You are here: Home Work Issues Work: Return To Return To Work: ... Overview
Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.


If I Return To Work, When Will My Income From My Disability Income Policy Stop?

Generally, you lose your right to continue to receive an income once you no longer meet the policy's definition of "totally disabled."

The only way you can start collecting benefits again would be if you become disabled again from the same health condition that initially disabled you and the policy contains a Recurring Disabilities Provision, see below, which pertains to you.

If you return to work for a new employer: In addition to the income from the policy terminating, your right to continue to receive any benefits from the policy also terminates.

If you return to work for the employer for whom you worked prior to your disability: Coverage under the old policy will continue if you are treated as if you are continuing to work. It won't continue if you are treated as a new hire. How you will be treated depends on a combination of the provisions in the insurance policy and the employer's internal policies. Ideally you will be treated as an employee returning to work, and not as a new hire, so there is no new probation waiting period before you are considered a full time employee and no new pre-existing conditions waiting period during which pre-existing health conditions are not covered. (To learn more, see HIPAA).

If your former employer's policy is to treat returning employees as a new hire, you can 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.

How Do I Confirm My Interpretation of Provisions of a Long Term Disability Income Policy?

Many of the provisions affecting benefits when you return to work are only briefly outlined in a Summary Plan Description, so you will need to speak to the insurance company to clarify how the company will interpret provisions that seems relevant, preferably in a phone call.

It may seem like the easiest way would be to send a letter asking for a written response. However, the drawback to a letter in this circumstance is that the human contact is lost. Also, it is difficult to communicate in writing that you are not yet ready to return to work, but that you are simply exploring possibilities, and that you have concerns about not being ready to go back to work and are afraid to try it too early. Without the personal contact, the insurance company would be more inclined to take questions as a trigger to undertake a disability review to see if you're healthy enough to stop receiving benefits -- and possibly discontinue your income well before you have a new job.

Hopefully, you will have been assigned a particular claims representative and there will already be a relationship with that person.

When you get the answer(s), it  is advisable to ask for written confirmation. Rather than say somet hing like, "I'd like t his in writing in case there are problemsin the fu ture" consider saying something like "It's just because my memory is so bad, and this is very important."

If the claims representative is hesitant to commit the statement to writing, ask if it is all right for you to write to him or her, and confirm your understanding of what the person said. The person can  then easily confirm or revise what  was said in a return e mail or letter.

If you are not comfortable making the call, ask a friend or family member to do it for you -- or ask a social worker, or hire a professional such as an attorney or a health finance counselor.

Regardless of who does the calling:

  • Make sure the person with whom you speak understands that your inquiry is theoretical -- that you aren't ready to return to work yet even though you would like to. For example: "Say, I was just wondering. I have some good days, but they don't happen enough to work regularly. But, in case they did start happening frequently enough that I felt good enough to try to go back to work, what would happen?"
  • Ask your specific questions, always reminding the person with whom you speak the situation is still theoretical. For instance, "If I couldn't stay at the job would my benefits start up again? I see something in my policy called Recurring Disabilities. If I had to go back on disability before six months is up would this cause my benefits to start up again, even if I had tried to work at a different employer? Oh really?"
  • Ask for the company's interpretation in writing. Companies do not always stand behind what one of their employees may have told you over the phone - even if you could prove what was said. "Would you send me a letter explaining that; I don't quite understand it fully."
  • Assume that the conversation is being recorded. Even if it's not, the assumption will keep you on your toes and from saying anything you shouldn't.
  • Read Making a Friend for tips on how to handle a phone call to the insurance company.

CAUTION: Proceed very carefully. Understand how taking a new job will impact your current benefits, and the possible new ones. Returning to work is a major step if a substantial portion of your disability income is due to Long Term Disability benefits. If you just jump back into the workforce, lose your current coverage and find you can't continue to work, you may end up collecting only Social Security Disability Insurance (SSDI) during the second disability period.

Before you go back to work, see Preparing to Return to Work.

Will The Insurance Company Help Me Become Able To Go Back To Work?

Many Long Term Disability policies contain a Rehabilitation Benefit provision that can be of real value if you require training to return to work. This provision is especially helpful if you are interested in returning to work but do not want to return to the same type of job that you used to do.

In addition to paying for training, a rehabilitation benefit may also provide a continued income until your training is complete and you’re ready to enter the job market in your new field.

Many policies even continue to pay partial or full benefits for a temporary period while you adjust to the new job.

If I Can Only Work Part-Time: Do I Still Receive A Benefit?

There are two types of provisions to look for in your policy to find out what happens when you can return to work, but only part time.

The first provision is called a “Partial Disability Provision.” In essence, it provides that you receive a benefit if you are able to do some work, but are unable to work full-time – even if the partial disability is not preceded by a total disability.

Usually the definition of “partial disability” is the same as the definition of total disability but it is changed to read something like “….you can perform one or more but not all material duties of ……… occupation.”

Partial disability is generally a matter of hours. For example, you can work a few hours a day but not a whole shift, or a few days a week, but not five of them. It could also be a question of duties. For example, if you work in a warehouse you may be able to do the paperwork, but no longer lift boxes. Or you may be able to work in the head office, but are unable to travel every week.

