Navigating the System: When You’re Disabled
A disability is a health problem that limits an person's ability to do everyday activities, such as hearing, seeing, walking, or working.
Fortunately, the US government has implemented laws and provided resources designed to help people who have disabilities. Having a disability should not interfere with your right to employment (and getting employer-provided health insurance). And if you are unable to work, government-funded benefits and/or supplemental disability income insurance might be able to help reduce some of the financial burden.
What Are Your Rights?
The Americans with Disabilities Act (ADA) took effect on July 26, 1992. The ADA makes it illegal for employers to discriminate against qualified people with disabilities in all employment-related activities, including:
According to the ADA, a disability is a mental or physical impairment that substantially limits a major life activity (eg, hearing, seeing, walking). If you can do the essential functions of a job with “reasonable accommodation” (eg, accessible facilities, job restructuring, special equipment), the ADA prohibits job discrimination against you because of your disability.
If you have a disability and are able to work, try finding an employer who provides a group health insurance plan. Under the Americans With Disabilities Act (ADA), employers are required to provide employees with disabilities equal access to the health insurance offered to other employees. But look closely at a potential employer’s health insurance plan, since the ADA does not protect you from pre-existing condition clauses that may be part of the plan. In other words, you still may not be covered for certain healthcare costs related to your disability under some company-sponsored health insurance plans. Keep in mind, though, that the Health Care Reform bill will make it illegal for insurance companies to deny coverage based on pre-existing conditions.
Benefits for People With Disabilities
The US Social Security Administration (SSA) has two programs that pay benefits to certain people with disabilities: the Social Security Disability Insurance program and the Supplemental Security Income (SSI) program. You can apply for either program through the Social Security Administration.
Social Security Disability Insurance Program
This program pays benefits to Social Security taxpayers who cannot work because of a disability that is expected to last more than one year or result in death. If you qualify for this program, you will receive monthly payments that may begin after you have been disabled for at least six months. These payments will continue as long as your medical condition has not improved and you cannot work, but not necessarily indefinitely. The SSA will review your case at regular intervals to determine if you are still disabled. You must tell the SSA if your condition improves, if there is a change in your ability to work, or if you return to work.
Supplemental Security Income (SSI) Program
The SSI program pays benefits to certain people with disabilities who are low-income and have few resources. SSI benefits are also available to some disabled or blind children. Unlike the disability insurance program benefits, you still may be able to get SSI payments while you work, depending on your earnings.
Medicare and Medicaid
If you receive SSI, you may also qualify for ]]>Medicaid]]>, a state-administered federal healthcare plan that can help pay doctor and hospital bills. You may also qualify for ]]>Medicare]]>, the federal health insurance program that covers healthcare costs for most Americans age 65 and older and for people with certain disabilities. To find out if you are qualified for Medicare or Medicaid, contact the Centers for Medicare and Medicaid Services.
Some states can extend Medicaid coverage to working people, help pay Medicare premiums and other healthcare costs, and provide other services to people with disabilities. You can find out more about the types of services your state provides by going to their official website.
Disability Income Insurance
While government benefits can be extremely helpful if you are eligible, many people do not qualify to receive them. If this is the case, how can you replace your lost monthly income if you become disabled and are unable to work?
Disability income insurance provides people with income if they become sick or injured and are unable to work. Some employers offer disability income insurance through group plans, and people can purchase individual policies from insurance companies. The benefits offered through these plans vary widely, so read the policy carefully when deciding on the type of insurance and how much of it you need. Ideally, disability income insurance should pay at least 60% of your income.
Your Overall Health
If you are or become disabled, it is important to not only deal with your disability-related health needs, but also to take care of your overall health and well-being.
Be proactive in maintaining your overall health by eating a healthy diet, getting regular exercise, not smoking, not drinking excessively, and receiving routine preventative care.
Centers for Medicare and Medicaid Services
National Council on Disability
The ADA: your employment rights as an individual with a disability. US Equal Employment Opportunity Commission website. Available at: http://www.eeoc.gov/facts/ada18.html . Updated March 2005. Accessed June 28, 2010.
Benefits for people with disabilities. Social Security Administration website. Available at: http://www.ssa.gov/disability/ . Updated June 2008. Accessed August 26, 2008.
Disability benefits. Social Security Administration website. Available at: http://www.ssa.gov/pubs/10029.html . Updated May 2008. Accessed August 26, 2008.
Disability in health in 2005. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncbddd/factsheets/Disability_Health_AtAGlance.pdf . Updated December 2005. Accessed August 26, 2008.
Guide to disability income insurance. America’s Health Insurance Plans website. Available at: http://www.ahip.org/content/default.aspx?bc=41|329|352 . Accessed August 26, 2008.
Health care reform bill 101: who gets subsidized insurance? The Christian Science Monitor website. Available at: http://www.csmonitor.com/USA/Politics/2010/0320/Health-care-reform-bill-101-Who-gets-subsidized-insurance. Accessed June 23, 2010.
Medicaid buy-in for working people with disabilities. Social Security Administration website. Available at: http://www.socialsecurity.gov/disabilityresearch/wi/buyin.htm . Updated January 2008. Accessed August 26, 2008.
Medicaid: state-by-state descriptions & plans website. Available at: http://126.96.36.199/medicaid/states.html . Updated August 2008. Accessed August 26, 2008.
Social Security Online. What you need to know when you get social security disability benefits. Social Security Online website. Available at: http://www.socialsecurity.gov/pubs/10153.html#2. Published June 2010. Accessed June 23, 2010.
Last reviewed June 2010 by ]]>Brian Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.