How Does Aflac Short-Term Disability Work? Benefits, Claims, and Costs

Aflac short-term disability insurance works by paying you a cash benefit directly after a short waiting period when a covered illness or injury keeps you from working, continuing for a set number of months or until you can return to your job. You can only get it through an employer that offers it, premiums come out of your paycheck, and the money is yours to spend on rent, groceries, medical bills, or anything else. Three variables shape every policy: the elimination period before payments start, the benefit period over which they continue, and the monthly benefit amount tied to your income.

When Benefits Start and How Long They Last

The elimination period is the gap between the day your disability begins and the day Aflac starts paying. Most policies split that wait, with a shorter one for accidents than for illnesses. A common “7/14” structure pays accident benefits starting on the eighth day and illness benefits starting on the fifteenth.¹ You pick your elimination period at enrollment. Across the short-term disability market, waits run from 7 to 30 days, with 14 days being typical.²

The benefit period is how long the policy will keep paying once benefits start. Several months is typical, and some plans go up to a year.³ At least one employer plan structure lets you choose between a six-month benefit period paired with a 14-day elimination period and a 24-month benefit period paired with a 30-day elimination period.⁴ What’s actually on the menu depends on the plan your employer set up.

The benefit amount is designed to replace part of your pre-disability pay rather than all of it. Aflac illustrates one scenario in which a policyholder totally disabled for six weeks receives up to $2,800.³ When you enroll, Aflac suggests adding up your essential monthly expenses, including rent or mortgage, utilities, loan payments, groceries, and childcare, to figure out how much coverage you need.

What Counts as Being Disabled

If you have a full-time job when the disability starts, Aflac uses an “own occupation” standard. You’re considered totally disabled when a physician confirms you cannot perform the material and substantial duties of your specific job and you are not working at any job.⁵ If you don’t have a full-time job when the disability occurs, the test is tougher: Aflac looks at whether you can perform the duties of any occupation for which you’re qualified by education, training, or experience.⁶

There’s also a partial disability benefit for the transition back to work. If you can work but are earning less than 80 percent of your pre-disability income, Aflac pays 50 percent of your selected monthly benefit for up to three months after the elimination period.⁷ You don’t have to collect total disability benefits first to qualify. Partial payments stop once a physician releases you to full duty or you’re earning 80 percent or more of your pre-disability income again.⁸

What’s Covered and What’s Not

The policy covers illnesses and injuries that occur on or off the job and temporarily keep you from working.⁹ Common exclusions across Aflac’s STD plans include:

Pre-existing conditions, generally not covered unless the disability begins more than 12 months after the policy’s effective date. A pre-existing condition is typically one for which medical advice, treatment, or symptoms existed within the 12 months before coverage began.¹⁰
Self-inflicted injuries or suicide.
Illegal drug use or intoxication, unless a substance was prescribed by a physician.
Committing or attempting a felony, or being incarcerated.
Active military service, including National Guard or Reserve duty.
War or acts of war.
Cosmetic or elective surgery that isn’t medically necessary.
Work-related injuries, which are generally handled by workers’ compensation instead.⁹

Aflac also won’t pay for disabilities treated outside the United States, or for any illness diagnosed or treated within the first 30 days of coverage unless the resulting disability begins more than 12 months after the effective date.¹¹ Only one disability benefit is payable at a time, even if more than one condition contributes.

Pregnancy and Childbirth

Pregnancy and childbirth are covered, but with a timing restriction that trips people up. Benefits for childbirth are payable only after the policy has been in force for at least ten months.⁸ You need coverage in place well before becoming pregnant for the delivery to be covered.

Once that waiting period is satisfied, the maximum disability period for childbirth is six weeks for a vaginal delivery and eight weeks for a cesarean, minus the elimination period. A longer disability requires proof submitted to Aflac. Complications of pregnancy are treated like any other sickness. Post-partum depression, however, falls under the mental health exclusion in the A57600 policy series and is not covered under those plans.⁸

Mental Health Conditions

Aflac expanded its individual short-term disability coverage in August 2022 to include disabilities caused by common mental health conditions, with no rate increase for existing policyholders.¹² Covered conditions include schizophrenia, bipolar disorders, depressive disorders, anxiety disorders, eating disorders, post-traumatic stress, and substance and alcohol use disorders.¹³

There are limits. Under the A57600 policy series, benefits for disability caused by mental illness are capped at a lifetime maximum of 24 months. You must be under the care of a licensed mental health provider to receive benefits. Bereavement, situational depression, somatoform disorders, and stress are explicitly excluded.¹⁴ The 12-month pre-existing condition rule and the 30-day diagnosis limitation also apply.

Mental health coverage varies by policy series and by state. The older A57600 series used by many employer groups explicitly excludes mental and emotional disorders, while newer individual and expanded plans cover them.¹⁰ Check your own policy documents before assuming either way.

If the Same Condition Comes Back

When the same condition causes a second disability, Aflac treats it as a continuation of the earlier one unless at least 180 days have passed since the end of the previous benefit period. To open a new benefit period for the same or a related condition, you must have been released by a physician, no longer be disabled, and go 180 days without receiving benefits.⁶

For an unrelated condition, the rule is different. A new benefit period starts if you return to work for at least 14 working days performing the material duties of your job. Fall short of that, and the new disability is treated as a continuation drawing from the same benefit period rather than resetting the clock.⁶

Filing a Claim and Getting Paid

You can file online through the MyAflac portal or mobile app around the clock, or submit paper forms by fax or mail.¹⁵ A disability claim normally has four parts: a policyholder’s statement, an employer’s statement, an attending physician’s statement, and a signed authorization. Supporting documents can include chart notes, admission and discharge paperwork, surgical reports, and receipts for follow-up visits.¹⁶ If forms arrive incomplete or unsigned, the policyholder is notified within seven to ten business days.¹⁷ Claims involving pre-existing condition reviews, waiting periods, or contestability can take longer because they need additional medical records.

Benefits can arrive by direct deposit or check. For direct deposit, you submit an authorization form along with a voided check or a direct deposit form from your bank.¹⁶ If a claim is denied, Aflac provides a formal appeals process.¹⁵

Cost, Taxes, and Keeping the Policy

Short-term disability insurance generally runs one to three percent of annual salary, with the actual premium depending on the insurer, the type of coverage, state laws, and the plan level.² Aflac doesn’t publish dollar-amount price schedules on its website and directs prospective policyholders to a local agent for a quote. Premiums come out of your paycheck,¹⁸ and some plans guarantee that your rate won’t go up because of age.⁴

Whether the benefits you receive are taxable depends on who paid the premiums. Under IRS guidance, if your employer pays, the benefits are fully taxable as income. If you pay the whole premium yourself with after-tax dollars, the benefits are not taxable. When the cost is shared, only the share tied to the employer’s payments is taxable. Here’s the catch most people miss: if premiums are paid through a cafeteria plan (sometimes called a Section 125 plan), those pre-tax dollars are treated as employer-paid, making the benefits fully taxable.¹⁹ If your benefits are taxable, you can submit Form W-4S to Aflac to request federal income tax withholding, or make estimated payments with Form 1040-ES.

Aflac STD is sold only through employers, so you can’t buy it on your own.³ Many plans offer guaranteed-issue enrollment, which skips medical questions and exams, though that varies by state. Policies are guaranteed renewable up to age 75.⁹ At least some Aflac STD plans are portable, meaning you can take the coverage with you if you change jobs or retire; under those portable plans, coverage is guaranteed to age 72 and premiums don’t rise because of age.⁴ Portability terms vary, so confirm the details of your plan with your employer or an Aflac agent before counting on them.

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