Working can jeopardize your disability claim.
Insurance companies will use any work-related activity (including volunteer work) as grounds to deny or terminate your long-term disability benefits, often before you are fully healed and ready to return to work full-time. The potential length of time an individual may be unable to perform their job due to injury can extend over an extended period, complicating the recovery and return-to-work process.
If you are receiving disability benefits and are considering returning to work, you MUST do two things:
- Review your ENTIRE disability insurance policy.
- Get the support of your doctor.
Understanding Long-Term Disability Benefits
Long-term disability benefits are designed to provide financial support to individuals who are unable to work due to a medical or mental health condition. These benefits can be a lifeline for those who are struggling to make ends meet while they are unable to work. Whether you are dealing with a physical injury, a chronic illness, or a mental health issue, long-term disability benefits can help you maintain your financial stability during a challenging time.
Definition of Disability Benefits
Disability benefits are payments made to individuals who are unable to work due to a disability. These benefits can be provided through a variety of sources, including employer-sponsored plans, individual insurance policies, and government programs. The goal of these benefits is to replace a portion of your income, helping you cover essential expenses while you focus on your recovery. Understanding the source and structure of your disability benefits is crucial to managing your finances effectively during your period of disability.
Types of Long-Term Disability Policies
There are two main types of long-term disability policies: “own occupation” and “any occupation” policies. Own occupation policies provide benefits if an individual is unable to perform the duties of their own job, while any occupation policies provide benefits if an individual is unable to perform any job for which they are reasonably suited based on their education, training, and experience. Understanding the type of policy you have is essential, as it determines the criteria for receiving benefits and the extent to which you can work while still qualifying for those benefits.
Step One: Review Your Insurance Policy
There are two occupational periods in all long-term disability policies: the “own occupation” period and the “any occupation” period. In the “own occupation” period, you qualify for benefits if you cannot perform the primary duties of your own job. After a period of time (often 24 months, but check YOUR policy carefully) you are considered disabled only if you cannot work at ANY gainful occupation.
Other items to look for (and understand!) in your policy:
The definitions of Total Disability vs. Partial Disability
“Other Income” offsets, which allow the insurance company to pay you less if you receive income from other sources
Incentives to work and/or attend an approved rehabilitation or job training program, which often mean more money in your pocket than disability payments alone. Participation in these programs can lead to additional monthly benefits and rehabilitation incentives, potentially increasing your total income up to 100% of your pre-disability earnings.
The Fine Print…while they share some similarities, each policy is unique, and you must understand the details and “fine print” of YOUR policy to understand how working might affect your eligibility for benefits
Working While on Disability
Working while on disability can be a complex issue, and it’s essential to understand the rules and regulations surrounding this topic. The ability to work while receiving disability benefits depends largely on the type of policy you have and the specific terms outlined in your insurance policy. It’s important to navigate this carefully to avoid jeopardizing your benefits.
Own Occupation vs. Any Occupation Policies
Individuals with own occupation policies may be able to work in a different job while still receiving disability benefits, as long as they are not working in their own occupation. This means that if you are unable to perform the duties of your specific job but can work in a different capacity, you may still qualify for benefits. However, individuals with any occupation policies may not be able to work at all while receiving disability benefits, as these policies provide benefits only if the individual is unable to perform any job for which they are reasonably suited.
It’s essential to review your insurance policy carefully to understand the specific rules and regulations surrounding working while on disability. Consulting with a long-term disability lawyer can also be beneficial to ensure you understand your rights and obligations. This professional guidance can help you navigate the complexities of your policy and make informed decisions about your ability to work while receiving benefits.
Step Two: Talk with Your Doctor
If you feel ready to try to return to work, it is vital that your doctor is onboard. Ideally, your doctor will examine you BEFORE you return to work in some capacity and will do two things:
Document any restrictions and limitations you have (especially related to sitting, standing/walking, and overall work capacity over an 8-hour day), and
Write a detailed office note in your medical record about your restrictions and limitations, and note that you are approved for a “trial of work.” This keeps open the possibility that the “trial” may not be successful and you may need to stop working again.
Step Three: Follow Through
Be up front with the insurance company: tell them you are attempting to return to work, make sure they have your medical records that both support and limit this, and let them know what income you receive so they can offset your benefits. Be aware that working while receiving LTD benefits may affect your eligibility, especially if certain income thresholds are exceeded. Follow up with your doctor to document how things are going. If your new job requires an occupational license, understand that this may restrict your ability to work in fields related to your disability. In a perfect world, your policy will support a return to work at a speed that is healthy for you. However, restrictions within disability insurance policies specific to professional services may impact your ability to work in your prior profession. You control that as much as possible by keeping everyone – the insurance company, your doctor and your employer – informed and involved. Be mindful that working in a new job involving the same license as your previous occupation could affect your benefits.
And of course we understand that it’s not a perfect world. That’s where we come in – and our experienced team can help. Before making any changes, book a flat-fee consultation with us. We’ll look at your policy, explain all the different clauses and how working will impact your eligibility for benefits, review your recent medical records, and highlight any areas where it would be helpful to have your doctor provide more information.
If your benefits are denied, we credit 100% of the consultation fee to your appeal fee. Our disability clients tell us this is the best money they could have spent to understand their policy and protect their benefits while doing what’s best for them – getting back to work.
