Disability Benefits From State Government
From January 2021, the;Department of Paid Family Medical leave offers a cash benefit to Massachusetts employees who need to take paid leave for medical or family reasons. Find out more at;Paid Family and Medical Leave .
Some employers offer short- or long-term disability insurance as a benefit to their employees. You should check with your human resources department to find out whether your employer offers this benefit and if you have previously enrolled in it.;If you have private disability insurance through your employer, or that you’ve;bought individually, typically it will require you to apply for any public benefits available. In conversations about disability insurance, if people are referring to “disability,” they often mean PFML.;
The Department of Transitional Assistance provides cash benefits to people with very low income and assets. If you are unable to work for at least 60 days due to a disabling condition, you may be eligible for one of their programs.;
What Qualifies For Long
The qualifications for long-term disability are usually more stringent than those for short-term disability. With short-term disability, benefits can be awarded if the employee is unable to do their job. With long-term disability, benefits will typically only be awarded if the employee is unable to do;any;job. What constitutes a qualifying event will be specified in the policy, so it is important to understand when benefits may apply before accepting a long-term disability policy.
Qualifying events may include chronic pain, cancer treatments, or debilitating illness or injury lasting more than 26 weeks. If an employee could qualify for another form of income replacement, such as Social Security Disability Insurance, the long-term disability policy will no longer provide benefits.
Chapter 1: Getting Help With Your Ssdi Claim
Social Security law is highly complex. The very complexity of the process is the reason why most individuals who apply are denied.
Having the right help with your Social Security disability claim can make the difference in winning or losing benefits, and in how quickly you may qualify for benefits.
You have the right to appoint a qualified individual to represent you in your claim for Social Security Disability benefits. The appointment must be in writing and filed with SSA.
Your SSDI representative must be an attorney or a qualified non-attorney representative.
Attorney vs. Non-Attorney Representation
Attorney Representation
A disability attorney is able to advise you on the law and can interpret the law to build a case that avoids the pitfalls that cause so many SSDI claims to be denied in the first place. A lawyer who focuses on Social Security Disability benefits, or is Board Certified in Social Security disability law, takes out the guess work in your disability case.
Non-attorney Representation
SSA requires that non-attorney representatives possess a bachelors degree or equivalent qualifications, pass SSAs written examination, secure professional liability insurance or equivalent, undergo a criminal background check, and complete continuing education courses.
There are various organizations that allege that they can represent you, but there are some factors to consider beforehand.
Example 1:
Example 2:
Example 3:
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Canada Pension Plan Disability
Many Canadian workers are eligible to apply for disability payments from the Canada Pension Plan. To qualify you must be under age 65, unable to maintain gainful employment due to disability, and have made recent contributions to the Canada Pension Plan. You have to be continuously disabled and off work for 4 months to before you can become eligible to receive payments.
To learn more about CPP disability benefits, check out our Ultimate Guide to CPP Disability.
Chapter : Can I Get Retroactive Payments For Ssdi & Ssi
SSDI:
Social Security disability might be paid retroactively for up to 12 months before the date you actually applied, if all requirements are met. This retroactive pay is only considered when a first-time claimant is entitled to at least one month of benefits during the 12-month period, which establishes a period of disability.
The period of disability is yet another reason it is essential to apply for Social Security disability benefits as soon as possible.
SSI:
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Whats The Difference Between Short Term And Long Term Disability Insurance
As the name indicates, short term disability insurance is intended to cover you for a short period of time following an illness or injury that keeps you out of work. While policies vary, short term disability insurance typically covers you for a term somewhere between 13-26 weeks and can replace anywhere from 40-70% of your income during that benefit period. If you have both short term and long term disability policies in place, short term disability will pay you benefits during the waiting period before your long term disability coverage begins, at which point youll transition from one policy to the next to receive benefits. For that reason, it makes sense to have both policies to help ensure an unexpected illness or injury wont derail your financial confidence for a few months or for several years.;
Chapter 1: Psychological & Cognitive Disabilities
Disability Compensation for Mental Disabilities Other Than PTSD
If your case concerns a mental disorder, various unique issues may be present during the claim process. First you must be sure to have your mental disability professionally diagnosed. Once diagnosed, you will need to identify which particular mental disorder you are seeking benefits for; you will also need to show that the disability is service-connected in one of five different ways.
The 5 Ways to Service Connect a Mental Disorder in a VA Claim
Disability claims involving mental disorders can be extremely challenging, and more than one mental disorder can exist.
Note: if you have applied for the wrong mental disorder, that alone is not basis for denial. As long as some of the symptoms overlap, the claim can be applied to the correct disorder once it has been diagnosed. You may be required to provide new evidence in the case.
