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What Is Disability Insurance? 3 Basic Questions

By Jenny Tsay, Esq. | Last updated on

If you're unable to work because of an injury or a debilitating illness, you may be wondering what disability insurance is and whether you're covered by it.

The answer can depend on many factors including the type of injury you suffered, where the injury occurred, and what type of disability insurance you or your employer may have.

For a general overview of how disability insurance works, here are three frequently asked questions about disability insurance:

1. What Is Disability Insurance, Anyway?

Disability insurance can pay for some or all of a worker's salary if a worker becomes disabled. Disability insurance can either be purchased privately or it may be provided by an employer. Depending on your state, employers may be required to have some sort of disability benefits insurance. For example, in New York, most private employers must provide disability benefits unless they fall under certain exemptions.

State disability insurance plans, however, typically only provide benefits for a specified period of time. If you can afford it, private disability insurance may also work to your benefit.

With private disability insurance, you can decide if you need short-term or long-term coverage. Short-term plans usually last between three to six months, whereas long-term plans cover disabilities lasting six months or longer and may even provide benefits until a policyholder reaches a certain age.

2. What's Covered by Disability Insurance?

The scope of disability insurance coverage depends on the type of plan you're talking about.

For example, in California, state-provided disability insurance only covers a disability that isn't caused by an injury at work. This can include disability relating to a non-industrial injury, illness, or even a pregnancy-related condition, according to California's Employment Development Department. Similarly, in New York, the state's disability insurance only covers off-the-job illnesses and injuries.

Private disability insurance plans, however, can be more extensive, covering disability due to workplace injuries, outside-of-work illnesses and injuries, or both.

3. Do You Need a Lawyer for a Disability Claim?

While it's not mandatory that you hire an attorney to help you with your disability insurance claim, it may be a smart move because the process can get complicated and claims often get denied. This is because some policies exclude certain illnesses or injuries, and because some individuals don't file their claims on time, among other reasons.

To appeal a denial, you may have to go through an administrative appeals process before you can sue, but again, it depends on the terms of your policy and the facts of your individual case.

If you're considering a disability insurance claim, or if you feel your claim has been wrongly denied, it may be best to consult with an experienced disability attorney who can help guide you through the process every step of the way.

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