Are you out of work due to illness, non-industrial injury or pregnancy related condition? If so, you may be entitled to receive disability insurance benefits.
Disability insurance offers fractional wage replacement to eligible workers who are not capable to work because of a disability. There is a number of disability insurance and other types of disability benefit programs that will assist you pay the bills, get back to work, or both.
Definition of Disability
Disability is defined as any physical or mental illness or injury which stops you from performing your customary or regular work. Short term disability unemployment insurance can cover you for a few months to a few years while long term disability covers you if something lays you low for some years or everlastingly, although policies normally stop paying you money once you reach retirement age.
It’s a better idea to be familiar with these disability programs before you need them, so you may take benefit right away. For example, disability benefits might begin on the date you file your claim, not on the date your disability started. Besides, there might be a waiting period before disability benefits begin, from the date you file your claim.
Eligibility for Disability Insurance
Disability insurance benefits can be paid only after you meet all of the following requirements:
- You should be incapable to do your regular work for at least eight consecutive days.
- You must be employed or keenly looking for work at the time you become disabled.
- You must have lost wages because of your disability or, if jobless, have been enthusiastically looking for work.
- You must have earned at least $300 from which SDI deductions were withheld during a previous period.
- You must be under the treatment and care of a licensed doctor or recognized religious practitioner during the first eight days of your disability. You must remain under care and treatment to carry on receiving benefits.
- You must complete and mail a claim form within 49 days of the date you became disabled or you may lose benefits.
How to File a Disability Claim?
No one desires to think about filing a disability claim, but sometimes there is need for them. Expectantly, it is only for a temporary disability and not a permanent one. You will be thankful for disability insurance if it does happen, because you will in any case have some money coming in while you can’t work.
- Obtain a disability form. This can be acquired from the Department of Labor in your state. You can print the form from their website.
- Fill out your part of the form. Some of the detail you will need to provide should be collaborated with your doctor, as he has the records. You may need to submit the dates you were hospitalized and/or all treatment you have received from the doctor of record as well as any experts you have seen for your medical condition.
- Have your doctor fill in his part of the form. This will be the diagnosis part of the form and should be filled in by a practicing physician. He must give a specific diagnosis or the claim may be left without.
- Acquire other supporting documentation to go with the form. In case you were hospitalized or if you were treated by a specialist you must include this detail since it will be helpful in supporting your unemployment claim for disability.
- Have your employer fill out their portion of the form. The employer must do this so that the disability department knows how much to pay you. Do not wait for your salary; it will only be a portion of it. Disability has a cap on the sum they pay.
- Send the filled in disability form to the Department of Labor Temporary Disability Department (TDI). You will then need to wait. If there is a difficulty with the form they will send it back to you with precise guidelines on what is still required. Hopefully it won’t be too long before you collect a check.
How much is Paid?
The main term in a disability policy comprise the payment to be made in the event of disability. Unlike other policies give a lump amount upon a qualifying event; most disability policies pay a recurring sum on a usual basis, normally monthly. The amount to be paid, and for how long, are variables in a disability policy. For instance, you may decide a policy that pays $3000 per year for up to 5 years. In any case, you cannot buy disability insurance for a sum more than your present salary. There are riders obtainable that add to the payout amount every year to stay even with when inflation and wage increases.
Collecting Disability Insurance
Anticipating you have a legal in-force policy when you become disabled, you can file a claim with the insurance firm. The insurance form will evaluate the claim to ensure that it obey the rules of all the terms of the policy and to avoid fraud. After a claim is approved, the insurance company will pay every month until you return to work, or the payments are completed depending on either duration of time or other terms in the policy.
The two most common programs that fall under the umbrella of disability are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Medicare and Medicaid are also components of these programs.
Social Security Disability Insurance Benefits (SSDI)
Unlike retirement benefits, you may obtain Social Security Disability Insurance benefits at any age, if you have paid Social Security Taxes. But you ought to have a serious physical or mental injury that your doctors and the Social Security Administration’s doctors agree will stop you from performing considerable work for a year or more. Social Security Disability Insurance does not cover partial or short-term disabilities, but the state disability insurance does.
Supplemental Security Income (SSI)
SSI is paid to individuals with little or no income and very few assets, who may or may not have ever worked. These benefits are funded by general federal taxes most of us pay (Abbott).
Medicare is federally-funded health insurance for people aged above 65; it is benefit of Social Security. It is also obtainable to people who have been on SSDI for 2 years. Instant eligibility is available for some unusual situations, but normally not for mental health disabilities. For those entitled for Medicare, a monthly premium will be withdrawn from your monthly SSDI check.
Medicaid is a health insurance accessible for those on SSI. It is supervised by your state and mutually funded by the federal and state governments.
Cobra Health Insurance
Consolidated Omnibus Budget Reconciliation Act (COBRA) insurance may be an alternative for health care coverage if you have been laid off.
COBRA contains provisions giving definite former employees, spouses, retirees and dependent children the right to temporary continuation of health coverage at group rates.
While the term “group rate” makes it sound like you will be receiving a discount that will make the insurance premiums reasonable, they are normally much pricier than people expect. When you were working, you likely paid a small fraction of your actual health insurance premium. You may have paid 10% while your employer paid 90%. Under Cobra, you have to shell out 100% of the premium. Sometimes you even have to pay an extra 2% administrative charge. The total premium can be difficult to pay.
What Happens When COBRA Ends?
COBRA coverage is limited, generally to 18 months for terminating employees, and 36 months for dependents losing eligibility. But what can a person do when COBRA ends?
For someone who is totally disabled, federal law offers an extension that will continue COBRA until the start of Medicare. For those who are completely disabled, but have a medical condition that would put them off from buying individual health insurance, there is another federal law, HIPAA (Health Insurance Portability and Accountability Act) that permits such persons to procure coverage.
If you leave work due to disability
In 1989 COBRA was revised to allow people, who had to discontinue work due to disability, to lengthen the time they can keep COBRA Continuation. Under this law, someone who meets the requirements may stay on their employer’s COBRA Continuation until they become suitable for Medicare, which is usually 29 months after they leave work due to disability.
Can you receive UC Benefits and Disability Benefits?
After being laid-off due to a disability, many people apply for and collect state unemployment benefits. Unemployment compensation benefits offer short-term income to unemployed workers. In order to obtain weekly unemployment compensation benefits, you must confirm with your state Department of Labor that you are vigorously looking for and is available for work. Every state has different necessities to acquire unemployment compensation benefits.
Receiving jobless compensation benefits can affect your social security disability claim. But, you cannot be deprived of social security disability benefits only because you received unemployment compensation benefits.
Social Security Administration (SSA) allows SSDI benefits to individuals who not only can work, but are working. For instance, to make possible a disabled person’s reentry into the workforce, the SSA authorizes a 9-month trial-work period during which SSDI recipients may collect full benefits. Progress in a totally disabled person’s physical condition, while allowing that person to work, will not immediately lead the SSA to end SSDI benefits.
SSA looks at the totality of the conditions in evaluating whether or not you are disabled including but not limited to your medical conditions, treating past work history, source records, and earnings.
Bottom line is receiving unemployment compensation benefits will not automatically debar you from obtaining receiving social security disability benefits BUT it can be used against you. Some Administrative Law Judges (ALIs) consider that if you are collecting unemployment compensation, then you believe that you can work, and this clashes with a claim for disability. The ALI may inquire you about the particulars of why your job ended due to a mental or physical condition(s).