Glossary of Key Terms Used in Mental Disorder VA Claims
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Whether You Are Working
Social Security will look at whether you are working, and if so, how much. Social Security can grant you disability benefits if you are unable to work at or over the substantial gainful activity level for at least one year. But if you are earning more than that, Social Security will deny your claim without even looking at your medical records.
Long Term Care Insurance
Long-Term Care insurance pays for a variety of services for people who are unable to care for themselves due to an injury such as a paralysis from a car accident, a chronic illness such as arthritis, an acute episode such as a stroke, or a cognitive impairment like Alzheimer’s disease. Long term care services may include assistance in a home, adult day care center, an assisted living facility, or nursing home.
New enrollments into LTCi are no longer available as of February 1, 2016.
Employees who had enrolled in LTCi may continue the coverage currently in place. Employees enrolled in this coverage must pay CNA directly for their LTCi premiums.
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Chapter : Getting Legal Representation
Initially, claimants are not skeptical of the insurance industry or the disability insurance process. Once their claim is denied, they are at a loss about what to do to get their badly needed insurance coverage.
When it comes to filing a successful appeal, experienced legal counsel is in order. A disability insurance lawyer can take the burden of proof off your shoulders, develop your case properly and apply the law to your benefit, and provide all of the necessary evidence to effectively appeal a wrongly denied insurance claim.
How Much Will You Get Paid When You Take Short
When you take advantage of your short-term disability benefit, your time off is paidbut that doesnt necessarily mean youll be getting your full paycheck.
The amount youll earn is dependent on your specific plan. Some plans offer full salary replacement, but most dont. Instead, they offer a percentage of compensation with a dollar amount cap.
There are also programs that award you different amounts based on your longevity with the company, says McDonald. If you are there for 10 years and have a 26-week disability period, you might get three months at 100% and then three months at 50%.
If you live in one of the five states where short-term disability benefits are mandated, then the amount youll be compensated will be regulated as well.
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Chapter 1: Step Two Proving You Have A Severe Impairment
To qualify for SSDI, your impairment must be established as severe under Social Security rules. Proving a severe impairment is not easy. If SSA finds that your impairment or impairments are severe, then you continue to step three of the Five Step Sequential Evaluation.
Below is information regarding how SSA determines if your impairment is severe enough for you to receive Social Security disability benefits.
How SSA Defines Severity
Severity in impairment occurs when an injury or illnessor combination of injuries or illnessesnotably interferes with your physical or mental ability to perform basic work activities.
Social Security disability benefits are not likely to be awarded if your health issues are considered slight. This is why it is important to have your treating physician specifically describe mental and physical limitations caused by a diagnosed condition.
For example, a doctor should write the patient has difficulty with walking, standing, balancing and muscle control, if that is the case, instead of using general terms like the patient has difficulty performing duties at work.
How SSA Measures Severity
If your impairment is not deemed severe, then SSA will not consider you disabled. SSA does not factor in age, education and work experience. However, it is possible for you to have been disabled for a period of time in the past, even if a severe impairment no longer exists.
Which Disability Benefit Should I Be Claiming
If you havent already claimed DLA then youll need to find out which benefit you should claim, as there are different ones depending on your age:
- If you havent already claimed DLA and youre under State Pension age, then Personal Independence Payment is the benefit you need to look into.
- If you havent already claimed DLA and youre over State Pension age, then the benefit to claim is Attendance Allowance.
Not sure when you reach State Pension age? You can find out;here.;
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Interaction With Ei Sickness Benefits
You cant receive EI sickness benefits and short-term disability at the same time. In fact, if you do receive both, you will need to pay some back.
For example, imagine you got EI sickness payments for 2 weeks. Then, you get approved for short-term disability, and they will pay you for those same 2 weeks. This creates an overlap. If theres an overlap, then youll need to pay back the EI program.
After youre approved for short-term disability, youll receive a back payment. Then, you can refund EI using that money.
Chapter : The Administrative Law Judge Hearing
The most important level of appeal before the Social Security Administration is what is known as an ALJ Hearing. The hearing is informal and is conducted by an Administrative Law Judge . The hearing takes place in the third step of the appeals process.
The hearings are usually conducted in a small conference room with the judge versus an official-looking courtroom. The hearing is recorded by a person known as a hearing monitor. All testimony is taken under oath, on penalty of perjury.
The hearing generally lasts about an hour to an hour and a half. It is seldom that these hearings take more than two hours.
The Administrative Law Judge
An ALJs job is to issue an independent decision on your Social Security disability case. The decision should not be influenced by the fact your case was initially denied or reconsidered.
Fortunately, more than half of the ALJ decisions nationwide are in favor of the claimant.
