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Do I Make Too Much Money to Claim Long-Term Disability?

A Lesson in Why You Should Never Receive Disability Advice From Your Well-Meaning Friends

We had a dentist come to us for a consultation, and he did not claim disability when he first could have. Apparently, his friends had told him not to bother submitting a disability claim because “you make too much money.” He had a condition that prevented him from performing complicated dental procedures (which tend to be more highly compensated), but he was still able to perform general dentistry procedures. Over time, the inability to perform complex dental procedures caused his income to drop substantially.

The problem was, he asked his friends for advice, and his friends did not read his disability policy. The policy clearly was designed to protect him in this exact circumstance – when he was partially disabled, and could still work, but couldn’t earn what he used to earn because of his disability. His friends didn’t realize that – they thought disability was “all or nothing,” and if he was still working, he would never be approved for benefits. They wanted to save him the stress and hassle of applying only to be denied. By the time he came to us, our dentist missed out on a substantial amount of money because his friends persuaded him not to file a claim.

Are You Unsure Whether You’re Covered Under Your Disability Policy?

Policies are like snowflakes…from a distance they may all look alike, but when you get down to the detail level, each one is unique in some way. Individual policies are different from group policies that are different from government-sponsored programs like Social Security Disability Income (SSDI) and even the Virginia Retirement System (VRS). Just because your well-meaning friend understands their policy, it does not mean they understand yours. Even more important – just because your well-meaning attorney thinks they probably understand your policy, there are vital nuances they could be missing unless they see a LOT of these policies.  

Often, policies will allow you to both work and receive disability benefits if you can prove that your disability is causing a loss of income. These can be tricky claims to make because while you are still working, you need to prove that you are unable to work as much or earn as much as you were before you became disabled. But an attorney who has experience with these policies and these partial-disability claims can guide you.

If you are making a claim under a group disability policy provided by your employer, you are most likely making a claim that is governed by ERISA, the Employee Retirement Income Security Act. You need to talk to someone who has looked at the ERISA snowflake from all angles – you need an ERISA-experienced attorney. At BenGlassLaw, we will review your disability denial letter for free, and we offer a flat-fee consultation to anyone with questions about a potential disability claim.

If you are disabled and cannot do your job, then you should be covered by your policy. DO NOT let ANYONE tell you differently unless they are an experienced ERISA long-term disability attorney who has read the policy and can explain to you why you are not covered.

Own Occupation Disability v. Any Occupation Disability – Can You Still Work?

Disability policies generally have two scenarios for whether you can work while receiving disability benefits.

Own Occupation Disability simply applies to your current job. The policy asks, does the disability of the insured prevent them from performing the substantial and material duties of their current, specific occupation? Under an own occupation disability, you are not barred from working another job while you receive disability benefits. For example, a surgeon who develops a disability that prevents them from performing surgery could still practice a different field of medicine while they receive disability. Your disability pay will depend on how much you are earning in your other occupation – usually, there are no benefits if there is no overall loss of income.

Any Occupation Disability applies to the inability to work ANY occupation. The insured can only receive disability benefits if they cannot perform the duties of any occupation that they are qualified for by education, experience, and training and earn above a certain percentage of their pre-disability earnings. That percentage varies by policy…which is why it is so important to talk an attorney who knows how to read and interpret these policies.

How We Can Help

We cannot emphasize enough that every policy is different. We have seen everything from strong disability policies that are favorable to the employee to disability policies that are illusory shams, providing no real coverage at all.

Bottom line, if you have suffered a loss of income due to an injury or other disability, you may well have a valid disability claim, even if you are still able to work in some capacity.

If you have been denied disability benefits, we will review your denial letter for free. If you have not yet made a claim, or have questions about your policy or disability, we offer a flat-free consultation. We’ll review your policy and your recent medical records and talk in detail about what is best for you so you can make the wisest decision for your unique situation.

Your friends mean well, of course. They may know their own policies. But your policy plus your medical condition is a different snowflake. Talk to someone who understands these differences so you can be sure to receive the benefits to which you are entitled.

Ben Glass
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Ben Glass is a nationally recognized ERISA disability & life insurance attorney in Fairfax, VA.