There are a few reasons why the date that you can no longer work due to disability is important. Two very specific reasons are:
- It impacts coverage; and
- You may not be disabled.
In our previous installment, we talked about pre-existing conditions, waiting periods, and effective dates of coverage. Those are important topics to understand when you and your doctor are determining that you can no longer work.
- Are you sure that you are covered under your employer’s long-term disability policy?
- Did you fill out your election timely and has the waiting period passed?
- Are you beyond the pre-existing condition exclusion?
- These are just a few of the questions that impact whether or not you have coverage and are entitled to benefits at the time you can no longer work.
If you have been following along, you know the importance of having your doctor diagnose your disabling condition.
You also know that your policy contains a specific definition of disability. To get benefits under the policy, you must be disabled according to the definition. Most definitions will require that you could no longer work because of a disability.
Unfortunately, some people stop working BEFORE their doctor diagnoses a disabling condition. When that happens, the person will have no medical proof of a disability until AFTER they stopped working. Sometimes, people file without any medical support.
The long-term disability provider will have an easy decision – that person decided to stop working (quit). The person cannot prove that a disability caused their inability to work. Why? Because they have no medical opinion saying so. The medical opinion only comes after the decision to stop working.
A good example here is the chicken and the egg. You know the one – which came first, the chicken or the egg?
While there is no clear answer on the chicken or the egg, in long-term disability settings there is. You must have a doctor’s opinion and medical proof of disability BEFORE stopping work and filing a claim.[Just for the record – the chicken came first]
You should only stop working after you are certain that you are covered under the long-term disability policy, and you have adequate medical support and documentation. And not before.