What is short-term disability and how does it differ from FMLA?

Short-term disability (STD) provides partial wage replacement (typically 50-70% of salary) when an employee cannot work due to illness or injury. FMLA provides job protection but is unpaid leave. They can run concurrently: FMLA protects the job while STD provides income. STD is insurance-based (employer or private policy), while FMLA is a federal law.

What documentation do disability insurers require?

Insurers typically require: diagnosis with ICD-10 codes, date condition began, objective clinical findings, functional limitations preventing work (specific to job duties), treatment plan, expected duration of disability, and provider attestation. Be specific about what the patient cannot do rather than just listing the diagnosis.

How do I determine the duration of disability?

Base duration on clinical evidence, published disability duration guidelines (like ODG or MDGuidelines), and individual patient factors. Avoid overly long durations unsupported by clinical evidence. Document why the expected duration is appropriate. Insurers may request reassessment if duration seems excessive for the condition.

What if the insurance company denies the disability claim?

Review the denial reason. If you believe the patient is disabled, provide additional documentation addressing the insurer's concerns. Write a letter explaining why the clinical findings support disability. Patients can appeal denials. If peer-to-peer review is offered, participate and advocate for your patient with clinical evidence.

Can I refuse to complete disability paperwork?

While providers can set reasonable policies (fees for paperwork, requiring recent visits), refusing to document a genuine disability could harm the patient. If you don't believe the patient is disabled, document your clinical findings honestly rather than refusing the paperwork. The insurer makes the final determination based on your objective findings.

Short-term Disability Letter Template - STD Documentation

Administrative — Short-term Disability Letter Template

Administrative Primary Care Updated: 11/7/2025

The Short-term Disability Letter Template is designed for physicians and healthcare providers completing documentation to support employee requests for short-term disability benefits. This template provides the structured format required by disability insurance companies to evaluate claims and includes sections for patient demographics and employment information, medical diagnosis with ICD-10 codes, clinical course and current status, functional limitations preventing work, expected duration of disability, treatment plan, and provider attestation. This template streamlines the disability documentation process, ensures inclusion of all required elements, supports timely claim processing, and protects provider time by standardizing documentation. The structured format is adaptable for various medical conditions causing temporary work disability. Ideal for primary care practices, occupational medicine practices, and practices frequently completing disability documentation.

Letter Header

Provider name, credentials, practice name
Address, phone, fax, NPI
Date

Patient Information

Patient name, DOB
Employer: [If known]
Disability insurance: [Company name if known]

Medical Diagnosis

Primary diagnosis: [Diagnosis name]
ICD-10 code: [Code]
Secondary diagnoses: [If applicable]

Clinical Course

Onset: [Date condition began]
Current status: [Patient's current condition]
Treatment: [Current treatment]
Prognosis: [Expected recovery]

Functional Limitations

Work restrictions: [Specific limitations]
Inability to perform: [Job functions patient cannot perform]
Physical limitations: [Standing, lifting, etc.]
Cognitive limitations: [If applicable]

Expected Duration

Disability period: [Start date - Expected end date]
Total duration: [X] weeks/months
Reassessment date: [If applicable]

Treatment Plan

[Current treatment and expected course]

Provider Attestation

I certify that the above information is accurate and that this patient is unable to perform their job duties due to [medical condition] for the period specified above.

Provider Signature

[Signature, credentials, date]