What to Think About Before Filing a Disability Benefits Claim

If you are struggling with a medical condition that is negatively impacting your ability to perform your job, there are many different disability benefit programs out there that you may be able to take advantage of (some of which you may have never heard of). This article will serve as a general guide so that you can determine for yourself what type of claim would be best for you to pursue. Here are four questions to think about before filing a disability benefits claim:

1. Are you unable to perform your job? Or do you simply need accommodation?

Before even applying for a disability benefits claim, you should consider whether it is worth it to request a reasonable accommodation from your employer. When you apply for a reasonable accommodation under the Americans with Disabilities Act, you are stating that you are medically able to perform your job, but that you need a change in how your position is performed to allow you to continue to perform the essential functions of your position. If an employer approves your request for reasonable accommodation, you can give it a try and see if performing the job with accommodation is sustainable. If you are not able to perform the job even with reasonable accommodation, then you may want to consider applying for disability benefits.

1. Are you a Federal or Private Employee?

Assuming you are not medically able to perform your job, the next question you should ask is whether you qualify for a Federal Employee Retirement System (FERS) disability retirement benefit. If you are a federal employee and have at least 18 months of civilian federal service, you may be eligible to apply for a FERS disability retirement. In a FERS disability retirement application, you have to make the case that you are medically unable to perform the essential functions of your federal position, with or without reasonable accommodation, and that you will be out of work for at least one full year. To do so, you must have a demonstrated performance deficiency that is caused by your medical condition, such as poor performance or excessive absences. To establish a performance deficiency, you typically must no longer be actively working. You must apply for the disability retirement benefit within one year from your date of separation from your federal agency. If you prevail on your FERS disability retirement claim, you will be entitled to 60% of your Average High Three salary in the first year, and then 40% of your Average High Three salary in each subsequent year. When you qualify for normal retirement, your benefit will be recalculated based on your earnings in all of your years of service.

1. Does your employer offer Short-Term Disability or Long-Term Disability Insurance coverage?

Whether you are a federal employee or not, you next want to ask your Human Resources specialist if you are covered under Short Term Disability or Long-Term Disability insurance benefits. Disability insurance coverage is often provided as a benefit of employment, depending on whether your employer has a policy through a disability insurance carrier. Short Term Disability and Long Term Disability insurance claims, when granted, provide income replacement for a specific period of time. Typically, Short Term Disability benefits claims pay 60%-66% of salary for a 6–12-month period, whereas Long Term Disability benefits can provide income replacement through one’s normal retirement age, assuming the claimant continues to meet the definition of disability in the policy throughout the life of the claim. While in both claims you will have to prove that you are medically unable to perform the substantial and material duties of your own occupation. In Long Term Disability benefit claims you typically will also have to prove that you are not able to perform any occupation once you receive two years of benefits. Applying for Short Term Disability and Long Term Disability insurance benefits are best for employees who have recently stopped or intend to stop working soon.

1. Are you unable to perform any full-time work?

If your condition has worsened to the point where you are medically unable to perform any full-time work, you may want to consider applying for a Social Security Disability claim. To apply for a Social Security Disability claim, you normally need to have worked in five of the last ten years and paid Social Security (FICA) tax in those years. If you under the age of 55, you must prove that you are medically unable to perform any job in the national economy and that you will be disabled to work for at least one full year. If you are 55 or older, you must prove that you are unable to perform any of the work that you performed within the last 15 years. People who are successful on Social Security Disability claims typically have already stopped working and have been out of work for at least 6 months.

Of course, there are many other things to think about before applying for a disability benefits claim. It is best to discuss these matters with an experienced disability benefits lawyer. If you want to have a better understanding of which claim is right for you, please give my office a call today at 703-558-9311 for a free consultation or fill out the contact form by clicking here and we will contact you.