If you suffer from a degenerative condition, how does continuing to work affect your ultimate application for long-term disability benefits? How do you keep working and protect your LTD benefits? Whether you suffer from Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis (“ALS” or Lou Gehrig’s Disease), rheumatoid arthritis, or degenerative cognitive disorders such as early-onset Alzheimer’s disease or other dementias, you may want to work as long as possible, but you don’t want your additional time working to make it more difficult to get your long-term disability benefits:
Clients in my long-term disability insurance practice in Connecticut regularly confront the consequences of working while disabled. What should you consider in deciding how long to work?
You may be able to keep working part-time and still get long-term disability benefits if you have a policy or plan that provides for partial disability benefits. With a partial disability benefit, if you are only working part time, you can get a partial benefit that makes up all or much of the decline in income. You can reduce your hours and duties, reduce your pay, and replace all or most of the lost income with a partial disability benefit. Since your employer can pay you less for the reduced hours you are working, it is more likely that they will keep you on.
This is a great provision, but the formulae for calculating the benefit for a given level of income can be complicated and the conditions to qualify for partial disability benefits can be complicated. If your plan has a partial disability benefit, it can be useful to consult with an experienced ERISA benefits attorney to have the best chance of qualifying for that benefit.
One of the most unfair consequences of working while disabled is that the insurer may conclude that if you are working, you must not be disabled. For instance, let’s say your medical records reflect a level of impairment in May 2021 that could support a finding of disability, and the records for each subsequent month report that you are “stable.” If you keep working until May2022, the insurer could say that the fact that you did work for a year shows that you are not disabled. The insurer may say the medical records reflect no change in condition that could explain why you could do the job from May 2021 – May 2022 but could no longer perform it at the end of the 12 months. With some conditions, like multiple sclerosis, there may be no obvious explanation for the degeneration in your condition, as your condition can degrade severely even if an MRI shows no additional lesions. Some courts haven’t bought the LTD insurers argument. As one judge wrote: “Hawkins may have forced himself to continue in his job for years despite severe pain and fatigue and finally have found it too much and given it up even though his condition had not worsened. A disabled person should not be punished for heroic efforts to work by being held to have forfeited his entitlement to disability benefits should he stop working.” Hawkins v. First Union Corp. Long-Term Disability Plan, 326 F.3d 914, (7th Cir. Ill. 2003). So, if you are making heroic efforts to stay in your job, there are things you can do, with the help of a knowledgeable ERISA long-term disability attorney, to protect your ultimate claim for long-term disability benefits.
Whether you are planning to receive partial disability benefits, or just trying to avoid having your insurer claim that you are not disabled because you have worked during your disability, here are the steps you should take to make sure working while disabled doesn’t hurt your long-term disability insurance claim:
Don’t let working while disabled turn into not working and not getting long-term disability benefits. Talking to your doctor and keeping a log will make it more likely you will prevail on an initial claim for long-term disability benefits or in an appeal of any denial. An experienced ERISA long-term disability attorney can work with you to develop a strategy to address your particular career and personal goals so that you can work as long as you want to and still receive the benefits you have earned.
Click on the link below for more articles on long-term disability benefits and moving from working to disability.
