Who Is Eligible for Disability Insurance?

Most Americans seek disability insurance as a way to overcome the loss of wages due to an unexpected disability. Disability insurance can cover most kinds of physical or mental impairments, but certain requirements for eligibility must be met for approval. Understanding what these requirements are is extremely important. Though eligibility requirements are not necessarily rigorous, if you fail to meet them that could mean that you will be denied important benefits.

Eligibility Requirements

In order to be eligible for disability insurance, you must meet certain criteria. You must have been unable to perform regular or customary work for at least eight consecutive days. Likewise, you must have been under the care and treatment of a licensed medical caregiver or accredited religious practitioner during the same time period following disability. You must also have been employed or seeking employment at the time of disability. And you must have lost wages due to disability and must have earned at least $300 prior to disability out of which SDI deductions were withheld.

Required Forms

Two forms are required in order to successfully apply for disability insurance. You must complete and mail a claim form within 49 days after disability. If this form isn't completed and mailed to the appropriate address, you will lose benefits. A treating physician or any medical caregiver (including midwife, nurse, etc.) must complete a medical certification as evidence of your disability and provide any other information pertinent to the application for disability insurance.

Expectations

You can expect to undergo an independent medical examination to prove that you are disabled, physically or mentally, in such a way that the disability prevents you from working or seeking gainful employment.

Considerations

If you are uncertain whether you meet any of the requirements above, you can still apply for disability insurance. A determination will be made whether you meet all or part of the requirements. It is important to recognize that not all eligibility requirements target physical disabilities; a person suffering from disabling mental disorders may also be eligible. Social Security disability benefits are based on work history. You must show that you have worked at least five out of the ten years prior to disability. Work history doesn't necessarily have to be continuous; you merely have to show that you have been working or pursuing work during that time

Warning

You will be ineligible for disability benefits if you are not suffering from a loss of wages due to disability; are claiming or receiving Unemployment Insurance or Paid Family Leave benefits; become disabled during the commission of a felony that has resulted in a conviction; are in jail, prison, a recovery home or any other location due to a criminal conviction; are receiving Workers' Compensation benefits at a weekly rate that is equal to or greater than the rate you might receive from disability insurance; or have failed to respond to a request for an independent medical examination.