Short-term disability (STD) insurance replaces part of your income if you’re temporarily unable to work due to an illness, injury, or medical condition. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) considers an SUD to be a medical condition. Thus, SUDs can qualify under STD if treated as medical conditions.
The Americans with Disabilities Act (ADA) regards addiction as a disability. This can make people with SUDs eligible for certain disability benefits.
Cigna is a major provider of both health and disability coverage. It offers STD insurance as part of its group benefits package. This article will explain eligibility, the claims process, and key considerations.
If you or your loved ones need help navigating insurance or starting addiction treatment, please reach out to our team at Nirvana Recovery. We’re a supportive partner for treatment and insurance/disability claim guidance.
Cigna’s Short-Term Disability Plans
Types of Plans Offered
1. Employer-Sponsored Group Plans
Through employer-sponsored group plans, Cigna provides STD insurance to replace a portion of your income when you’re temporarily disabled. The employer or employee may pay for coverage, or it may be jointly funded. Your employer pays or subsidizes most group STD plan premiums.
2. Voluntary Individual Coverage
Cigna doesn’t offer individual STD policies. Its short-term disability offerings are group-based, entered through your employer. Cigna’s short-term disability products are tied to your employer’s eligibility and group plan structures.
These group STD plans require employer participation in enrollment and administration, even when employee-paid.
Coverage Percentages and Limits
Many policies provide benefits of up to 60% of weekly earnings. This is the portion of your income that Cigna’s STD replaces. In some cases, benefit coverage may be as low as 40% of pre-disability earnings. This depends on the specific group plan set by your employer.
Your weekly payouts are capped at $1,000. Caps exist for the following reasons:
Affordability for Employers: They help stabilize group premiums
Risk Management: They prevent excessive payouts relative to actual income levels
Uniformity: Standard caps simplify administration across varied salary ranges
For higher-paid employees, these limits mean they’ll receive less than the full 60%.
Waiting Periods and Elimination Periods
Cigna’s group STD plans offer two common waiting period structures:
7-Day Waiting Period: Benefits start on the 8th day of disability. This is regardless of whether the disability is due to illness, injury, or hospitalization.
14-Day Waiting Period: Benefits begin on the 15th day of disability.
These waiting periods play the following roles:
Administrative Efficiency: They help minimize claims for very short absences
Cost Control: Shorter waiting periods cost more; offering both options gives flexibility
Benefit Timing: They help you plan financially for the initial days of disability
Your employer may offer either or both elimination period types. Verify which applies to you.
Common Exclusions and Limitations
Long-term disability (LTD) policies may exclude pre-existing conditions. However, short-term disability policies may not. STD benefits may still apply even if the disability stems from a condition existing before coverage began.
In some cases, prior symptoms or treatment 3 to 12 months before the policy starts can affect eligibility. In other instances, STD plans may not pay benefits for a disability caused or contributed to by a pre-existing condition if the disability starts within the first 12 months after coverage.
Some Cigna supplemental riders may exclude “mental or emotional disorders, alcoholism, and drug addiction.” This means that benefits won’t be payable for such conditions under those particular riders. Voluntary add-ons to the coverage could also significantly limit rehab eligibility.
How Short-Term Disability Applies to Addiction Rehab
Qualifying for STD Benefits for Rehab
Cigna aligns with the American Society of Addiction Medicine (ASAM) Criteria to assess medical necessity across various treatment levels. Cigna defines medical necessity as services that:
Are for evaluating, diagnosing, or treating an illness
Align with generally accepted standards of medical practice
Are clinically appropriate
To support a claim, you need a doctor’s evaluation and diagnosis. Your doctor will provide details about your withdrawal risk and justification for a specific level of care. You will also need an ASAM-based treatment plan.
Cigna covers inpatient and outpatient programs when deemed appropriate. Inpatient treatment aligns with short-term disability eligibility due to the complete absence from daily work duties. STD may apply to intensive outpatient programs and partial hospitalization programs if participation disrupts your ability to perform job functions.
While Cigna covers standard outpatient care, the intensity is insufficient to warrant short-term disability. It’s because employees may still perform work duties.
