I Just Became Disabled – What Should I Do First?

What happens if you are injured suddenly or contract a serious illness and are unable to work for an extended period of time? What should you do first?

Author: Attorney Lonnie Roach

In addition to coping with the physical and mental stress of a disabling medical condition, there are financial issues to consider. Should you file for Social Security? Quit your job? File for Unemployment?

I Just Became Disabled – What Should I Do? What happens if you are injured suddenly or contract a serious illness and are unable to work for an extended period of time? What should you do first?

The first thing you should do is check with your employer to confirm any employer- sponsored benefits you currently have.

Many employers provide both short-term and long-term disability insurance for employees through group plans. Quitting your job at the outset of disability is not a good idea because any coverage under employer sponsored short-term or long-term disability insurance ends when an employee terminates employment. Most short-term and long-term disability insurance pay approximately 60% of an individual’s salary. A short-term policy usually provides coverage for six months, while a long-term policy’s coverage lasts as long as the disability continues; it can last two to five years, until age 65, or for life. Some insurance plans offer an option to purchase more coverage.

If you have long-term disability insurance either through your employer or purchased privately, review your plan summary for the terms and limitations of your policy.

Check the policy’s definition of disability, the medical conditions the plan covers, and its exclusions. Look at the waiting period (the “elimination period”), the amount of time you must wait before you can receive benefits. The average wait period is 90-180 days, though group policies may have shorter periods. Some long-term disability insurance offers a rider that will pay partial benefits if you work part-time. Know whether your policy is written as an “own occupation” or “any occupation” policy. In an “own occupation” policy the claimant must be unable to perform the substantial duties of his or her particular occupation. An “any occupation” policy or general disability policy defines disability as the insured’s inability to engage in any gainful occupation that they are reasonably suited for based on their training and work experience.

If you have been denied disability don’t give up! Contact a Disability lawyer at 512-454-4000 for a free consultation and get the benefits you deserve.

You may qualify for Social Security disability benefits if your illness or injury prevents you from working and is expected to last at least 12 months.

Social Security’s definition of disability is strict and the medical criteria required to prove disability is rigid. Additionally, you must meet Social Security’s work credit requirements for how long you were employed and how recently. If you decide to apply for Social Security, you should do so as soon as possible because the application process can take up to 5 months.

You may apply for and receive both Social Security disability benefits and long-term insurance benefits at the same time.

In fact, most LTD companies require claimants to apply for Social Security benefits. However, if you are approved for both SSDI and LTD benefits, the monthly payments you receive from the insurance company may be offset or reduced by the amount of the SSDI benefits.

Should I quit my job if I become disabled?

The initial stages of a disability are an uncertain time for most people. You may not know how long you will be out of work, if you will need to find part-time work, or stop working altogether. You can apply for unemployment benefits, but be aware that the eligibility requirements for unemployment and Social Security benefits are in sharp contrast to one another. To be eligible for unemployment in Texas, you must be able to work full time and actively seeking employment while to receive Social Security disability benefits, you must be unable to work because of a physical or mental condition for 12 months. In 1999 the U.S. Supreme Court held that Social Security disability claims “did not inherently conflict” with other types of benefits, but the claimant must prove that their eligibility for unemployment benefits does not conflict with a disability claim. As an alternative, you could go on unemployment while you search for a new job or part-time work and decide whether to apply for SSDI. If you are unable to find or keep a job because of your medical condition, you can terminate unemployment benefits and then apply for SSDI. If you apply for SSDI while you are receiving unemployment, Social Security will deny your claim.

Adjusting to a lifestyle with physical or mental disabilities requires patience and determination and involves making complex decisions.

Surround yourself with family, friends and medical providers who will support you and consult with a qualified disability attorney who can guide you in making those decisions.

Author: Attorney Lonnie Roach has been practicing law for over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.