Understanding Disability Insurance Options
DISABILITY INSURANCE
Figuring out insurance can cause an instant headache. That’s why Triage Cancer CEO Joanna Morales is here to help break down disability insurance options while you’re going through cancer.

Individuals diagnosed with cancer may find that they are not able to work and earn a living in the same way that they did before their diagnosis. Disability insurance can help replace the wages that are lost during time off from work due to a medical condition. 

 

How Disability Insurance Works with Employment Protections

Disability insurance can work with fair employment laws and leave laws at the local, state and federal levels. For example, the Family and Medical Leave Act (FMLA) is a federal law that allows employees to take time off work while protecting their job and sometimes their health insurance coverage. 

Employees may also have access to certain employee benefits, such as sick time, vacation time, general paid time off (PTO) and policies allowing co-workers to donate their leave hours. 

While the FMLA provides job-protected leave, it is unpaid leave. Many people don’t actually take FMLA leave because they can’t afford to not get paid. Disability insurance is a way to get paid. 

Disability insurance benefits are offered by the federal government, some state governments or through a private insurance company.  

Private Disability Insurance

Private insurance companies sell short- and long-term disability policies. Short-term policies typically last up to one year, while long-term disability insurance policies are for medical conditions that last one year or longer. It is possible to buy these policies directly from an insurance company; however, many people don’t think about purchasing coverage until they have a serious medical condition. Unfortunately, it is more difficult to get a policy with a pre-existing condition because insurance companies can use medical underwriting to deny coverage or charge people more for coverage based on those conditions. 

Most people get access to a private short-term or long-term private disability insurance plan as an employee benefit. Employers often pay the monthly premiums for these plans, so people may forget that they signed up for the coverage when they started working.  

Federal Disability Insurance

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are federal programs that provide financial assistance to people with disabilities, and are administered by the Social Security Administration (SSA). To qualify for SSA disability benefits, you must have a disability: that has, or is expected to, last for at least one year or to result in death; and you cannot do your current job; and you cannot adjust to a new job. There are differences between the two programs.

Social Security Disability Insurance (SSDI)

You may qualify for SSDI benefits if you are “insured,” meaning that you have worked long enough and recently while paying Social Security taxes. The maximum monthly benefit from SSDI, for someone who is not blind, is $3,345 per month in 2022. Sign up for a “My SSA” account online at SSA.gov to find out the amount of your monthly SSDI benefit. 

There is a five-month waiting period before SSDI benefits begin. You automatically receive health insurance through Medicare after you have received SSDI benefits for 2 years. 

Supplemental Security Income (SSI)

You may qualify for SSI benefits if: you have a low income and resource (aka: assets) level; and are aged 65+, or blind, or disabled. The maximum 2022 federal amount for most people receiving SSI is $841 per month. States may add to that amount.

In most states, people eligible for SSI automatically get health insurance through Medicaid. It is possible to receive SSDI and SSI benefits at the same time.

Applying for SSDI and SSI

The application process for SSA disability benefits can take a long time. One way to speed it up is to see if you qualify for the Compassionate Allowances (CA) program. This is a list of medical conditions that SSA thinks presumptively qualify for disability benefits. This is not the same thing as automatically qualifying. They will still look to see how your medical condition impacts your ability to work. If you have a medical condition on the CA list, you should include that in your application. 

Appealing a Denial 

Many SSA disability applications are initially denied. Appealing that denial will improve your chances of getting the benefits that you need. Be sure to work with your health care team during the appeals process, as they can provide useful information about your medical condition, side effects from treatment and how those side effects impact your ability to work. 

State Disability Insurance

California, Hawaii, New Jersey, New York, Puerto Rico and Rhode Island offer short-term state disability insurance programs. Each state has different eligibility requirements and the length of coverage varies. Most state programs are easier to qualify for than the SSDI or SSI. It is also possible to receive both state and federal disability benefits.

For more information about disability insurance options and how to navigate benefits, as well as other cancer-related legal and practical issues, visit TriageCancer.org. For information about Medicare: Quick Guide to Medicare. For information on SSI: www.ssa.gov/pubs/EN-05-11000.pdf. For information on SSDI: www.ssa.gov/pubs/EN-05-10029.pdf. For more information on the appeals process, visit www.ssa.gov/pubs/EN-05-10041.pdf. For information about hiring an SSA appeals attorney, see our Quick Guide to Legal Assistance. For more information, see our Quick Guide to State Disability Insurance.  

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