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Disability Income Insurance: Individual: 101

Recurring Disabilities Provision

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Most disability plans contain a provision to determine how a second claim is treated if it comes shortly after the disabled person has returned to work. This provision determines whether the second claim is a new claim and requires a new Elimination Period or whether it is considered part of the first claim and benefit payments start immediately.

The typical provision will state that the second claim is a continuation of the first claim if:

  • It is due to the same cause as the first claim, AND
  • The time between the two periods of disability does not exceed a period of months which varies by policy but is generally six months.
  • For example, if your policy has a recurring disabilities provision: If you return to work and find that after four months, you can't continue. The reason you have to stop working again is the same diagnosis that originally disabled you. The new claim will be considered to be part of the first claim. Your benefits will start immediately. On the other hand, if you were disabled due to heart problems and return to work, but the next week you get hit by a car, the second disability is a new claim and the Elimination Period must be met all over again.

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