Paul Fisher Insurance Services LLC

I’d like to talk to you about a topic that comes up quite a bit in my social security disability practice here in Atlanta, and the issue has to do with part-time work. As you know, Social Security Disability is dealing with a lot of very, very long delays in the management and handling of cases. It’s not uncommon for cases to be pending in the Social Security Administration for two or three years, sometimes even longer. Of course, when you’re waiting two or three years to get to a hearing, it can be very tempting to try to go back to work. After all, you have to make ends meet, right? Well, the problem is that sometimes work activity, even if it’s just part-time work, can result in your claim for benefits being denied. And then you are really in trouble.

As a practical matter, it’s important for you to realize that part-time work makes it much more difficult to win your social security disability case. The simplest explanation would be this: the judges, when they see part-time work, are likely to believe that if you are able to do part-time work, then perhaps you would be able to do full-time work if your job responsibilities could be slightly lessened. In simple terms, a SSA Judge might think that if you tried a little bit harder, you could probably work full-time. This is just the thought process here. Or, if you’re working a part-time job that requires a certain amount of physical activity, the natural thought of the Judge will be that if you took something a little bit less strenuous, you could probably do it full-time. Then the Judge will likely deny benefits.

I really think the part-time work muddies the waters, and I like to say that Social Security sees disability as a black and white thing: either you’re disabled or you’re not. Part-time work tends to blur that distinction and, again, judges sometimes are less inclined to give you the benefit of the doubt. It’s too bad that this is how it goes, since many people rely on that part-time work to make ends meet while they are waiting for their claim to be heard.

Now, I will tell you that unsuccessful work attempts – any work attempt that lasted three months or less – may actually benefit you in a social security hearing. Judges do see unsuccessful work attempts as good evidence that you’re not able to work full-time. So, I don’t think there’s a problem with trying to work, but I want to warn you that once you get beyond three or four months on any given job, then it starts to look like a regular type of job, and that’s when a judge might be inclined to deny your case.

Now, a couple of strategies to keep in mind about this: the definition of disability is that you are unable to engage in substantial gainful activity because of a medically determinable condition that has lasted 12 consecutive months or is likely to last 12 consecutive months or result in death. So, I’ve had some cases where somebody might go back to work, but I’ll tell them, if at all possible, wait until after 12 months have elapsed before going back to work. This is because if they go back to work, let’s say, in month 14, that means they were out for at least a year and we could win them benefits for that time period. However, if they went back to work after 8 months of not working, the SSA is sure to deny the case (since it is shown that their condition did not disable them for a year – as is required in order to win benefits). In cases where the claimant was out for more than a year and returned to work, however, we argue for what is known as a “closed period of disability” and get that lump sum for the chunk of time they were out. They wouldn’t get on-going benefits, but at least it would give them 12 or so months of benefits for when they were out of work.

So, I guess the big picture here is if you’re thinking about going back to work or trying to work and you’re represented, call your attorney and talk to him or her about it. The one thing that we don’t like as attorneys is finding out the day of the hearing that our client has attempted to work and has earnings of several thousand dollars during the last couple of years while the case was pending before Social Security. Judges have access to earnings records, so they can see if you’ve tried to work and they can see that you were able to work. So if they see $20,000 or $30,000 of income during that two or three years before the hearing, it’s going to have to be explained. And, as I said, it’s very difficult to explain away part-time work that generated $15,000. It’s not a lot of money, but it looks like regular work and it makes it much more difficult to win your disability case.

So, the big picture here is that there’s nothing wrong with trying to work but, if you do, you certainly risk getting your benefits. If you are thinking about going to work, it’s wise to consult with your attorney first to get a sense from him or her as to whether or not that’s going to make it difficult for you to pursue your claim for disability benefits.

Jonathan Ginsberg has been practicing Social Security Disability law in the Atlanta, Georgia area for over 20 years. His website can be found at http://www.atlantasocialsecuritydisabilityattorney.net

via Social Security Disability (SSDI) and Part-Time Work.

Individual disability income insurance is a very flexible product. Many types of policies with an array of features and options are available, allowing you to design a policy that fits both your needs and your budget. But because there’s no such thing as a standard disability policy, comparing policies can be difficult. To make it easier, figure out the coverage and features you want before you begin to compare policies, so that you’re comparing equivalent policies. You can obtain a great deal of information directly from insurance companies, including brochures that describe insurance products, specific insurance product proposals, and sample policies. Read this literature carefully, and ask questions if anything seems unclear. Here are some important things to consider before choosing a disability policy.

