medical circumstances, type of employment, and policy terms. It may cover certain pregnancy-related conditions but typically does not extend for the entire duration of pregnancy unless medically necessary, including postpartum recovery and birth-related complications.
How much of my income will be covered by short-term disability benefits while pregnant?
Short-term disability benefits in Canada may cover 50% to 100% of pre-pregnancy income, depending on the employer’s policy, insurance provider, and specific coverage terms and regulations.
How long does it take for short-term disability benefits to be approved in Canada?
The approval process for short-term disability benefits in Canada varies based on situation, application completeness, and insurance provider. Claims may be processed within a few weeks or take months if additional documentation or review is required.
Are there any waiting periods before short-term disability benefits for pregnancy are paid out?
Most short-term disability benefits in Canada have a waiting period before payments begin. This elimination period can range from one to two weeks, during which an individual may rely on sick leave or unpaid time.
Can I combine short-term disability benefits with other types of pregnancy-related leave in Canada?
Short-term disability benefits in Canada can sometimes be combined with maternity leave, parental leave, or other pregnancy-related leave. Programs like Employment Insurance (EI) provide financial support, but specific combinations depend on eligibility criteria.
What happens if my short-term disability claim is denied while I’m pregnant in Canada?
If a short-term disability claim is denied in Canada, the applicant can appeal the decision by submitting additional supporting documentation, medical evidence, and a claim letter. Consulting an employment lawyer or contacting the Employment Standards office may help with the appeals process.
What happens to my pregnancy disability benefits after giving birth?
After birth, the continuation of disability benefits depends on severity, complications, and a doctor’s verdict. With proper supporting documentation, coverage may extend for two weeks after a standard delivery, six weeks for a cesarean section, and up to eight weeks for severe medical conditions, as per company policy.
Can I apply for longer disability status when pregnant with multiples?
A pregnant individual carrying multiples (twins, triplets, etc.) may qualify for extended disability status. Some policies provide eight to 12 weeks of benefits based on the estimated due date, medical complications, and physician’s recommendation for a legal extension.
Can I apply for short-term disability status more than once a year?
Applying for short-term disability status more than once a year depends on the disability benefits policy, eligibility requirements, and insurance provider's limit. A new claim typically requires medical documentation and approval.
Can you use short-term disability for maternity leave?
Yes, short-term disability can be used for maternity leave if a person meets medical criteria due to pregnancy complications or inability to work. Coverage depends on the policy terms and insurance provider.
