Disability: Employer and Government

Acquiring disability through the government is a two to three year painful process. If you are fortunate to have disability insurance at work, this is definitely a plus; although if you do achieve disability from the government you are in for a rude awakening at the end of the insurance coverage.

First of all:

The disability requirements vary with the insurance company and the government.

When you file government disability, you will likely be turned down on your first application. It is wise to seek an attorney or non-attorney representative that is familiar with the filing process to help you file an appeal. Their fee is 25% of your back pay up to a maximum of $5,300.00 plus their expenses. This is well worth it and it is subject to change.

The courts are so overburdened with appeals, it will take two years or more to receive a hearing before a judge and your representative will be with you. He or she will ask you well ahead of time to prepare your medical records for review. If you are fortunate, your decision will be made without an appeal. It will be either denial, partially favorable, or fully favorable.

If favorable, you will qualify for Medicare part A,B and D if your disability goes back for two years. This includes partial coverage of your prescription costs.

If you have disability coverage at work, they will pay you the afore mentioned amount which is a percentage of your wages. You must not have any other income for yourself or this will be deducted from your payment. This is also taxable and I recommend you withhold an amount you think is suitable. Your spouses income should not affect your payment by the insurance company as long as you don't work. The disability coverage for you at work will vary to the extent of two years, five years or a lifetime depending on the company and the coverage. The insurance company will more than likely require you to go to the doctor at least every two months and will require your physician to complete a form stating your progress about every quarter of a year. The doctor and prescriptions are your responsibility; again this may vary with the policy, this is just a general article. They require continuous proof of disability, which is a painful process in itself. When they closed my file and I had no income, I had to practically beg to get it re-opened, and I had to send them proof of Dr. visit every month. There are many things insurance companies conveniently don't tell you and it is up to you to stay on top of things. I would suggest you request a copy of their contract with your employer. The contract contains a great deal of legal language that someone may have to interpret for you.

The insurance company may drop your benefits at any time they deem you are fit for work. If you return to work, the government will automatically see you are fit to return to work. If you do not return to work and continue to pursue the government disability, you will eat a lot of bologna sandwiches and may even reduce your pride and apply for food stamps. There are also HUD housing authorities that reduce your rent based on your income and the availability of housing. Please check into this to find out if you qualify and get on an availability list as soon as possible.

If the time comes and you are awarded government disability benefits, your benefits go back to when you are first disabled. If it has been two years, you are due a windfall of money from the government minus your representatives fee. The representatives expenses are paid by you out of your Social Security back pay as I understand it. If not, it is your responsibility to pay him/her plus their expenses. It will probably take a little time before you receive this check.

The gross disappointment in all this depends on the type of disability your employer carried. In general, all the monies minus the representative fee and the cost of living allowance awarded by the government is to be reimbursed to the insurance company by you, so they say. They frequently fail to tell you that the money they paid you is a "loan" and is repayable to them...by you. You have no windfall. Please be advised you can try and negotiate with the insurance company yourself. Don't hire an attorney unless absolutely necessary; you can negotiate as well as they, and it won't cost you a lot of money.

In addition, at the present time, Medicare part B (which I strongly encourage you to take) is $96.00 per month and the Medicare part D prescription assistance varies with the plan. Medicare part B is automatically taken from your Social Security check, and part D can be deducted or paid monthly by you. At the time of this writing it is about $96.00 per month; but, believe me it is worth it. Since I have worked in health care in the past, I can attest to this.

If you can't work, it's the best you can do. I just wanted to shed some light on what an event I have been through and tell you some things that may help you in the future. By the way, if you are eligible for retirement from a previous employment for which Social Security was paid, you are allowed to keep this retirement in addition to your Social Security payments.

Disclaimer: I am not an attorney. I write with great difficulty and it is therapy for me. If you question any part of this article, I suggest you consult a professional. I am only sharing my experience with you. Thank you.