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Fresno, CA Attorney Blog

Saturday, November 26, 2016

The Impact of Private Disability Policies on Social Security Disability Insurance

Q: Can I collect both Social Security Disability Insurance and private or employer-based disability insurance at the same time?

Social Security Disability Insurance “SSDI” is government-funded insurance available to those who are considered “disabled”, under the age of 65, and who have worked for a certain period of time (depending on their particular case) and have contributed to the Social Security System.

The definition of “disabled” for purposes of qualifying for SSDI is “the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months”.

Most people don’t realize that you can qualify for SSDI even if you aren’t bed-ridden and even if your initial application is denied. Benefits and requirements differ based on an applicant’s age. Because of that, and the fact that the application and appeals process can be overwhelming to the average person many seek counsel from a skilled SSDI attorney. After all, so much is riding on the outcome.

Private or employer-based disability insurance policies differ widely in their terms, definitions, and requirements and payment of claims submitted thereunder can be denied. They are privately purchased or are part of an employee benefits package and may be either short-term disability STD, long-term disability LTD or a combination. STD policy benefits usually kick in fast and only cover the first few months of a disability, whereas, LTD policies, by definition, kick in later and cover a longer period. Private or employer-based policies may have elimination periods (periods of time before which they will kick in) or may have limitations on the length of the payouts (i.e. two year maximum vs. lifetime benefits). What percentage of the employee’s income will be paid may also be a variable.

An Antioch man was recently denied STD benefits from his private insurance policy even though he qualified as “disabled” and was collecting benefits from SSDI. He recently filed suit alleging improper interpretation and administration of the plan, inadequate notices with respect to the denial of his claim, and conflict of interest.

Generally, you can collect both SSDI and private or employer-based disability insurance benefits at the same time without any issue. However, if your private insurance policy contains a Social Security Benefits Offset Clause, your private insurance benefits may be partially reduced, or “off-set”, by your SSDI benefits.

While your SSDI benefits are not reduced by private disability insurance, they may be affected in part by certain other public disability benefits, such as Workers Compensation or other federal, state, or local government-based disability programs. Deciphering what benefits you are entitled to receive when you may be eligible to receive disability benefits from more than one source can be complicated. A skilled SSDI can help.

If you are disabled and would like to apply for SSDI or other benefits, or have had your application denied and want to explore an appeal, contact the Fresno, California Law firm of Peña & Bromberg today at 559-644-0031for a free disability evaluation. We assist clients with Social Security Disability and Veterans claims nationwide, at any phase of the process.


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