
Budget If Disabled
My Cash Flow On Disability |
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DATE | ||
LAST REVISED: |
Income |
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Income Sources | Current | 1st 6 Months of Disabilty | After 6 Months |
---|---|---|---|
Your Job | |||
Spouse/Partner's Job (if any) | |||
Other Job | |||
Self-Employment Income | |||
Unemployment Benefits | |||
Short-Term Disability Income (State) | |||
Short-Term Disability Income (Employer) | |||
Private Long-Term Disability | |||
Social Security Disability Income | |||
Pension Income | |||
Supplemental Security Income | |||
Food Stamps | |||
Other Income: | |||
Other Income: | |||
Total Income |
Medical Expenses |
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Expense | Current | 1st 29 Months | After 29 Months |
---|---|---|---|
Insurance Premiums | |||
Deductibles | |||
Medical office/hospital copayments | |||
Prescription & Prescription copayments | |||
Eyeglasses / Contact Lenses | |||
Over-the-counter Medications | |||
Nutritional Supplements | |||
Medical Equipment | |||
Medical Supplies | |||
Home Care | |||
Dental | |||
Therapy | |||
Alternative Therapies | |||
Experimental Treatments | |||
Other | |||
Total Medical Care |
Food |
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Type | Current | If Disabled |
---|---|---|
Supermarket | ||
Restaurant / Takeout | ||
Tobacco / Alcohol | ||
Vitamins | ||
Other | ||
Other | ||
Total Food |
Transportation |
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Expense | Current | If Disabled |
---|---|---|
Car loan(s) and/or lease(s) | ||
Auto 1 Insurance | ||
Auto 2 Insurance | ||
Gasoline, Oil | ||
Maintenance, Repair | ||
Public Transportation | ||
Tolls | ||
Registration | ||
Other | ||
Other | ||
Total Transportation |
Household Expenses |
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Expense | Current | If Disabled |
---|---|---|
Rent / Mortgage Payments / Maintenance | ||
Electricity | ||
Oil | ||
Gas | ||
Water / Sewer | ||
Telephone | ||
Mobile Phone(s) | ||
Cable / Satellite TV | ||
Internet Access | ||
Property Taxes | ||
Renters or Home Insurance | ||
Maintenance / Repairs | ||
Home Furnishings | ||
Other | ||
Other | ||
Total Household Expenses |
Personal Care |
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Personal Care | Current | If Disabled |
---|---|---|
Hair Care / Haircuts | ||
Wigs / Hairpieces | ||
Makeup | ||
Toiletries | ||
Clothing | ||
Dry Cleaning / Laundry | ||
Tailor | ||
Gym Membership | ||
Other | ||
Other | ||
Total Personal Care |
Recreation |
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Type of Recreation, Hobby, Etc. | Current | If Disabled |
---|---|---|
Vacation / Travel | ||
Movies / Theatre | ||
Parties At Home | ||
Newspapers, Books | ||
Music CDs | ||
Software | ||
Pet Food / Supplies | ||
Vet Expenses | ||
Movie Rentals / Videos | ||
Other | ||
Other | ||
Total Recreation |
Professional Services (Non-Medical) |
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Service | Current | If Disabled |
---|---|---|
Lawyer | ||
Accountant | ||
Financial Planner | ||
Other | ||
Other | ||
Total Professional Services |
Childcare |
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Childcare | Current | If Disabled |
---|---|---|
Day Care / Babysitting | ||
Toys / Clothing | ||
Education / Books | ||
Other | ||
Other | ||
Total Childcare |
Debts and Obligations |
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Category | Current | If Disabled |
---|---|---|
Estimated Federal Tax Payments | ||
Estimated State Tax Payments | ||
Alimony / Child Support | ||
Credit Card Payments | ||
Student Loans | ||
Other | ||
Other | ||
Total Debts and Obligations |
Savings and Income Protection |
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Savings and Income Protection | Current | If Disabled |
---|---|---|
"Just In Case" Fund | ||
Disability insurance not paid through employer | ||
Life insurance not paid through employer | ||
Investments | ||
Other | ||
Other | ||
Total Savings |
Gifts and Contributions |
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Savings and Income Protection | Current | If Disabled |
---|---|---|
Birthday Gifts | ||
Holiday Gifts | ||
Place of Worship | ||
Other Charities | ||
Other | ||
Other | ||
Total Gifts and Contributions |
When do you want to plan for going on disability? | Month | |||||||||
Year | ||||||||||
What inflation rate do you want to account for? |
Monthly Cash Flow Projections For Disability Lasting Up To 5 Years |
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Today | through | through | through | through | through | through | through | |||
Monthly Income | ||||||||||
Monthly Expenses | ||||||||||
Monthly Cash Flow |
Savings Needed To Supplement Income* |
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Length of Disability | Amount to Save by Start of Disability | |||||||||
One Year | ||||||||||
Two Years | ||||||||||
Three Years | ||||||||||
Four Years | ||||||||||
Five Years | ||||||||||
(*assuming 4% after-tax return on savings during disability. See Investing for Your Time Horizon) | ||||||||||
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