How Health Insurance and STD Work Together
Cigna health plans cover treatment costs. In-network rehab facilities offer lower out-of-pocket costs, access to care coordination, and no surprise billing. Some plans may still provide coverage for out-of-network rehab facilities. But you need to prepare for higher deductibles and coinsurance, possible balance billing, and complex claims processing.
Cigna covers the following types of treatment services:
When you’re on treatment leave, for example, attending rehab, Cigna’s short-term disability benefits come in to replace a portion of your lost income. Many group short-term disability policies provide a flat benefit, like 60% of your gross base income. Most plans have a waiting period before benefits begin. Any absence shorter than the waiting period isn’t covered. Once the waiting period is satisfied, STD can come in and start replacing your income.
Employer Involvement
When you’re planning to take STD leave, such as for residential treatment, it’s essential to coordinate with HR. Notify HR within a few days of being unable to work. While short-term disability leave provides income replacement, it doesn’t guarantee job protection.
The Family and Medical Leave Act (FMLA) offers the job protection you need. Eligible employees can take up to 12 weeks of unpaid, job-protected FMLA leave in one year. For foreseeable leave, you should give your employer 30 days’ notice. For emergencies, you should notify them as soon as possible. The ADA also comes in when you’re recovering from your short-term disability. The ADA may require that you get reasonable accommodations if your condition qualifies.
Unlike the FMLA, the ADA doesn’t specify a maximum leave length. It depends on whether more extended leave can be considered a reasonable accommodation without undue hardship to your employer.
Filing a Short-Term Disability Claim With Cigna for Addiction Rehab
Step 1 - Confirm Eligibility
Find your Summary Plan Description document. It explains in plain language who’s eligible, how to enroll, benefits provided, and claims/appeal procedures. Your Certificate of Coverage is equally essential. It serves as your plan’s legal backbone; you can confirm eligibility rules and exclusions.
Verify that you’re actively enrolled in the short-term disability plan and employed at the time of disability onset. Ensure your medical condition aligns with the policy’s definition. For example, an inability to perform essential job functions.
Review how long you must be continuously disabled for benefits to begin. Also, look for details on benefit percentage and maximum duration.
Step 2 - Gather Required Documentation
Essential clinical documentation includes:
Provider Assessment and Diagnosis: It should clearly state the SUD diagnosis and severity
Treatment Plan: It should indicate the required level of care (e.g., residential treatment), duration, required activities (e.g., group therapy), and risk factors (e.g., relapse risk)
Progress Updates: These may include continued stay notes if treatment extends beyond initial authorization
You should also prepare the following:
Medical Records: Doctor’s notes, prescriptions, and any relevant treatment records
Job Impairment: A detailed account of your job duties and how your condition impairs specific tasks
Policy Documentation: Your STD plan details to confirm eligibility, benefits, waiting period, and duration
Step 3 - Submit Your Claim
Here are ways you can submit your claim:
Online: Through the myCigna portal. It’s the fastest option for claim initiation. Log in to myCigna, go to the “Disability/Leave of Absence” section under “Review My Coverage,” and click “Submit a request for a disability or leave of absence.”
By Phone: Call Cigna’s STD intake line on 1-855-795-8367. A representative will walk you through the submission and eligibility process.
Paper, Fax, or Mail Submissions: Download claims forms from the “Customer Forms” section of myCigna or Cigna’s official site. Mail or fax completed forms to Cigna’s STD processing center.
Step 4 - Follow Up and Provide Additional Information
Cigna may request additional documentation during the processing of your short-term disability claim. Respond promptly to avoid denial for incomplete documentation. You can also do it as part of ongoing claim monitoring since Cigna may seek periodic updates. Here’s what you need to do:
Plan to respond within days of receiving Cigna’s request for additional documentation
Confirm that your response includes exactly what Cigna requested
Encourage your healthcare or rehab provider to submit records quickly
In your response, you can include signed medical authorization forms and additional documentation like updated physician notes or progress status.
Step 5 - Understanding the Decision Timeline
Short-term disability approval can take a few days to several weeks. Exactly how long depends on the complexity of the claim and the completeness of the documentation submitted.