How does each policy define disability?

If you want to make sure your disability claim will be paid when you are sick or injured, it’s extremely important to know how the policy you are buying defines disability. No standard definition of disability exists, so when you’re comparing policies, you have to read the wording of each carefully. Do you want the policy to pay benefits only if you’re completely disabled or if you can return to work part-time? Do you want coverage only if you can’t work in your own occupation or if you can’t work in any occupation? Remember, the more liberal the definition of disability is, the more expensive the policy will be.

What are the contractual guarantees of the policy?

Is the policy you’re considering noncancelable and guaranteed renewable, or only guaranteed renewable? Does the policy offer special provisions (e.g., for rehabilitation coverage) or exclusions (e.g., for pre-existing conditions)?

What base and optional features does each policy offer?

Disability policies offer a variety of base and optional features. How long is the waiting period before you can begin collecting benefits? How long are benefits payable for? What optional benefits can you add? For example, can you add a cost-of-living rider to adjust the benefits for inflation?

How much does each policy cost?

Once you’ve found two or more equivalent policies that have the features you want, compare their premiums. Is one policy a better value for the price? If one policy is more expensive than the other, can you find an explanation for the disparity? Maybe the cost of additional riders is higher with the more expensive policy. It’s possible that you overlooked an important provision, or that one policy is simply the better value.

Does each insurer have a good reputation?

Although it’s unlikely that an insurance company will become insolvent, it has happened. To protect yourself, find out as much as possible about of each of the companies you are comparing. Several companies rate insurers on financial strength, profitability, and claims-paying ability (e.g., A. M. Best, Fitch, Standard & Poor’s, and Moody’s). You can also contact your state division of insurance.

Choose the policy that best suits your needs and your budget

After you’ve compared disability income insurance policies, you can decide which one to buy. In many cases, one policy is far superior to another, and your decision is easy. Sometimes, though, you’ll have to spend time weighing the strengths and tradeoffs of each policy before you can decide which one is right for you. Of course, because disability insurance is expensive, the price of each policy is always a factor, but be careful not to buy a policy that’s seriously lacking because it’s cheaper. Quality of coverage is as important as price, something you’ll find out if you ever file a disability claim.

Although the final decision always rests in your hands, a professional opinion can be valuable. Your insurance advisor or broker may be able to detect hidden weaknesses in a policy, explain confusing terms or provisions, and help you weigh the strengths and tradeoffs of each policy you are considering. However, don’t let yourself be pressured into buying a policy you don’t want or can’t afford.

via Comparing Disability Income Insurance Policies.

How do you judge the best Disability Insurance? First, the simple answer:

1. Which company is financially strongest?

2. Which policy will pay the most in the most different claims scenarios?

The first thing that one hears about disability insurance is: Get an “Own occupation” definition of disability and even more importantly, for physician disability insurance, get a policy that further defines occupation as your specialty.

But is this the only factor? You can have a policy that has an own occupation definition but is weak in other areas. An important and overlooked area is that of recovery benefits. This is crucial as the majority of people who receive benefits from their policies do go back to work and mostly back to the occupation or specialty that they were involved with before the disability.

So, what happens when one is released from care and back to work? Well, that depends on the company and policy. One company has a good long term occupation definition of disability but says that when you return to work and are released from care and are no longer impaired your benefits end with a 4 month payment for recovery.

A question is: How long will it take to get back to 100% income, even if well, after being out of the loop for one, two, three years or more? Is there a chance that it will never get back?

The right alternative is a disability insurance policy with recovery benefits to age 65. What happens here? In the same set of circumstances as above you go back to work with no impairment but no income as you build back your business. Your claim continues at 100%. A year later your income is still only 40% of pre-disability income. What do you get? 60% of your insurance benefit. Two years later you get up to 50% of pre-disability income. What do you receive from your policy? 50% of your monthly disability insurance benefit?

In this last example, what if you never get above 50% of pre-disability benefit yet you no longer have the impairment? With one policy you would have received a 4-month “recovery benefit.” With the other you’d continue receiving benefits. It’s an important part of your choice of disability insurance policies.

