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Summary

When returning to work for the employer for whom you worked before going on disability, it's important to understand what happens to your benefits. This discussion assumes that your time off because of a health condition was not under a law such as the Family and Medical Leave Act (FMLA) or another employer program. (To learn more about your rights, see FMLA).

Look at what happens to the benefits you have now such as the following. Click on the links for information about each benefit that concerns you. 

When it comes to the benefits you will receive from your employer, the first question is whether your employer will treat you as a new hire (like a new employee) or as a continuation of your former employment.

If you will be treated as a new hire, the effect will be the same as if you went to work for a new employer. Read: Return to Work For A New Employer- Impact on Benefits.

Ideally you will be treated as an employee returning to work, and not as a new hire. As an employee returning to work there will not be a new probationary waiting period before benefits start. Health insurance will not have a waiting period before your pre-existing health condition is covered. If your employer provides a pension plan, your seniority and vesting will continue as it was.

If your former employer's policy is to treat returning employees as a new hire, you can still ask for an exception. The more unique your skills and experience, the better your bargaining position will be. If you use the "If you don't do this for me, I'll go to another employer" argument, keep in mind that at a new employer's you will be subject to all the new hire restrictions, including the possibility of a waiting period and a pre-existing condition waiting period.

Whether as a new hire or a continuing employee, look at the employer's benefits for which you will qualify. They may have changed since you were working. For example, if the health insurance is changed, you may not be able to continue to see the doctors you've been seeing.

Also look at what happens to your benefits if you find you're not able to continue to work because of your health condition. Include public benefits such as SSDI, SSI, Medicare and Medicaid as well as benefits from your employer.

If you are receiving an income from Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI), click here.

If you are thinking of returning to work for a new employer instead of your previouis employer, see Return to Work For A New Employer- Impact on Benefits.

Before you start the process of returning to work, be sure to read Returning To Work.

Effect Of Return To Work On Health Insurance

The impact of returning to work on health insurance depends on the source of that insurance.

If your health insurance is due to COBRA

Returning to work by itself does not effect COBRA. Your COBRA coverage will continue until its normal termination date as long as premiums are paid.

COBRA will end as soon as the employer's health plan takes over again ends as soon as the new plan takes effect and it begins to cover any pre-existing condition. While this is good news, on the down side you have to continue to pay the COBRA premiums.

You may not have to pay COBRA premiums if you had your previous health insurance long enough, and the gap between your old coverage and the new coverage is short enough. Under the federal law known as HIPAA, you can generally offset the amount of time you had your previous health insurance against a new pre-existing condition exclusion.

For more information, see COBRA and HIPAA-Portability.

If your health insurance is from your employer and continues because you are on disability leave

Some employers continue health coverage as long as the employee remains disabled or continues to collect Long Term Disability benefits. If this is the case, your coverage will end when your Long Term Disability benefits stop.

Discontinuing disability leave could be an event under the laws known as COBRA which would allow you to keep your health coverage until you qualify again.

For more information, see COBRA.

If you purchased health insurance on your own

Your health insurance continues in force as long as you pay the premiums even if you obtain additional health insurance from your employer. If you have two health insurance coverages, there are rules as to which company pays for what.

To learn more, see Coordination of Benefits.

Effect Of Return To Work On Social Security Disability Income (SSDI) Benefits

  • SSDI provides a trial work period that continues full benefits for up to twelve months while you attempt to return to work.
  • If you become sick again within the first three years immediately after a trial work period, (known as an extended period of eligibility) no new application will be required. You only have to call your local Social Security Administration office.
  • If you become sick again and your income drops within five years, no new waiting period for benefits will be imposed.

To Learn More

More Information

SSDI-Return to Work

Effect Of Return To Work On Supplemental Security Income (SSI) Benefits

As a general matter, the amount of your check from SSI will decrease by the amount of your new income.

Some of your income may not be counted to reduce your SSI payment. For example, if you have a Plan for Achieving Self-Support ("PASS").