File a claim within five days of beginning a leave that you expect to last at least five days. Failure to do so puts you at risk of being deemed ineligible for income replacement. This doesn’t set a timeline for approval, but shows the importance of prompt filing.
If Cigna denies a claim, you can file an appeal. Cigna may take up to 45 days to reach a decision on the appeal.
Common Challenges and How to Overcome Them
Denial Due to Lack of Medical Evidence
Cigna expects sufficient, complete documentation, including treatment notes and a link between your condition and your inability to work. Cigna may deem your documentation weak if your healthcare provider’s notes are generic or inconsistent. In some cases, Cigna may conclude that you can still perform your work, even with a diagnosis.
Ensure consistency in treatment records to demonstrate that your condition is ongoing and significant. Ask your provider to use detailed statements and include symptoms, treatment responses, clinical observations, and how your condition affects your daily and work life.
Misinterpretation of Addiction as a Non-Covered Condition
Emphasize that addiction is recognized as a medical condition. The DSM-5 classifies SUD as a diagnosable mental health condition. It may qualify as a disability if it substantially limits one or more major life activities. Highlight how addiction can qualify as a disability under the ADA if it substantially impairs your ability to work or function.
Reference the Affordable Care Act (ACA). The act considers substance use treatment as an Essential Health Benefit (EHB). Mention that denying addiction rehab coverage or labeling it non-covered conflicts with federal law. Parity violations allow you to challenge unequal treatment.
Coordination Issues Between Cigna Health and Disability Departments
The following are coordination issues that can arise:
The separate handling of health claims (medical billing and treatment coverage) and disability claims (STD payouts or eligibility). It can lead to delays if medical data doesn’t flow quickly from one department to another.
Your healthcare provider may secure pre-authorization through the health plan, but the disability team may still require separate documentation.
Here’s how you can improve coordination:
Activate “My Personal Champion” if eligible. They ease communication across departments and simplify case handling.
Share medical authorization documents with STD to ensure both teams have the needed information.
Keep HR informed. They can bridge both teams under leave programs like FMLA or ADA.
Legal and Workplace Protections While on STD
ADA and FMLA Protections
The FMLA allows you to have up to 12 weeks of unpaid, job-protected leave for the treatment of your serious health condition.
When you’re back from your leave, your employer is required to reinstate you to the same position you held before the leave. If that’s not possible, they must reinstate you to an equivalent position in terms of responsibilities, pay, and benefits.
Your group health benefits stay in place during your leave, under the same terms as if you had been working. You’re also protected from retaliation. Your employer cannot discipline, demote, or penalize you for taking an FMLA leave.
If your FMLA leave isn’t sufficient for your treatment, you can take an extended leave protected under ADA. It’ll be considered an accommodation for your disability. Addiction qualifies as a disability, and the ADA protects you from discrimination.
Confidentiality Rights
Your medical information is protected when you submit a short-term disability claim for sensitive issues like addiction rehab. The Health Insurance Portability and Accountability Act (HIPAA) ensures the confidentiality of your Protected Health Information (PHI). Cigna, as a covered entity, must comply with HIPAA’s Privacy Rule regarding the use, disclosure, and safeguarding of your medical information.
Your information is used for necessary purposes only, such as treatment and payment. Disclosure is minimized to only what’s required.
Furthermore, the ADA requires that any medical details you provide (e.g., to request leave or accommodations) must be kept in separate medical records, not in your regular personnel file. Very few individuals (like your manager or HR) may access your medical records, and only on a need-to-know basis.
Break the Barriers to Recovery With Nirvana Recovery
Before today, you probably didn’t know about short-term disability benefits. Some people still struggle with the idea that addiction is a disability. The ADA considers it so. Short-term disability benefits can make rehab financially possible. Unlike unpaid leave, STD provides partial income replacement during an approved medical leave. You can use the money you get to facilitate treatment.
Navigating insurance can be complicated. Filing claims can feel even more challenging, especially when you don’t have any guidance. It’s why at Nirvana Recovery, we spend extra time ensuring you understand what you need to do and do it right. We’re experienced in helping people coordinate Cigna coverage and claims.
How Long Can I Receive STD Benefits For Addiction Treatment?