Informal Non-Adversarial Hearing
The ALJ hearing is a non-adversarial hearing, which means there is no lawyer on the other side who is going to ask you questions . The hearing is solely for a judge to find out the facts about your disability claim by asking you questions and/or calling other professionals to testify.
Who Comes to the Hearing
Besides these officials and the hearing monitor, no other persons are able to attend the hearing without your permission.
What Questions Will the ALJ Ask?
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The Employer Pays A Portion And The Employee Pays The Balance With Post
If the employer pays a portion of the premium, and the employee pays the balance with post-tax dollars, then the benefits are taxable in the same proportion as the percentage of the premium paid by the employer. For example, if you paid for 50% of your premium with post-tax dollars, you would only be taxed on 50% of the benefit that your employer had been paying.
They Abuse You Harass You Or Insult You
I once saw a therapist who said my tattoos are an ugly way of trying to make myself special, and that they remind him of the iron stamps put on cows. While I was about to burst into tears, I stood up, kept myself composed, told him hes an embarrassment to his profession and elegantly left. If something like this ever happens to you, know that you are not there to be judged upon your body, life choices, sexuality, health or general decisions. You are there to learn about yourself and heal with the help of a professional who is not allowed to hit you when youre at your most vulnerable. From that experience, I learned I always have a choice, and my choice was to leave and never look back.
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How Much Does Short Term Disability Insurance Cost
The cost of short term disability insurance is determined by the underwriting process. The underwriting for short term disability insurance may differ slightly from long term disability policies.
Individual long term disability insurance requires full underwriting. Insurers have to assess a personâs risk of filing a claim because benefits may be paid out for a long period. Therefore, insurers will assess your application based on your age, health, gender, the level of risk associated with your job, and any hobbies or interests that could cause disability.
On the other hand, disability insurance carriers may not fully underwrite short term policies. As stated earlier, many short term policies sold on an individual basis are guaranteed issue, which means no underwriting. Others may only require the answering of questions about your health without the medical exam required for long term disability insurance.
Injuries that cause temporary disabilities generally are not related to the insuredâs age, health, job, or other risk factors. They just happen, be it a bad fall that causes a broken bone or a complication of pregnancy. Still, you may be asked about pre-existing health conditions that disqualify you from coverage or that will limit your benefits.
The main factors that affect the cost of short term disability insurance include:
What Medical Conditions Qualify For The Disability Tax Credit
The disability tax credit is different from other disability benefits plans. The above disability plans focus on how your medical condition affects your ability to work. The is not focused on your ability to work. Rather, it focuses on impairment with your daily activities.
Eligibility Criteria for the Disability Tax Credit
- be blind
- be in at least one basic activity of daily living
- be significantly restricted in two or more basic activities of daily living
- need life sustaining therapy
You will automatically qualify for the disability tax credit if your medical condition causes blindness or you to need life sustaining therapy.
To qualify as blind your visual acuity in both eyes must be 20/200 or less or your field of vision in both eyes is 20 degrees or less.
To qualify under the life sustaining therapy requirement, the therapy must be needed to support a vital function, and you must need it at least 3 times per week for an average of 14 hours per week.
The basic activities of daily living include the following:
- Speaking
- Dressing
- Mental functions necessary for everyday life
To qualify for the disability tax credit you must show that you are markedly restricted in one of these areas. A marked restriction means that you are unable to do the BADL or take an inordinate amount of time to do it. This restriction must be present 90% of the time.
Learn the secrets for winning disability benefits, even after a denial
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Guide To Long Term Disability Insurance Claims
Chapter 1: About Long Term Disability Insurance
The onset of disability can rob you of your ability to work and make a living. Disability insurance policies protect employees and working individuals from the loss of income in the event they become disabled due to illness, injury or other serious impairment.
Insurance companies provide various forms of disability coverage ranging from group workplace benefits to customized, individual benefits, each with varying definitions of disability and levels of coverage.
Examples of some of the largest companies that provide disability insurance include Hartford Life, Unum, CIGNA, MetLife, The Standard, Lincoln Financial, Prudential, Aetna, Dearborn National, Liberty Mutual, Provident Life and Paul Revere Insurance.
Chapter 2: Types of Disability Insurance Policies
Disability policies are separated into two main forms regarding duration of coverage: Short Term and Long Term disability coverage.
Policies are also classified into two main types regarding which laws regulate the policy. These two types include group plans and individual disability policies.
As explained below, the laws governing each are quite different, and will affect your claim in a big way.
Short Term Disability
Long Term Disability
Most long term disability policies have a waiting, or qualifying period. This means that before you can apply for LTD benefits, you first must
Group Disability Plans