Partial Disability Benefits

If you can perform limited functions of your job after an injury, you have a partial disability. Some disability policies have a provision that will pay a lower benefit for partial disability. Whether or not your disability policy covers partial disability depends on the details of the specific policy. If the policy covers partial disability, it will probably pay a portion of the full payment to help cover any added expenses or minor losses in income until you can resume all of your regular job duties.

TIP: Before you purchase a plan, ask how your insurance policy would handle a partial disability. If your policy does not include benefits when you are still able to perform an types of work, consider adjusting it to accommodate the situation where you are injured, but still able to perform some functions of your job.

The Details of Partial Disability Coverage

If you are planning on working while on disability, then you need to know how partial disability coverage works.

• If your policy does not include it, partial disability coverage is usually offered as a rider to a total disability policy.
• Partial disability is not the same as residual disability benefits. Both types of coverage (residual or partial disability) pay benefits if you can perform some, but not all of the duties of your occupation. Residual disability benefits are based on the income you lose by not being able to work.
• Partial disability coverage is calculated as a portion of total disability coverage offered by your policy, and pays an amount equal to 50% or less of the benefit that you would earn if you were totally disabled.
• The partial disability benefit period is much shorter than that for residual disability (normally a few months and up to a year).
• Whether or not you qualify for partial disability coverage depends on your policy’s definition of disability, and what your policy says about working while on disability.

A partial disability addition to your policy can vary depending on the insurance company and the plan that you purchase. Be sure to read your disability insurance policy to make sure you are getting the coverage you need.

Who Qualifies for Disability Payments

To determine who would qualify for disability payments, review your policy’s definition of disability.

• Some definitions of disability allow payments if you cannot perform the duties of your own occupation (OCC). Under this definition of disability, if you are able to work another job then your disability benefits will kick in and pay. An OCC policy will pay for partial disability providing you can take on another job.
• Another definition of disability states that the company will pay only if you cannot be gainfully employed. This means if you can not do your job, but can do another job, you would not receive disability payments. Partial disability is much less common under policies operating under this definition, but this kind of policy may also have residual benefit payments. If your income goes down, the insurance company will pay a percentage of your total disability insurance payments. This should not be confused with being on partial disability, however.

If you are confused about who qualifies for disability benefits under your policy, click here to ask a disability insurance professional for assistance.

Partial Disability with Loss of Sight or Limbs

The loss of sight or a limb can be devastating, but does not always guarantee disability coverage. Under the gainful employment definition, this devastating injury may not be classified as a partial disability or even a totally disability if you can still obtain employment. However, there are some policies that have a presumptive disability that states that the insurance company will deem you totally disabled if you experience one or more of these conditions. The most common conditions under this clause are:

• Loss of eye sight
• Loss of Hearing
• Loss of use of two or more limbs

Check your policy or ask your agent if your policy has a presumptive disability clause and if it deems you totally or partially disabled should any of the above conditions occur. In many cases, policies with presumptive disability clauses will allow benefits to begin immediately, waiving the standard elimination (waiting) period. You also would not be required to have periodic medical examinations to prove continuing disability. You would receive disability benefits as long as your policy states it will pay.

Determining who qualifies for disability benefits and what constitutes partial disability depends on the definition of disabled as well as any riders added to enhance your coverage. Discuss any scenarios with your agent or insurance representative before you purchase a disability policy. Make sure you are comfortable with your policy’s definition of disability and understand how your policy would handle any type of partial disability income payment.

If you would like a free quote on a policy that includes payment if you are working while on disability, click here to visit the Free Advice quote center today.

Case Studies: Understanding Partial Disability Benefits

Case Study 1: John’s Partial Disability Claim

John, a 45-year-old office worker, was involved in a car accident that caused injuries to his back. Although he could still perform some functions of his job, he experienced pain and limitations that affected his productivity. John’s disability insurance policy included coverage for partial disability. As a result, he was eligible for a reduced benefit payment that helped cover his added expenses and minor loss of income until he could fully resume his regular job duties.

Case Study 2: Lisa’s Partial Disability and Loss of Sight

Lisa, a 32-year-old graphic designer, suffered a severe eye injury in an accident, resulting in the loss of sight in one eye. Her disability insurance policy had a presumptive disability clause that considered her totally disabled in the event of such a condition. This allowed Lisa to receive disability benefits immediately, without the need for a waiting period or ongoing medical examinations. The benefits provided financial support during her recovery and rehabilitation process.

Case Study 3: David’s Partial Disability With Limb Loss

David, a 50-year-old construction worker, had a workplace accident that led to the amputation of one of his legs. Although he could no longer perform his previous job, his disability insurance policy classified his situation as a partial disability. However, his policy included a provision that paid benefits for partial disability caused by the loss of a limb. This ensured that David received the necessary financial support to adjust to his new circumstances and pursue a different line of work.