There’s no specific length. Benefit durations vary by employer plan, but they may range between 8 and 26 weeks. Many group plans pay 11-13 weeks, and some may extend to 25-26 weeks. The range that applies to you depends on your employer’s certificate, state rules, and medical necessity reviews.
Can I Use STD and Health Insurance Benefits At The Same Time?
Yes, you can. It’s because they both do different jobs. Your health insurance pays for medical care, like detox, medications, therapy, or facility bills. It’s subject to network rules, deductibles, copays, and pre-authorizations. STD replaces a portion of your lost wages while you’re unable to work. It doesn’t pay medical bills.
Will My Employer Know the Reason for My Short-term Disability?
No, they will not. Your employer will know you’re on medical leave and the leave’s expected dates or work restrictions. But they don’t automatically get your complete clinical information. HR and the disability administrator need enough medical information to process the STD or FMLA request. But detailed diagnoses and treatment notes are kept confidential.
Can I Extend STD Benefits Beyond the Initial Approval Period?
Yes, you can. However, extensions aren’t automatic. They require timely requests and up-to-date medical documentation showing continued medical necessity. This may mean ASAM-level justification, progress notes, continued-stay evaluations, and an expected return-to-work plan.
Short-Term Disability Coverage With Cigna for Addiction Rehab
Published On September 22, 2025
Table of Contents
Short-term disability (STD) insurance replaces part of your income if you’re temporarily unable to work due to an illness, injury, or medical condition. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) considers an SUD to be a medical condition. Thus, SUDs can qualify under STD if treated as medical conditions.
The Americans with Disabilities Act (ADA) regards addiction as a disability. This can make people with SUDs eligible for certain disability benefits.
Cigna is a major provider of both health and disability coverage. It offers STD insurance as part of its group benefits package. This article will explain eligibility, the claims process, and key considerations.
If you or your loved ones need help navigating insurance or starting addiction treatment, please reach out to our team at Nirvana Recovery. We’re a supportive partner for treatment and insurance/disability claim guidance.
Cigna’s Short-Term Disability Plans
Types of Plans Offered
1. Employer-Sponsored Group Plans
Through employer-sponsored group plans, Cigna provides STD insurance to replace a portion of your income when you’re temporarily disabled. The employer or employee may pay for coverage, or it may be jointly funded. Your employer pays or subsidizes most group STD plan premiums.
2. Voluntary Individual Coverage
Cigna doesn’t offer individual STD policies. Its short-term disability offerings are group-based, entered through your employer. Cigna’s short-term disability products are tied to your employer’s eligibility and group plan structures.
These group STD plans require employer participation in enrollment and administration, even when employee-paid.
Coverage Percentages and Limits
Many policies provide benefits of up to 60% of weekly earnings. This is the portion of your income that Cigna’s STD replaces. In some cases, benefit coverage may be as low as 40% of pre-disability earnings. This depends on the specific group plan set by your employer.
Your weekly payouts are capped at $1,000. Caps exist for the following reasons:
For higher-paid employees, these limits mean they’ll receive less than the full 60%.
Waiting Periods and Elimination Periods
Cigna’s group STD plans offer two common waiting period structures:
These waiting periods play the following roles:
Your employer may offer either or both elimination period types. Verify which applies to you.
Common Exclusions and Limitations
Long-term disability (LTD) policies may exclude pre-existing conditions. However, short-term disability policies may not. STD benefits may still apply even if the disability stems from a condition existing before coverage began.
In some cases, prior symptoms or treatment 3 to 12 months before the policy starts can affect eligibility. In other instances, STD plans may not pay benefits for a disability caused or contributed to by a pre-existing condition if the disability starts within the first 12 months after coverage.
Some Cigna supplemental riders may exclude “mental or emotional disorders, alcoholism, and drug addiction.” This means that benefits won’t be payable for such conditions under those particular riders. Voluntary add-ons to the coverage could also significantly limit rehab eligibility.
