What’s Rumor And What’s Fact?

I have probably heard as many untrue rumors about benefits as facts. Some of the rumors travel so well and seem so logical that they’re sometimes accepted as true by counselors and advisors who should know better.

While most professionals, including are very careful to provide accurate information, these are some very complicated areas, and it’s virtually impossible to know absolutely everything. And things change, not just from time to time but from they change state by state, company by company and even office by office. For example, Social Security operates under the same set of rules (called POMS) throughout the country. However, different Social Security offices will interpret and handle similar situations in a different manner so even a program that should be identical nationwide will vary in how it is administered.

Below are some of the more common rumors that have unfortunately caused many people grief. Like most rumors, there’s usually just enough grain of truth to them that it makes them easy to believe and impossible to stop entirely.

RUMOR: "Social Security Disability turns down everyone the first time." (Sometimes: "You have to be on your deathbed to get Social Security disability")

FACT: It's really about fifty-fifty.

Social Security’s requirements for disability are not liberal, however, one of the primary reasons many people are turned down the first time is because they didn’t do their homework and understand what Social Security is seeking and how to provide it.

Getting approved by Social Security takes preparation just as you need to prepare for any exam whether it’s a driver’s test or the SATs. You need to know what they’re going to ask and how you should answer.

 

RUMOR: "I can’t get SSD if I have any savings in the bank."

FACT: There are two Social Security disability programs and it’s easy to get them confused:

Social Security Disability Insurance (SSDI or sometimes SSD) is a disability program for disabled people who have paid into the Social Security system during their recent working career through F.I.C.A. payroll taxes. If you are disabled and meet the other requirements, you get the benefit regardless of how much money you have in the bank or under the mattress or how big you lottery winnings were. If he becomes disabled, Bill Gates will be able to collect Social Security Disability.
Supplemental Security Income (SSI) – This is a totally different disability program run by Social Security and it is "needs based" which means that, in addition to being disabled, you have to show that you "need" the money. In other words, your other income as well as your bank accounts and other assets must be under their guidelines to get the SSI benefit.

 

RUMOR: "If my employer provides Long Term Disability insurance, I can get that and don’t have to worry about applying for Social Security."

FACT: It would be so nice, but it’s just not the case. If you have long term disability insurance from work, the insurance company is permitted to subtract what Social Security pays you each month from their monthly payment. And if you don’t bother to apply for Social Security, they will estimate what you would get and subtract it anyway.

 

RUMOR: "My doctor said that if he or she says I’m disabled, then they have to approve me."

FACT: The scary part of this rumor is that many doctors believe it to be true, and it isn’t.

Each program, whether insurance or Social Security, has its own definition of disability and criteria to establish it. You may need to educate your doctor on this.

 

RUMOR: "Your employer can’t fire you as long as you’re out on disability."

FACT: Not true, not true. If you can’t do your job, they can let you go. The germ of truth here that makes this confusing is that a federal law, called the Family and Medical Leave Act (FMLA), prohibits terminating certain covered disabled employees, but that law doesn’t cover every worker, and even those that are covered only have job protection for twelve weeks. Some states have similar laws for longer periods, and a few larger companies extend employment beyond that.

 

RUMOR: "You should file for Long Term Disability from work as soon as you stop because if you’re terminated it will be too late to get it."

FACT: The key to getting Long Term Disability is not the date you file the claim, but when you became unable to work, that is, totally disabled. As long as you were insured under your employer’s LTD plan when you became unable to work, you are still eligible for benefits.

 

RUMOR: "Threaten to sue your insurance company and they’ll treat you better."

FACT: First, even if you can sue, they’ve heard that threat too many times to be very concerned.

Now for the really disappointing news, if you get your benefits through your employment, it comes under a federal law called ERISA (Employee Retirement Income Security Act) which almost makes it not worthwhile to sue.

Under ERISA, the worst punishment an insurance company can get is to have to pay the benefit they should have paid in the first place, plus some attorney’s fees. No increased damages for pain, suffering, punitive, etc. Because of this, even finding an attorney to take ERISA cases can be difficult.

 

RUMOR: Once you become ill, there’s no way to get health insurance.

FACT: Not necessarily true. If you are able to work and you work for an employer that offers health insurance to its employees, you cannot be refused health insurance because of your medical condition or your health history.

Also many states offer high risk coverage, or open enrollment periods or some form of "guarantee issue" health insurance that is available regardless of your health. Finally, there’s the government health plans, Medicare and Medicaid, which you may become eligible for.

CONTACT ME if you’ve heard other rumors you want to check.

---

Bio | Site Goals | Contact Me | Archives | Testimonials | Home
Privacy Policy | Webmaster
copyright 2002, Jacques M. Chambers