Applying to receive benefits from your disability insurance can be a confusing process, and to make matters worse, there’s a period of time called an elimination period. During this time, you don’t receive benefits even if you have a qualifying condition. But knowing how this timeline works will help you plan for the future. If you’re unsure about how to get your insurance claim rolling along quickly, take a look at how we at Osterhout Berger Disability Law can help you.
Elimination Period Vs. Probationary Period
When you apply to receive benefits through your insurance company, there are two main periods that you should be aware of. First of all, the elimination period is a time when you’ve been able to show that you have a condition that qualifies you for disability benefits even if you aren’t able to actually collect yet. While the elimination period is often confused with the probationary period, they’re actually very different. A probationary period is the space of time directly after you’ve purchased the insurance but aren’t yet allowed to make a claim on the insurance.
Things to Keep In Mind
There are several things that can affect the benefits that you’re allowed to collect, and you should keep them in mind when you’re buying a policy or thinking about making a claim on one that you have. First of all, when you want to buy insurance benefits, you should look into whether or not your pre-existing conditions will be covered in the event that they become worse and you need to leave work. Insurance companies pretty much always have the underwriter put in an exclusion on a pre-existing condition. Additionally, policies will also have a probationary period of about two years in which you can’t make a claim. This is to prevent someone from buying the insurance, lying about a condition that they know they have, and then filing a claim right away. If people did this, insurance would have to be very expensive for everyone else, too.
You should also be aware of the accumulation period, which is actually beneficial to the policyholder. The accumulation period refers to the elimination time adding up even if it’s not consecutive. For instance, if your policy required 90 days of elimination time, you couldn’t work for a period of 60 days, tried going back for a few days, and then found out that you couldn’t work at all, you would only have 30 days of elimination period left to go with the accumulation period.
Some people have disabilities that recur after they’ve been treated and the applicant has had the opportunity to go back to work. If you have a recurring disability, more than likely, your policy is written so that you can skip the elimination period if and when the disability recurs. An example of this would be if you had cancer, went back to work when you were in remission. If your cancer returned, most policies wouldn’t require that you go through the elimination period again. If you had cancer and later got disabling rheumatoid arthritis, you would still have to go through the elimination period for your rheumatoid arthritis.
You might want an idea of how long it would take to receive your benefits in the event that you had to make a claim because of a disabling condition. The first period of time that you would need to satisfy is the elimination period, which starts the first day that you become disabled. The date that you’re disabled is when you receive the diagnosis from your doctor and they say that you can no longer do your job. The elimination period can last for however long your policy calls for. Some might be 90 days, and others might be 180 days.
An example of this timeline, assuming a 90-day elimination period and an accumulation period of two days, might look like this:
- January 12, 2017 – Insurance policy is purchased/two-year probation period begins
- January 12, 2019 – Probationary period over/policyholder is eligible to make a claim on benefits
- October 20, 2021 – Policyholder is diagnosed with disabling rheumatoid arthritis by doctor/elimination period begins
- November 13, 2021 – Policyholder attempts to go back to work/elimination period is suspended and accumulation period begins
- November 15, 2021 – Policyholder cannot go to work because of rheumatoid arthritis/accumulation period ends and elimination period picks back up with 25 days already going toward the entire elimination period
- January 20, 2022 – Policyholder eligible to begin receiving benefits
If the policyholder never tried to go back to work, they would reach the day that they’re eligible for benefits by January 18, 2022.
How We Can Help
There are several ways in which the team at Osterhout Berger Disability Law can help you receive the benefit you deserve. We help individuals who need to…
- Apply for Social Security Benefits and want to ensure everything is done right the first time
- Appeal a denial of Social Security Disability Benefits
- Appeal an existing denial of Long Term Disability (LTD) Benefits
If you are facing one of these situations, please do not hesitate in reaching out. Our team of experienced attorneys are here to help, and your consultation is free.