How Short-Term Disability Applies to Addiction Rehab
Qualifying for STD Benefits for Rehab
Cigna aligns with the American Society of Addiction Medicine (ASAM) Criteria to assess medical necessity across various treatment levels. Cigna defines medical necessity as services that:
To support a claim, you need a doctor’s evaluation and diagnosis. Your doctor will provide details about your withdrawal risk and justification for a specific level of care. You will also need an ASAM-based treatment plan.
Cigna covers inpatient and outpatient programs when deemed appropriate. Inpatient treatment aligns with short-term disability eligibility due to the complete absence from daily work duties. STD may apply to intensive outpatient programs and partial hospitalization programs if participation disrupts your ability to perform job functions.
While Cigna covers standard outpatient care, the intensity is insufficient to warrant short-term disability. It’s because employees may still perform work duties.
How Health Insurance and STD Work Together
Cigna health plans cover treatment costs. In-network rehab facilities offer lower out-of-pocket costs, access to care coordination, and no surprise billing. Some plans may still provide coverage for out-of-network rehab facilities. But you need to prepare for higher deductibles and coinsurance, possible balance billing, and complex claims processing.
Cigna covers the following types of treatment services:
When you’re on treatment leave, for example, attending rehab, Cigna’s short-term disability benefits come in to replace a portion of your lost income. Many group short-term disability policies provide a flat benefit, like 60% of your gross base income. Most plans have a waiting period before benefits begin. Any absence shorter than the waiting period isn’t covered. Once the waiting period is satisfied, STD can come in and start replacing your income.
Employer Involvement
When you’re planning to take STD leave, such as for residential treatment, it’s essential to coordinate with HR. Notify HR within a few days of being unable to work. While short-term disability leave provides income replacement, it doesn’t guarantee job protection.
The Family and Medical Leave Act (FMLA) offers the job protection you need. Eligible employees can take up to 12 weeks of unpaid, job-protected FMLA leave in one year. For foreseeable leave, you should give your employer 30 days’ notice. For emergencies, you should notify them as soon as possible. The ADA also comes in when you’re recovering from your short-term disability. The ADA may require that you get reasonable accommodations if your condition qualifies.
Unlike the FMLA, the ADA doesn’t specify a maximum leave length. It depends on whether more extended leave can be considered a reasonable accommodation without undue hardship to your employer.
Filing a Short-Term Disability Claim With Cigna for Addiction Rehab
Step 1 - Confirm Eligibility
Find your Summary Plan Description document. It explains in plain language who’s eligible, how to enroll, benefits provided, and claims/appeal procedures. Your Certificate of Coverage is equally essential. It serves as your plan’s legal backbone; you can confirm eligibility rules and exclusions.
Verify that you’re actively enrolled in the short-term disability plan and employed at the time of disability onset. Ensure your medical condition aligns with the policy’s definition. For example, an inability to perform essential job functions.
Review how long you must be continuously disabled for benefits to begin. Also, look for details on benefit percentage and maximum duration.
Step 2 - Gather Required Documentation
Essential clinical documentation includes:
You should also prepare the following:
Step 3 - Submit Your Claim
Here are ways you can submit your claim:
Step 4 - Follow Up and Provide Additional Information
Cigna may request additional documentation during the processing of your short-term disability claim. Respond promptly to avoid denial for incomplete documentation. You can also do it as part of ongoing claim monitoring since Cigna may seek periodic updates. Here’s what you need to do:
In your response, you can include signed medical authorization forms and additional documentation like updated physician notes or progress status.
Step 5 - Understanding the Decision Timeline
Short-term disability approval can take a few days to several weeks. Exactly how long depends on the complexity of the claim and the completeness of the documentation submitted.
File a claim within five days of beginning a leave that you expect to last at least five days. Failure to do so puts you at risk of being deemed ineligible for income replacement. This doesn’t set a timeline for approval, but shows the importance of prompt filing.
If Cigna denies a claim, you can file an appeal. Cigna may take up to 45 days to reach a decision on the appeal.
Common Challenges and How to Overcome Them
Denial Due to Lack of Medical Evidence
Cigna expects sufficient, complete documentation, including treatment notes and a link between your condition and your inability to work. Cigna may deem your documentation weak if your healthcare provider’s notes are generic or inconsistent. In some cases, Cigna may conclude that you can still perform your work, even with a diagnosis.
