Did your employer fire you while you’re on disability leave? The first thought running through your mind might be, ‘Will my disability benefits continue even though I’ve been fired?’
The short answer is yes, BUT there are some very important things you need to know.
If you call us with this question, the first thing we will tell you is “look at your insurance policy.” You would be surprised at how many questions can be answered by looking through it. If you have any trouble understanding your policy, then it is a great idea to reach out to an experienced ERISA disability law firm (like BenGlassLaw) to get a better understanding of the language used in your policy.
What is Disability Insurance?
Disability insurance is a crucial safety net that provides financial protection if you become unable to work due to illness or injury. Essentially, it replaces a portion of your income, helping you maintain your standard of living and cover essential expenses during tough times. You can obtain disability insurance either individually or through an employer-sponsored group health plan.
There are two primary types of disability insurance: short-term disability insurance and long-term disability insurance. Short-term disability insurance typically covers you for a limited period, usually up to 90 days. On the other hand, long-term disability insurance provides benefits for an extended period, often until you reach retirement age.
Disability insurance policies usually come with a waiting period, also known as an elimination period, before benefits kick in. This waiting period can range from a few days to several months. Additionally, the policy will have a benefit period, which is the duration for which benefits are paid.
Understanding the terms and conditions of your disability insurance policy is essential. This includes knowing the definition of disability, the benefit amount, and the waiting period. When determining your need for disability insurance, consider your financial situation, occupation, and health status. This knowledge will help you make informed decisions about your disability coverage insurance.
Can My Employer Fire Me While I’m On Disability?
Under The Americans with Disabilities Act (ADA), employers cannot fire or discriminate against employees with disabilities unless the employee is unable to perform the essential functions of the job, even with reasonable accommodations. This means that if you can do your job with some adjustments, your employer must make those adjustments. However, if you are unable to perform the essential functions of your job, even with those reasonable accommodations, your employer may have grounds to terminate your employment.
My Policy Says That My Benefits Will Continue If I Am Fired
You may be thinking, “okay, I will continue receiving benefits, so I am all set.” Well no, it’s not that simple. Virtually all policies require that you continue to provide proof that you are disabled. How? You have to keep seeing your doctor, and your doctor has to continue to support your claim.
and your doctor has to continue to support your claim.While receiving disability benefits, you must maintain your medical treatment. We cannot stress this enough. Regularly, claim examiners will look at your file to decide whether they think you still qualify for benefits. They will terminate your claim if they don’t have recent proof that “nothing has changed” and you remain disabled. So be sure that you continue to see your doctor as often as they recommend, and be sure your doctor completes the paperwork the insurance company continues to send them. There is no way around this – we have seen claims closed after many years of continued disability simply because the claimant and their doctor forgot to complete a form.
Your next question might be, “okay, I understand that I need to continue visiting my doctor, but my health insurance was provided by my employer, so how will I afford all of this now?”
How Can I Afford Medical Bills With No Health Insurance?
We get it – this is a horrible situation to find yourself in. You can already see the medical bills beginning to pile up in the future, and you are worried that you will not be able to afford them with no health insurance. But the reality of the situation is, no medical treatment, no disability benefits.
The insurance company will not make an exception for you. They will follow the policy language, and if the language calls for “continued proof of disability,” that’s what you must provide. They simply will not take your word for it – you have to have a doctor fill out their forms and explain why you remain disabled.
Though far from perfect, you often do have options:
COBRA Health Insurance
Generally, employers with 20 or more full-time-equivalent employees are required to offer COBRA coverage for former employees, so make sure to check with HR to see if your former employer has it. If you worked for a large corporate company, then you are probably covered by COBRA.
You may be wondering, “what is COBRA?”
COBRA is a health insurance program that allows eligible employees and their dependents the continued benefits of health insurance coverage when an employee loses their job or experiences a reduction of work hours. You must be given at least 60 days in which to choose whether to elect continuation coverage. Even if you waive coverage, you can change your mind if it is within the 60-day election period.
It is important to note that the cost of COBRA coverage is usually high because the newly unemployed individual (you) pays the entire cost of the insurance (including the share that your former employer paid).
Medicare
If you are receiving long term disability benefits through your employer, you are likely also receiving Social Security Disability Benefits (SSDI). After two years of SSDI, you are eligible for Medicare. Medicare is the federal health insurance program for people who are 65 and older and those with with disabilities. It covers:
- Hospital insurance
- Medical insurance
- Prescription drug coverage
These plans are offered by insurance companies and other private companies approved by Medicare.
The Affordable Care Act (aka Obamacare)
The Affordable Care Act provides consumers with subsidies (“premium tax credits”) that lower costs for health insurance for households with incomes between 100% and 400% of the federal poverty level. Important for many individuals with disabilities, there is no “preexisting condition exclusion” for health insurance offered through the ACA marketplace. You can learn more at www.healthcare.gov.
Takeaway – How BenGlassLaw Long-Term Disability Team Can Help You
If you came across this article because you were recently fired while on disability leave, we understand that you are stressed and probably have a lot of questions.
First, check your policy. It will tell you whether “termination of employment” is a condition for “termination of benefits.” In most cases, it’s not.
Second, make a plan for providing continued proof of disability. Talk to your doctor about how important it will be to continue responding to the insurance company requests for information. Make sure you see your doctor as often as you need and they recommend.
Third, if you still have questions, contact us today! Our highly experienced long-term disability team can answer quick questions for free. If you’d like us to take a “deeper dive” into your policy and medical records to help you plan for the future, we offer a flat fee consultation (and if benefits are denied in the future and we handle your appeal, that consultation fee is credited to your appeal fee). No one plans to become disabled and lose their job. But we can help you plan for what comes next.
