Disability insurance can be purchased if you have pre-existing conditions, but there are caveats. Not all companies will offer you a policy, while others will exclude your pre-existing condition.
Getting coverage will depend on your situation and policy.
Here is a brief overview of when you can get disability insurance with a pre-existing condition, when you might be able to and when you can’t.
A pre-existing condition will not usually have an impact on your rates. Charging a higher premium wouldn’t offset the benefit amount that a company would have to pay if it allowed all pre-existing conditions.
Your disability insurance rates are mainly based on age, health, plan selections and occupation.
A pre-existing condition is any health issue you’ve received medical advice on, sought treatment on or took medication for. Some of the most common pre-existing conditions include:
Disability exclusions are specified conditions listed in your policy that the provider has stated they will not cover. Some exclusions are general and will apply to all applicants, while others can be related to a pre-existing condition. They’ll only provide coverage for conditions unrelated to listed exclusions.
An example is if you have lingering back pain. The company can offer you a disability plan that excludes any claims related to back pain.
If your back pain gets worse and you’re unable to work, the company won’t pay any benefits. But if you break your leg and have to miss work, the company will pay your disability benefit.
The reconsideration period is a specified amount of time you have to try and remove an exclusion from your policy. An exclusion can be removed if you demonstrate that your condition has improved and is no longer affecting you.
You will have to provide documentation from a doctor to your insurance company stating that your condition has improved enough to have it removed as an exclusion. It can take a few months to a couple of years to determine your health status.
The reconsideration period for Social Security disability is slightly different. This is when you can appeal a disability claim denial if you believe it was wrongly denied.
Pre-existing conditions don’t always prevent you from purchasing disability insurance. Some insurance companies might deny your application, while others will offer you coverage on disabilities unrelated to a pre-existing condition. It might even remove exclusions if you can demonstrate that a condition has gone away or significantly improved.
To review different disability insurance providers and see how they treat pre-existing conditions, check out our disability insurance page.
Why is it worth buying disability insurance if I have a pre-existing condition?
Many other injuries or illnesses could affect your ability to work and earn income. A disability policy can help replace a portion of lost wages if you cannot work.
What happens if the insurance company denies my claim because of the exclusion?
If you believe an exclusion shouldn’t have applied, then you can appeal the decision.
When are employer-sponsored group disability policies not enough?
Depending on how your company pays the premiums, your benefit money could be taxed when you receive it, meaning your benefit amount would be less. Thoroughly check your group policy to see if you need to buy a secondary individual policy.
What is a 3/12 pre-existing condition limitation?
This is a common look-back period found in many disability policies. It means that for disability claims filed within the first 12 months of owning your policy, insurance companies will look back three months prior to your effective date— to determine if your disability is due to a sickness or injury that you received treatment, consultation, care or services for.
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