—

Author, Neil Willner, owner of ProtectYourIncome.com, Disability Insurance Online, provider of disability insurance quotes and information, writes articles on disability insurance for ProtectYourIncome.com. For more information, visit www.ProtectYourIncome.com.

Author, Richard Reich, writes articles on disability insurance for ProtectYourIncome.com – Disability Insurance Online, an online source for disability insurance quotes and information. For more information, visit https://www.ProtectYourIncome.com.

via Disability insurance – What’s the most important aspect to consider?.

When was the last time you read the fine print of an insurance policy? The fine print tells you some important information–how the policy defines disability, what your benefits will be, what exclusions apply, and more. The disability definition used in the policy determines how you qualify for disability benefits.

To be considered disabled under most policies, you must be unable to earn income. However, many policies narrow down this definition quite a bit. They may specify that you must try working in another occupation if you can’t do your own job, or they may pay benefits if you can do some but not all of the duties of your own occupation. Other policies aren’t concerned with occupation at all; they consider you to be disabled when, because of illness or injury, you earn less than you did before.

Own occupation coverage

Although the terminology used to define disability varies from policy to policy, an own occupation policy generally defines disability as the inability to perform the material and substantial duties of one’s own occupation. This definition of disability is liberal, because even if you can work in another occupation, you still receive disability benefits. Own occupation coverage is often more expensive and may be available only to individuals who have a clean medical history and work in a relatively risk-free occupation.

Any occupation coverage

An any occupation policy defines disability as the inability to perform the duties of any occupation. This definition of disability is strict. To receive benefits according to this definition, you have to be unable to work in any occupation, not just your own. Generally, however, the wording is modified to take into consideration your earning level, education, training, and experience.

Split definition coverage

Many disability policies incorporate both an own occupation definition of disability and an any occupation definition. You purchase a policy that provides own occupation coverage for a limited period of time. After this period ends (usually two years), you must meet the any occupation definition of disability to continue receiving benefits. This is sometimes known as short-term own occupation coverage.

Presumptive total disability coverage

No matter how your insurance company defines total disability, most companies automatically consider certain catastrophic ailments to be totally disabling. If you are disabled by one of these ailments, you don’t have to meet the conditions normally required in order to be considered totally disabled. Not only do you receive immediate benefits, but you also continue to receive benefits even if you are able to return to work. These ailments (which may be caused by injury or illness) are the loss of sight in both eyes, hearing in both ears, speech, the use of both hands, the use of both feet, and the use of one hand and one foot.

Residual disability coverage

Disability policies can pay benefits in the event that you cannot work at all (total disability), can work some time but not all the time (residual disability), or both. Residual disability or income replacement policies pay benefits according to the amount of income you have lost due to disability. These policies pay benefits even if you are not totally disabled and can work part-time. Your benefit will be based on the percentage of income you earn working part-time in relation to what you used to earn working full-time. In some policies, to qualify for residual disability coverage, you must first qualify for a period of total disability. This is the least desirable method.

You can purchase a total disability policy with residual coverage as a rider, or an income replacement policy (as residual coverage is known when that is the only way benefits are paid) as a stand-alone policy. The income replacement policy will generally cost less than the total disability policy with the residual rider.

Partial disability coverage

Partial disability coverage is usually offered as a rider to a total disability policy, although it may be included in base coverage. It is similar to, but not the same as, residual disability coverage. Both types of coverage pay benefits if you can perform some but not all of the duties of your occupation. However, unlike residual disability, a partial disability definition does not consider loss of income. Rather, you are paid an amount equal to 50 percent (occasionally less) of the benefit that you would earn if you were totally disabled. In addition, the benefit period is much shorter than that for residual disability (a few months or a year at most).

Does your policy cover illness, injuries, or both?

Most policies offer coverage for both injuries and illnesses. Some policies, however, offer accident-only protection and don’t cover illnesses. Also, because work-related disabilities are covered by workers’ compensation, most policies will reduce their benefits by any amount of benefits paid by workers’ compensation, as well as any benefits received from Social Security and other government programs.

Sickness is usually defined in disability policies as illness or disease that manifests itself while the policy is in force. This definition covers mental as well as physical illness, but most policies limit payments for mental illness and drug- or alcohol-related disabilities to two years of benefits. Some policies have exclusions for disabilities caused by pregnancy, war, and self-inflicted injuries as well as other exclusions. All of the exclusions will be detailed in the policy.

via How Disability Income Insurance Policies Define Disability.