Disability Claim Tips With Ed Comitz, Esq.
Disability Claim Tips With Ed Comitz, Esq.
This guide is intended as a practical resource for dentists who think they might want to file a disability claim. Check in regularly for new claim tips.
Edward Comitz

Do I Lose My Disability Coverage If I’m Not Working?

3/24/2020 3:34:50 PM   |   Comments: 0   |   Views: 56

It depends. Some disability policies (most often employer policies or group/association policies) have a requirement that you must remain “actively at work” or working “full-time” in order to stay eligible for coverage.

While sometimes “full-time” is defined, other policies, like the ADA/Great-West policy, have an hourly work requirement that must be met to maintain eligibility. For example, you may need to work 20 hours a week, or 30 hours a week, depending on the disability policy.

Many times, there are exceptions that can be utilized to maintain eligibility, but it may require further action, like obtaining a formal leave of absence from your employer or getting approval for FMLA leave. However, these are things that need to be done proactively, to preserve eligibility.

Additionally, if you lose eligibility and regain it later (say, after the national coronavirus epidemic has passed), this can re-set the coverage date and preexisting condition provisions under some policies. As a result, your claim could be denied on the basis that your disabling condition pre-dates the new coverage date, even if you technically regain the ability to file a claim under the policy upon returning to work.

There are certain legal principles that will work in tandem with the provisions of your policy, and that may help you, especially in circumstance like coronavirus pandemic. However, the administrators of your policy may or may not believe that it is in their best interest to voluntarily assist you, notwithstanding these laws.

Action Step: Locate your disability policies and become familiar with the requirements for maintaining eligibility. If necessary, take additional steps to preserve your eligibility during periods where you are not able to meet the normal hourly work requirements. Talk to a disability attorney if you have questions about ways to maintain your eligibility during the coronavirus crisis. 

Each dentist’s claim for disability benefits involves different facts, disabling conditions, policy requirements, insurance companies, etc. While our attorneys are making an effort to share general knowledge with the dental community and answer dentists’ questions about the impact of the coronavirus, this not a substitute for individualized advice from an experienced disability insurance lawyer. If you would like to speak with our attorneys and have them take an in-depth look at your particular situation, please feel free to contact us directly.

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