If your health condition worsens so that you have to stop working and your income decreases, your benefit will revert to what it was before you tried to return to work. If that happens more than 12 months after SSI payments have stopped, you may have to file a new application in order to receive benefits.

For more information, see SSI-Return to Work, and PASS.

Effect Of Return To Work On Medicare

Keeping Medicare coverage is usually a good idea. If you get other health insurance, Medicare would act as a "safety net" of coverage.

Federal rules establishing priorities of payment between overlapping insurance will help minimize your co-payments and deductibles. To learn more, see Coordination of Benefits.

If you have Medicare as a result of receiving Social Security Disability Insurance (SSDI), and your SSDI benefits stop because of your return to work

Coverage will remain in force for three years without payment of premiums.

  • After that time, if you're still working but medically disabled, you can keep coverage in force indefinitely by paying premiums yourself.

  • If you qualify financially, your state welfare office will pay premiums for you.

If you have been receiving SSDI, but haven't qualified for Medicare by the time you return to work

You'll be given full credit for the months you've received benefits (against the 24 month wait) at any time you again become disabled, so long as the cause of both disabilities is the same.

Effect Of Return To Work On Medicaid

Even if you earn above Supplemental Security Income (SSI) limits and thus no longer qualify for benefits, you will remain covered by Medicaid so long as:

(1) You're still disabled, and
(2) You cannot afford similar coverage
(3) You depend on the Medicaid coverage to work.

Ask your Social Security representative what's the maximum amount of income you can earn in your state before you lose Medicaid coverage. Or contact your local Medicaid office through http://healthinsurance.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=healthinsurance&cdn=health&tm=17&gps=171_400_1020_598&f=00&su=p247.2.140.ip_p726.2.152.ip_p284.8.150.ip_&tt=12&bt=0&bts=0&zu=http%3A//www.nasmd.org/links/state_medicaid_links.asp offsite link.

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Medicaid - Return to Work

Effect Of Return To Work On Drug Assistance Programs

If you’re getting help with your drugs, or even free drugs from a drug assistance program, check with the program to determine what criteria disqualify you from continuing to receive assistance. Generally it is not a question of whether you are working or not, but how much you are earning, the amount of your assets, and whether you have drug coverage such as through work.

Effect Of Return To Work On Life Insurance

The existence of any group life insurance you continued may be affected in either of two ways.

If as a courtesy, your employer continued your life insurance while you were on disability

By returning to work you, if you are considered to be a new hire, you may be required to convert your coverage life insurance from group coverage to more expensive individual coverage until you qualify for life insurance again through your employer.

If your group coverage had a disability waiver of premium provision which has been in effect

Thanks to the disability waiver of premium provision, y ou have not been required to pay premiums to keep your coverage in force as long as you were disabled. By going back to work, you will have to start paying premiums again to keep the coverage in effect the waiver will end.

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Group Life - Conversion

Effect Of Return To Work On Long Term Disability Insurance

To know what happens to income you've been receiving from a long term disability insurance policy, you have to look at the policy. They're all different.

Check to see whether the policy covers inability to work in your "own occupation" or "any occupation." Each policy is different, but in general:

If your policy covers "own occupation," and you can work but can't return to your "own occupation"

Your income will continue. For example, a surgeon who hurts a hand can no longer do surgery ("own occupation") but can still function as a doctor. She would be entitled to income because she can't perform her own occupation.

If your policy covers "any occupation" and you can work

Payments will stop -- even though you can't return to your "own occupation." In our example, if a surgeon hurts a hand and can no longer work as a surgeon, she can still work as a doctor. As soon as she can work as a non-surgical doctor, her disability income will stop.

If you can work, but not to the same extent you used to, check your policy to see what it says about "residual" or "partial" disability.

These provisions encourage a return to work by supplementing reduced earnings.

If you go back to work, and become disabled again during a specified period of time after returning to work

Most policies provide that there is no new waiting period for the disability income to start. That would mean if you can't make it at work, your income will start again as soon as you stop working.