Ensure consistency in treatment records to demonstrate that your condition is ongoing and significant. Ask your provider to use detailed statements and include symptoms, treatment responses, clinical observations, and how your condition affects your daily and work life.
Misinterpretation of Addiction as a Non-Covered Condition
Emphasize that addiction is recognized as a medical condition. The DSM-5 classifies SUD as a diagnosable mental health condition. It may qualify as a disability if it substantially limits one or more major life activities. Highlight how addiction can qualify as a disability under the ADA if it substantially impairs your ability to work or function.
Reference the Affordable Care Act (ACA). The act considers substance use treatment as an Essential Health Benefit (EHB). Mention that denying addiction rehab coverage or labeling it non-covered conflicts with federal law. Parity violations allow you to challenge unequal treatment.
Coordination Issues Between Cigna Health and Disability Departments
The following are coordination issues that can arise:
Here’s how you can improve coordination:
Legal and Workplace Protections While on STD
ADA and FMLA Protections
The FMLA allows you to have up to 12 weeks of unpaid, job-protected leave for the treatment of your serious health condition.
When you’re back from your leave, your employer is required to reinstate you to the same position you held before the leave. If that’s not possible, they must reinstate you to an equivalent position in terms of responsibilities, pay, and benefits.
Your group health benefits stay in place during your leave, under the same terms as if you had been working. You’re also protected from retaliation. Your employer cannot discipline, demote, or penalize you for taking an FMLA leave.
If your FMLA leave isn’t sufficient for your treatment, you can take an extended leave protected under ADA. It’ll be considered an accommodation for your disability. Addiction qualifies as a disability, and the ADA protects you from discrimination.
Confidentiality Rights
Your medical information is protected when you submit a short-term disability claim for sensitive issues like addiction rehab. The Health Insurance Portability and Accountability Act (HIPAA) ensures the confidentiality of your Protected Health Information (PHI). Cigna, as a covered entity, must comply with HIPAA’s Privacy Rule regarding the use, disclosure, and safeguarding of your medical information.
Your information is used for necessary purposes only, such as treatment and payment. Disclosure is minimized to only what’s required.
Furthermore, the ADA requires that any medical details you provide (e.g., to request leave or accommodations) must be kept in separate medical records, not in your regular personnel file. Very few individuals (like your manager or HR) may access your medical records, and only on a need-to-know basis.
Break the Barriers to Recovery With Nirvana Recovery
Before today, you probably didn’t know about short-term disability benefits. Some people still struggle with the idea that addiction is a disability. The ADA considers it so. Short-term disability benefits can make rehab financially possible. Unlike unpaid leave, STD provides partial income replacement during an approved medical leave. You can use the money you get to facilitate treatment.
Navigating insurance can be complicated. Filing claims can feel even more challenging, especially when you don’t have any guidance. It’s why at Nirvana Recovery, we spend extra time ensuring you understand what you need to do and do it right. We’re experienced in helping people coordinate Cigna coverage and claims.
Contact our team at Nirvana Recovery today for confidential insurance and disability benefit guidance.
Frequently Asked Questions
There’s no specific length. Benefit durations vary by employer plan, but they may range between 8 and 26 weeks. Many group plans pay 11-13 weeks, and some may extend to 25-26 weeks. The range that applies to you depends on your employer’s certificate, state rules, and medical necessity reviews.
Yes, you can. It’s because they both do different jobs. Your health insurance pays for medical care, like detox, medications, therapy, or facility bills. It’s subject to network rules, deductibles, copays, and pre-authorizations. STD replaces a portion of your lost wages while you’re unable to work. It doesn’t pay medical bills.
No, they will not. Your employer will know you’re on medical leave and the leave’s expected dates or work restrictions. But they don’t automatically get your complete clinical information. HR and the disability administrator need enough medical information to process the STD or FMLA request. But detailed diagnoses and treatment notes are kept confidential.
Yes, you can. However, extensions aren’t automatic. They require timely requests and up-to-date medical documentation showing continued medical necessity. This may mean ASAM-level justification, progress notes, continued-stay evaluations, and an expected return-to-work plan.