Residual Disability – Private Disability Claim

Residual Disability – Private Disability Claim

I was diagnosed with MS and because of complications I have to cut back at work. I was told I should file a claim with my private disability company even though I will be able to work as i might qualify for what they called residual disability benefits. Any suggestions?


"Residual" disability is a partial disability payment based on your reduced work hours. There are a host of points you should consider, including the following:

  • Your policy is the key document. You must read and understand the policy. Speak first to your disability agent, and seek out someone with expertise in disability to understand it.
  • Make a copy of the policy. It will be much easier to understand it if you can highlight key words, make margin notations of explanations you either look up, are informed of or figure out.
  • Residual or partial disability may be defined very differently from one policy to the next so be certain that you understand what your policy says. Don't rely on what friends or others tell you.
  • If you have your own business so that the determination of your earnings is not as simple as comparing pay checks, speak to a Certified Public Accountant. You don't want to misinterpret the provisions of the policy. Even if you're an employee and receive different types of compensation (e.g., deferred compensation, stock options, etc.) it might be unclear how each of these items are treated under the policy. You should consult with your CPA to have them interpret and guide you on these items.
  • Many chronic illnesses and disabilities have organizations that support and help people living with that particular condition. In your case, the National Multiple Sclerosis Society (NMSS) has an excellent website. Their site also has substantial materials on the medical issues that pertain to someone living with MS explaining their situation to their employer and disability company. Review those resources immediately so you can educate yourself about what is involved. Knowledge is key. For readers with a different illness or disability do an Internet search. But focus on well known organizations if they have materials available as those sources may be more respected by employers and disability companies.
  • Start a log immediately. Keep track of every possibly relevant event concerning your situation and your claim. If you send a letter to the disability company send it via email or facsimile and certified mail so you can show proof of what you sent them. While certified mail is not that expensive it is a hassle to go to the post office especially while you're going through the difficulties of a recent diagnosis and obvious decline in your health. However, disability companies as a whole don't have a very positive reputation amongst many who have filed claims. Sure, there are those that try to scam the system when they should not be paid, but some companies (according to some people most of them) seem to intentionally give claimants a hard time to dissuade them from pursuing what their policies provide for. Since you have no way of knowing at the outside how your disability issuance claim will be handled, its best to plan for the worst and hope for the best. By carefully documenting EVERYTHING you may help protect your claim and rights. If insurance company verbally advises you of something, ask for it in writing. If they don't, send them an email or letter confirming what you heard. This approach can avoid misunderstandings (with all you're going through emotionally with your diagnosis and having to cut back at work you're under a lot of stress and could misunderstand). You also want to avoid the situation which some claimants have described of the disability company saying one thing to you but noting something else in their file. Sounds sinister, but as you speak to more people that have filed claims you will hear war stories.
  • Review the policy carefully (yes, we've said that several times above) and identify any key dates especially the date by when you have to file a claim. If you are required to provide the disability insurance company with certain information by certain dates notes those on your calendar and don't miss them. If you feel because of your health issues you need more time, call the disability company well in advance and get their agreement to an extension in writing. With a chronic illness like MS (and many other chronic illnesses) the dates at which certain events or situations occur can be much less clear than for example, for a work site injury that occurred on a specific date.
  • If you believe that you might have an issue with a valid claim, seek legal counsel sooner rather than later. You want to handle the matter appropriately. Since disability issues are rather specialized, be certain to find a lawyer that has handled many cases before.
  • Consult with a financial planner as the disability payments you will receive, the reduction in work compensation, and all the other changes you are going through will have a profound impact on your financial situation. The National MS Society has worked closely with financial planners around the country and in particular with the FSP - Financial Service Professionals organization and may be able to guide you to an adviser.

While this Q&A only touched on a few general suggestions and comments, you disability payments will be critical to your future financial security. Even with all the other issues you have to deal with, be sure to focus on this one. It is important. And if you don't protect your interests, no one else will.

Our Consumer Webcasts and Blogs

Subscribe to our email list to receive information on consumer webcasts and blogs, for practical legal information in simple English, delivered to your inbox. For more professional driven information, please visit Shenkman Law to subscribe.

Ad Space