If your policy is an individual one

You can continue it as long as you continue to pay the premiums.

If your disability insurance is group, and you return to the same employer

The original insurer's obligations end, although you may continue to receive income as noted above.

Return To Work: For What New Benefits Am I Eligible?

If you are treated as a continuing employee, you are entitled to the benefits currently offered to someone in your position.

If you are treated as a new hire (a new employee), you will be eligible for all employee benefits that are offered to other employees in the same classification -- regardless of your health history.

If Group Health, Long Term Disability, and/or Group Life Insurance are offered to employees in your classification, then they will also be available to you. Normally only the higher amounts of voluntary, supplemental life insurance will require evidence of good health.

If no more than 63 days has passed since your previous health coverage ended, under HIPAA, the amount of time you had the former health insurance will count against any pre-existing condition exclusion that may apply to a new employer's coverage. If you have the former coverage for twelve months or more, and sign up for the new coverage as soon as you are eligible, there will be no pre-existing condition exclusion at all.

What Happens To Public Benefits Such As Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), Medicare Or Medicaid If I Have To Stop Working Again?

Unfortunately, even when people give it their best, it is not always possible to remain at work. Fortunately, most benefit programs account for this situation.

Most public benefits programs provide generous trial work periods to encourage people to return to work. The odds are that new benefits or a continuation of existing benefits will start almost immediately if you have to stop work again.

What Happens To Benefits From My Employer If I Have To Stop Working Again?

Group Life Insurance

If you are considered to be a returning employee, the life insurance continued through your employer will work the same as it did when you were employed before your disability leave.

If you are considered to be a new hire, look at the terms of the new insurance policy. There may be a provision waiving premiums for disability. At the least, you should be able to convert it to an individual policy of the same or a lower amount.

Long Term Disability Insurance from your employer

If you stopped receiving income from disability insurance when you returned to work without an agreement about what would happen if you didn't make it at the new job, then the odds are the payments will not be started again. However, if your policy provided a trial work period, or if you negotiated with the insurance company before returning to work about this very situation, your income may start again.

Also, if you leave within six months of returning to work, if the plan included a Recurring Disabilities Provision, there may be a chance to get benefits started again.

Depending on whether you are considered to be a new hire or a continuing employee, you may qualify for new benefits under the employer's long term disability insurance. Generally, a Long Term Disability plan for a new hire will have a Pre-Existing Condition Waiting Period and will not provide any benefits if you leave work in the first year or two of coverage for the same condition that you were treated for prior to getting the Long Term Disability coverage.

To learn more, see Long Term Disability.

Health Insurance:

If you converted your employer's group health insurance to an individual policy

Leaving work again has no effect on the coverage.

If you qualified for insurance by returning to work, you will be entitled to continue the coverage under COBRA.

To learn more, see COBRA.

Health Insurance:

If you continued your health insurance under COBRA and you became eligible for health insurance again from the employer

Whether or not you took the new health insurance, your COBRA should have ended when you became eligible for your employer's health insurance. The fact that you now leave the new job does not affect the termination of your right to COBRA.

There will probably be COBRA continuation all over again from employer's current plan, and possibly a right to convert employer's health insurance to individual coverage.

If you continued your health insurance from your employer under COBRA but did not become eligible for health insurance from your employer when you returned to work

Going to work without becoming eligible for health insurance from that employer does not affect your COBRA coverage. Thus, it does not matter whether or not you continue to work.

Your COBRA coverage will stay in force until the time limit runs out or you become eligible under another employer's health insurance or you become eligible for Medicare or Medicaid. Keep in mind that when COBRA runs out, HIPAA permits a conversion to individual health insurance.

For more information, see HIPAA and COBRA.

Covered under current employer's health plan: There will probably be COBRA Continuation all over again for this health plan, assuming your employer comes under either the federal COBRA law or a state Continuation law