You might be wondering what disability insurance is and why it’s important to have. Disability insurance protects your income. It helps by replacing a portion of your monthly income if you are unable to work due to an injury or illness. This is important because you don’t have to worry about not having the money you need to support your family while you are unable to work. You can use the benefits to pay for whatever you need, like monthly bills, childcare, and groceries.
Disability insurance is a contractual agreement between you and your insurance company. You pay a monthly premium, or your employer does in some cases. In exchange for that premium, the insurance company agrees to pay you a monthly benefit if you can’t work due to a disability or illness. The amount will differ, but it’s usually between 60 and 80 percent of what you were earning before you had to stop working.
Long Term v. Short Term Disability Benefits
There are two different types of disability insurance: short term and long term. The biggest difference between the two is the amount of time that benefits are available to you. Typically, short term disability benefits last three to six months. Long term disability benefits are available for a much longer period, sometimes even into retirement. Long term disability comes into play when your illness or injury lasts for an extended period of time. This could be for months, years, or even permanently. Again, you have to prove you can no longer work and need a doctor to confirm this.
Short term disability benefits are often a pre-requisite for being able to transition over to long term disability. Some people think that applying for short term benefits might not be worth it. Depending on the reason that you are off of work, that may be true. However, most of the time it is worth applying for short term disability. Many people will go out on short term disability and then, if they are still unable to work once that period of coverage is over, they convert to long term disability. This is why it is important to have both. No one knows how long a disabling event might last.
Qualifying for Disability Benefits
To qualify for disability benefits under an insurance policy, you must be suffering from an injury or medical condition that makes it impossible for you to work. Your diagnosis needs to be confirmed by a doctor, as well. Here are some of the conditions that might qualify:
- Heart attack
- Cancer
- An Accident
- Pregnancy
- Surgery
- Rehabilitation
- Severe illness
Remember, all policies are different, so it’s crucial you have a copy of your policy and understand what is covered. If you need help, we are happy to review this with you. It’s also important to remember that injuries caused on the job are often covered by workers’ compensation insurance. In those instances, people will not be eligible for short term disability coverage.
Moving from Own Occupation to Any Occupation
After a set period of time, the terms of a long term policy will convert. Often, this time frame is two years but it is important to understand the coverage of your policy. Many long term disability policies are quite strict on what qualifies you to receive coverage beyond the initial period of “own occupation”, or “own occ.” At that point, benefits are typically only awarded if you can’t do any job (“any occupation”), not just your job (“own occupation”). This is when it might be necessary to hire a vocational expert.
Your policy will outline what conditions will need to be met. Here are some possible qualifying events and conditions:
- Chronic pain
- Cancer treatments
- Debilitating injury/illness lasting more than 26 weeks
- Nervous system disorders
- Mental health problems
Getting Help with Disability Insurance
Every disability policy is not the same. It’s important that you understand the details of your own unique policy and what is covered. We know what to look for and we can help you navigate all of the paperwork. We will make sure you are prepared before filing a claim. Insurance companies definitely don’t make it easy to understand what is required in all cases, so make sure you are informed. It’s also important to find out the length of the elimination period, or waiting period, before you gain access to your benefits.
As you can see, disability insurance can be complicated. It’s definitely great protection to have and can help you tremendously if you become ill or injured. Do your research and make informed decisions when choosing a policy. Don’t be afraid to ask questions if you are covered under a group policy.
Most people don’t really think about disability insurance until they need it. We offer a variety of services to help you, if you need it. Some of those services include:
- Review of your short term or long term disability policy to help you understand the terms of your policy (please call or email for a quote, as consultation fees may apply)
- Helping you to apply for short term insurance disability benefits
- Helping you to apply for long term insurance disability benefits under ERISA
- Complimentary review of your denial letter if your insurance company denied long term or short term benefits.
- Appeal of your disability benefits if you have been denied under the policy (be sure to claim your complimentary copy of our latest book before you even consider appealing on your own).
- Litigation in court if your appeal is lost, for appeals that we have handled. Please note that we will most likely decline representation if you filed the appeal without a lawyer, since in court you will be ‘stuck’ with whatever went into your appeal. If your appeal was not done very well, this will have a huge impact on anyone’s ability to ‘win’ your case in court. This is a very good reason to hire an attorney immediately after you receive a denial letter and before trying to do your own disability appeal.
Give us a call at 630 250-8813 for short or long term disability help, or fill out our webform to tell us your story. Don’t forget to request a free copy of our disability book, which explains the process for appealing an unfavorable decision from your insurance company, including why this is not something that you should try to do on your own.
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