Understanding Your Disability Insurance Policy

Unless a person works in an area that exposes him/her to the risk of injury on a regular basis, most people do not spend much time contemplating what would happen if they could not work due to a disability. But, people are injured or suffer the onset of a serious illness every day. In this situation, the disabled individual ideally has private disability insurance, either through an employer or purchased as an individual policy. A disability interrupts every aspect of a person’s life, particularly the ability to earn a living, so understanding the important financial contribution that disability insurance provides is central to figuring out a plan for supporting one’s household and getting the care needed to recover to the fullest extent possible. A discussion of the key differences between short- and long- term disability coverage, and some key components of these policies that affect when benefits become available, will be discussed below.

Short-Term Disability

As alluded to above, Florida does not have a state-mandated program covering disabilities that occur off the job, so disabled individuals in this situation must look to private disability insurance policies to replace a portion of lost income. Many employers include short-term disability in an employee’s benefits plan at no cost, and others offer employees the option of enrolling in a self-funded group policy. Short-term disability coverage applies when a person is suffering from a temporary medical condition that prevents him/her from working for a period of time. Typically, policies will pay 40 to 60 percent of a person’s income after a short waiting period is satisfied, one to fourteen days is the norm. Further, short-term disability benefits are only paid for a certain period of time, usually 10 to 52 weeks, and if a person is still unable to work when the policy benefit is exhausted, long-term disability would take over, if available. Group policies through an employer frequently require a disabled employee to use all of his/her sick/personal days before the disability coverage would start, and documentation of the employee’s medical condition, inability to work, and projected return date must be provided to prove a disability exists.

Long-Term Disability

Long-term disability is insurance coverage that pays a portion of a disabled person’s income when he/she is unable to work for an extended period or permanently, often due to a major illness, such as cancer, or serious physical injury. As noted above, long-term disability benefits are usually available once short-term disability coverage has run out. Long-term disability offered through employers is often optional voluntary insurance an employee must choose to purchase, but doing it through an employer group plan is almost always less expensive than purchasing an individual policy. Further, many policies are portable, meaning once purchased, they stay with the person, even if he/she changes employers. In light of the longer period out of work, long-term disability usually pays a slightly higher percentage of person’s income, 60-80 is typical, but most have maximum monthly limits. Further, the duration of the plan can vary from a set number of years or until age 65. Importantly, long-term disability plans have waiting periods before the coverage is available, and include a definition for what constitutes a disability. The most common definitions differentiate between own occupation and any occupation. Own occupation disability means the policy will payout if a person is unable to work in his/her profession, in contrast with any occupation disability, which requires the person be unable to perform any job before benefits will be paid. Plainly, own occupation is the definition of disability that is most beneficial to the disabled policyholder, since it is less restrictive. However, insurance companies regularly deny legitimate disability claims, and the services of an experienced disability insurance attorney are often needed to force providers to honor the terms of their policies.

Talk to a Disability Insurance Attorney Today

Securing disability benefits is too important an issue to leave entirely in the hands of insurance companies out to maximize profits. Protect yourself by working with a knowledgeable disability insurance attorney who understands the law, and knows tactics used by insurers to deny claims. Farrell Disability Law has years of experience helping clients obtain the disability benefits they deserve, and is available to evaluate the merits of your case. Contact the Jacksonville office today for a free consultation.

Resource:

leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0600-0699/0627/Sections/0627.4233.html