The second provision is called a “Residual Disability.” It provides a benefit in the event of a partial disability, but only when it is a continuation after a period of total disability.

NOTE: The key to partial or residual benefits is that your medical record must show that, although you are well enough to work part-time, it is your medical condition that prevents you from working full-time. It can’t be by choice.

If I Can Only Work Part-Time: If I Receive A Benefit, How Much Will It Be?

If you will receive a benefit even if you can work part time, the amount of the benefit varies according to your specific contract. The formula differs from policy to policy, but all have the same goal: to pay a percentage of the total disability benefit that reflects the amount of reduction in your income.

For example: because David is partially disabled he is only earning 30% of what he used to earn (a 70% reduction in income). The partial disability benefit will pay 70% of what David would receive if he were totally disabled. So, if David’s benefit for total disability is $2,000 per month under his Disability Income he would get $1,400 (70% of $2,000) due to his partial disability.

When determining how much is due you, look to see if there is a provision in your policy which adjusts your former income for inflation. The adjustment for inflation will complicate calculating how much money you’ll receive, but can be worth it in the dollars you’ll receive.

What Happens If I Make Less In My New Job Than I Did In My Old Job?

A few policies will continue to make payments if your new income is less than your income was at the time you left employment disabled. The requirements to qualify vary substantially by policy and can get complicated.

Read your policy carefully. If necessary, seek professional help to review your policy. See Finding Professional Assistance.

What If I Start Work, But I Have To Stop Working Again Because Of My Health? Recurring Disabilities Provisions

Most policies have a provision that states that if the later disability is for the same reason as the first, and the later disability occurs within six months of the first claim stopping, it will be considered the same claim. Note that the time period starts when the first claim stops -- not when it starts. This is called a "Recurring Disabilities" provision.

If the later disability is within the appropriate time period:

  • There will not be a new period during which you will not receive income (the "elimination period"). Payments will start immediately because they are considered to be a continuation of your prior claim.
  • As explained further in Group Long Term Disability, many policies provide that they will pay a benefit for a period of time, such as two years, if you are unable to perform your own occupation. After that, a benefit will only continue to be paid if you cannot perform any occupation -- not just your own. If your policy contains a provision like this, and if you have a later disability, the "own occupation" definition will be reinstated. For example, Ron W's policy has an "own occupation" definition for 24 months, and then changes to an "any occupation" definition. If Ron goes back to work after 18 months, and 7 months later becomes disabled again due to the same health condition, the own occupation definition will apply for an additional 6 months.

Wording of these provisions vary, and how insurance companies interpret the provision vary as well. Some companies say it only applies if you return to the same employer; others interpret it so that it can be reactivated no matter for whom you work.

  • If you were disabled due to a mental condition: There may be a provision that says if you are disabled for a mental condition, the policy will only pay for two years. If you go back to work after 13 months, and the condition recurs, you could receive an income for an additional 11 months due to the recurrence.

What If A New Employer Offers A Group Long Term Disability Policy? Or If My Former Employer Treats Me As A New Hire?

Whether it is a new employer or your old employer treating you as a new hire, if your new job includes a Long Term Disability policy as part of the benefits, be sure and enroll in it. Except for the possibility of using the Recurring Disabilities Provision discussed above, the coverage from your prior policy is gone forever. Enrolling in the new long term disability program will not affect the Recurring Disabilities provision of your former coverage.

Almost all group Long Term Disability plans are available without any proof of good health, so your health condition will not keep you from enrolling in the plan.

Keep in mind that there is generally a Probation Period after being hired before long term disability start. Also, every Long Term Disability policy has a Pre-Existing Conditions Provision that will prevent coverage for your existing condition for at least twelve months after the long term disability coverage starts.

You may want to consider whether what you would gain by working for this new employer will be as good as what you are now receiving from your former employer's policy. See Benefits From A New Employer.

What Should I Do If I Am Considering Going Back To Work?

If you have been receiving benefits from a prior employer's group Long Term Disability policy and are considering returning to work, you should plan the return very carefully. Remember that once you return to work, there is no going back to your past group policy, except under the Recurring Disabilities Provision. For more about Recurring Disabilities Provisions, see above.

  • Read your policy carefully, looking for provisions that describe what happens if you return to work, particularly what happens:
    • If you can only work part time because of your health condition.
    • If you can work full time, but your new income is less than your previous income, whether it's due to your previous health condition or not.
    • If you become disabled again due to the same health condition.
    • If you need training to help you return to work.
  • Read Return To Work thoroughly, focusing on the tips for preparing to return to work, practicing through volunteerism, sharpening skills through training, and other important subjects.
  • Seek assistance in planning your return either from a specialist who assists people with returning to work.
  • Contact your insurance company to make sure their interpretation of the policy matches yours. Many provisions may seem to mean one thing to you, but may mean something else to the insurance company. You don't want to get into the situation of taking an action based on one interpretation of your policy, only to find that the insurance company has a different interpretation. See the next section on how to communicate with the insurance company about your long term disability coverage.