What is Disability Income Protection for Miami-Dade County Employees?
Disability income protection protects your most valuable asset, your ability to earn a living. Most people do not have enough savings to be able to withstand more than a few months of lost income without suffering serious consequences. Thus, this type of insurance provides you with a safety net in the event that you suffer from a disability that impairs your ability to work. Miami-Dade County employees employed at least 60 hours bi-weekly, for a period of at least 60 days, are eligible to enroll for disability income protection insurance. Disability benefits should be distinguished from worker’s compensation in that worker’s compensation provides benefits to an employee if the cause of the injury or disability is work-related.
Why do you need disability insurance?
According to the most recent census report, approximately 1 in 5 people in the U.S. are living with some form of a disability. The Social Security Administration projects that 1 out of every 4 twenty year olds will develop a disability before they retire. Furthermore, the CDC estimates that the most common form of disability in the U.S. is some form of a mobility limitation. Additionally, research shows that the highest percentages of persons living with disabilities are generally in southern states, including Florida. The risk of becoming disabled during the course of your employment is always present, and may be much greater than you think.
What is the difference between short-term and long-term disability protection?
Disability income protection can be either short-term, long-term, or both depending on the plan you have chosen. Typically, short-term disability covers about 60% of your weekly salary for a maximum of 26 weeks. Short-term disability benefits will begin to accrue when the policyholder meets the definition of short-term disability, and then only after the insured has satisfied a 14-day waiting period, or has used all sick-leave, whichever is later. Furthermore, during the short-term disability period there is no waiver of premium, which means that the insured is still liable for all premium payments during this time. Finally, short-term disability benefits continue throughout the period of your disability, but have a maximum benefit period of 26 weeks.
Similarly, long-term disability benefits pay about 60% of your monthly income once the benefit begins to accrue. Moreover, long-term disability benefits begin to accrue once the insured meets the definition of “disability” as defined in the insured’s policy. To be eligible for long-term disability insurance you must satisfy a 90-180 day waiting period (depending on your policy), or have used all sick leave, whichever is later. Thus, in effect, short-term disability insurance can offset lost income before your long-term benefits kick in but only if your policy provides for it. Finally, long-term disability benefits continue for as long as you are disabled and generally terminate upon your normal retirement age, but may continue for longer depending on your age at the time you became disabled.
How do you know if you are entitled to disability insurance benefits?
Whether you are entitled to receive disability benefits depends on the terms of your policy. For Miami-Dade County employees enrolled in short-term and/or long-term disability protection through Miami-Dade County’s sponsored insurance carrier (MetLife), you will be entitled to disability benefits only if you meet the definition of “disability” as defined by your policy.
You will be considered “disabled’ and thus entitled to short-term disability benefits “if, due to sickness, pregnancy, or accidental injury, you are receiving appropriate care and treatment... and you are unable to earn more than 80% of your pre-disability income at your own occupation.” Thus, if you are complying with the necessary treatment and due to your disability you cannot work enough to earn more than 80% of your pre-disability income in your occupation, then you will be entitled to short-term disability benefits.
Similarly, you will be considered “disabled” and thus entitled to long-term disability benefits "if, due to sickness, pregnancy, or accidental injury, you are receiving appropriate care and treatment... and you are unable to earn more than 80% of your pre-disability earnings at your own occupation for any employer in your local economy.” Thus, if you are complying with the necessary treatment and due to your disability you cannot earn more than 80% of your pre-disability income carrying out the functions of your occupation for any employer in the community, then you will be entitled to receive long-term disability benefits.
What do you do if your disability insurance benefits have been denied?
While insurance companies have no problem collecting premiums, paying out on these benefits can be very expensive. Insurance companies will try to deny your benefits whenever they can. This may come as a surprise since you have consistently paid your premiums and were understandably relying on your insurer to provide you and your family with these benefits during your time of need. Perhaps you have mounting bills, mortgage payments, healthcare costs, etc.
Whatever the case may be, if you have been denied disability benefits you should promptly consult with an experienced long term disability insurance claims lawyer.
You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].
