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Keep in mind that workers compensation
takes effect only for an on-the-job injury or illness —
and most disabling injuries do not occur on the job. To meet
Social Security's stringent disability requirements, you
must be unable to perform any job duties at all. And the
benefits you'd get from Social Security are rather
minuscule.
Large employers will often offer
disability coverage at substantially reduced rates as part
of their benefits package, but the disability payments might
not go very far. A standard long-term group disability plan
replaces only 60 percent of your income, up to $5,000 a
month.
"Key people probably cannot
meet their needs through the group plan alone," says
Stuart Shaw, second vice president of group disability with
The Guardian Life Insurance Co. of America in New York City.
In addition, if your employer pays
your premiums, or if you pay it yourself with pre-tax
dollars, you'll have to pay income tax on any disability
benefits you receive — at a time when you'll be less
likely to be able to spare the money. And the coverage is
not portable, meaning that if you buy a policy through your
employer, it doesn't go with you when you change jobs.
That's exactly why more Americans are purchasing individual
disability insurance policies, either as a supplement to
coverage through work or because their jobs don't offer it
at all.
In general, Social Security
disability benefits are not taxable. However, if you receive
income from another source, you may have to pay taxed on
your Social Security disability benefits.
Options for individual disability
insurance
There are a variety of coverage
options available. You can buy a policy that pays out
benefits for a few months or your entire lifetime. The
number of months it takes for you to "qualify" for
disability benefits can also vary. On top of that, there is
the "definition" of your disability.
Traditionally, insurance companies
primarily offered what was known as "own-occupation
coverage." Under that policy, you receive benefits if
you are unable to work at the specific type of job you were
in when you became disabled. A neurosurgeon, for instance,
would be compensated if she were unable to perform
neurosurgery, regardless of whether she could work as a
general practitioner instead.
But because that kind of policy is
expensive and discourages people from returning to some type
of work, insurers now offer more restrictive plans. One of
these is known as a "modified occupation" or
"reasonable occupation" policy. This kind of
policy pays benefits only if you can't work at a job that is
consistent with your education, training, and experience.
Still, even if you can return to
work in your field, you might be earning less money. That's
where a "residual benefits" or "replacement
income" provision kicks in. Residual benefits are
designed to protect against income loss, not increase
income. A person could receive benefits up to 60
percent of the amount they had been earning before becoming
disabled. Earnings determine the amount of benefits.
Consider the doctor who was earning
$100,000 as a neurosurgeon, for instance. If the
neurosurgeon makes only $40,000 in her new job as a general
practitioner, she would be able to receive $60,000 in
benefits to make up for the lost income. If she were earning
$60,000 as a general practitioner, her benefits would be
$40,000 — again, for a total of $100,000.
However, she could not receive so
much in benefits that it would push her over the 60 percent
limit. That is, if she were only earning $20,000 in her new
position, she would not receive $80,000 in benefits.
How long these benefits last and
the circumstances under which you can collect are determined
by the specifics of your policy.
The lowest-cost premiums are for
"any occupation" coverage. Under that kind of
policy, you are considered disabled only if you cannot work
at any job at all — much like Social Security's definition
of disabled. It's the cheapest coverage because you are less
likely to become 100 percent disabled. Hence, the policy is
less likely to pay out.
Besides those broad categories, you
also have a variety of other coverage details to choose
among. Some policies have built-in flexibility that changes
through the years along with your income. One feature, for
example, bumps up your monthly benefit annually. Others
offer cost-of-living adjustments. That might be beneficial
if you are stricken with a longer-term disability, where
inflation can erode the buying power of your benefits over
time.
What it costs
How much your premiums cost will,
of course, depend on the type of coverage you want — and
the type of person you are and what you do on the job.
Consider these two typical
examples:
A healthy, 40-year-old female
executive who makes $100,000 a year would pay $2,530 in
premiums annually for a guaranteed renewable policy that
kicks in after 90 days of disability, with a standard policy
from UNUM Corp.
Sixty percent of her salary would
be replaced if she were forced to work at a lesser job in
her field. (Women will generally pay more than men because
insurance companies say they file more claims.) However, if
she teams up with two colleagues on a plan, gender is no
longer considered, and her premiums would be offered at a
unisex rate of $1,373 annually.
A 45-year-old man who smokes and
earns $80,000 as a plant manager can get the same policy for
$2,473. If he didn't smoke, it would be $1,944. He could get
a reduced rate of $1,725 if he signs on with at least two
colleagues.
Factors influencing cost
If you're in poor health or in
what's considered a dangerous or stressful job, your
premiums will probably be higher. The longer you want the
benefits to last — say until age 65, or even for the
length of your life — the more expensive the premiums. If
you want to reduce your premiums, consider coverage that
lasts only five years. Or delay the amount of time it takes
for your benefits to kick in. Instead of the standard 90
days, opt for six months or even a year (if your personal
savings can support that). You can even exclude certain
injuries or illnesses that could increase your premiums,
such as a bad back. One of the best ways to cut costs, as
the examples show, is to purchase coverage with several
other people.
In addition, many policies now tend
to be guaranteed renewable. With a guaranteed renewable
policy, the insurance company cannot refuse to renew your
policy and it cannot change any of the policy's terms except
your premium cost. And if your premium does go up, it must
go up for the entire policyholder classification (such as
everyone in a certain occupation), not just a few people.
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