Short & Long Term Disability Insurance
March 18, 2024
1. Enrollment and Coverage:
- Employer-Sponsored Plans: Many employers offer short-term and long-term disability insurance as part of their employee benefits package. Employees may enroll in these plans during open enrollment periods or when they first become eligible for benefits.
- Individual Policies: Individuals can also purchase private short-term and long-term disability insurance policies from insurance companies to supplement or replace employer-provided coverage.
- If you wait until after diagnosis with a brain tumor (or any condition or disability) to purchase an individual policy, you may have a hard time finding a policy that you can afford to pay the premium on. It’s easier with employer-sponsored disability coverage because the premium is based on the risk profile of the whole company, not the individual.
2. Qualifying for Benefits:
- Medical Certification: To qualify for disability benefits, individuals must provide medical documentation from a qualified healthcare provider certifying that they are unable to work due to a disabling condition, such as a brain tumor. There is often a waiting period before you are eligible for benefits, so even if your physician certifies your disability it could be 60, 90 days or longer before your receive any benefits.
- Definition of Disability: Disability insurance policies define disability differently. Some policies require individuals to be unable to perform the duties of their own occupation, while others may require the inability to perform any gainful occupation for which they are reasonably suited by education, training, or experience.
3. Applying for Benefits:
- Claim Process: When a disability occurs, individuals must submit a claim to the insurance provider or employer’s human resources department. This involves completing a claim form and providing medical documentation supporting the disability.
- Documentation: The medical documentation should include diagnoses, treatment plans, physician statements, and other relevant information to demonstrate the severity and impact of the disability on the individual’s ability to work.
4. Return to Work:
- Rehabilitation Services: Some disability insurance policies offer vocational rehabilitation services to help individuals return to work, such as job training, education, or job placement assistance.
- Partial Disability: In some cases, individuals may be able to return to work on a part-time or modified basis while still receiving disability benefits. This depends on the policy terms and the individual’s ability to perform alternative job duties.
Types of Disability Insurance
Definition: Short-term disability insurance provides income replacement benefits for a limited period, typically ranging from a few weeks to several months, when an individual is unable to work due to a temporary disability or illness.
Coverage Period: Short-term disability benefits usually begin after a waiting period, known as the elimination period, which can range from a few days to a few weeks.
Benefits: Short-term disability benefits typically replace a percentage of the individual’s pre-disability income, usually around 60% to 80%. The duration and amount of benefits vary based on the policy terms and the individual’s salary.
Duration: Short-term disability benefits typically last for a specified period, such as 3 months or 6 months, depending on the policy terms.
Definition: Long-term disability insurance provides income replacement benefits for an extended period, usually lasting for several years or until the individual reaches retirement age, when they are unable to work due to a permanent or long-lasting disability.
Coverage Period: Long-term disability benefits typically begin after the expiration of short-term disability benefits or after a waiting period of several months, depending on the policy terms.
Benefits: Long-term disability benefits replace a percentage of the individual’s pre-disability income, similar to short-term disability benefits. The benefit amount and duration depend on the policy terms and the individual’s salary.
Duration: Long-term disability benefits can last for a specified period, such as 2 years, 5 years, or until the individual reaches retirement age, depending on the policy terms.
Short and long-term disability policies can have maximum limits in terms of how long or how much in total they will pay out, but they can be a bridge as someone goes through the process of applying for Social Security disability benefits (which can often take 2-3 years).
It’s essential for brain tumor patients and caregivers to understand their short-term and long-term disability benefits, including eligibility requirements, coverage periods, benefit amounts, and application processes. Consulting with an experienced disability attorney or advocate can also help navigate the complex disability claims process and maximize the chances of approval.