Cancer survivors need disability insurance

If you’re a cancer survivor and still work, this is a must read. It’s long, but extremely important to protect your income in case you develop long-term side effects from treatments and at some point can no longer work. Or, you get cancer again.

I developed long-term, debilitating side-effects from the surgeries, radiation and chemo I had for stage 3 cancer. I went through treatments in 2009-10, and had to stop working in 2017. I was 37 and losing my income would have been devastating to me and my family.

Thankfully, I had disability insurance policies through work (3 complementary policies). I filed claims prior to leaving my job, and was approved for all of them, which meant that between the insurers, they took over paying my salary. I continued receiving 100% of my income, with no gap in receiving the pay from my last day at work, through today. And since my condition is permanent, I will receive this income until I’m 65.

My situation is ideal, ironically. So many others are not so lucky. Not only do they have disabling conditions, but they are stuck in hell trying to keep their job despite how much pain and fatigue they have. Essentially, they can’t afford to not work. And I’m thankful everyday that I’m not one of the people who are ultimately fired because they can no longer do their job well, and therefore lose their salary and having only social security disability income to rely on. This is literally how people can end up homeless… no exaggeration. Cancer and other illnesses have already taken so much from us, and I just hope to help as many people as I can from having cancer take anything more.

Disability insurance is CONFUSING at first. I’m breaking it down in simple terms; and I’m sharing tips so you get the RIGHT coverage, and you can get approved if you ever need to use this insurance. Top takeaways you need to know:

1. Opt in for Short-Term Disability (STD) insurance, Long-term Disability (LTD) insurance, and Supplemental Disability insurance. It sounds redundant, but it’s not at all. You need it all in the case that you ever can’t work due to medical conditions. Only by having all of these will you be able to receive 100% of your salary starting on day 1 of leave, and until age 65.
2. Get a Disability Insurance lawyer immediately to advise on the process and how you fill out the applications. Insurance companies ideally do not want to have to pay you and there are a lot of ways they can get out of approving your claim, even if you are truly disabled.
3. If you have any psychological issues, even just run of the mill depression or anxiety, the LTD companies and Social Security Disability may use that against you.
4. Psych related claims only pay disability for 2 years.
5. LTD insurers may send people out to follow and watch you, and take video and pictures that show you doing normal activities to try to say you’re capable of working
6. Make sure your monthly premiums are being paid until your policies kick in.

Full Details

Once you have had cancer or any serious illness, you should opt in for any and all extra insurance options that your work offers. If your job doesn’t offer short and long-term disability, look into changing companies. I know that might seem drastic… but, we all respond differently to the treatments and you don’t know what kind of long-term, latent (delayed) side effects you might have.

Once I recovered from chemo, radiation and surgery treatments, I was fine for about four or five years. Slowly I started experiencing excruciating neck, fascial, and jaw pain, nerve pain, dental issues, fatigue issues, immune issues, thyroid problems, and mild cognitive impairment. I had to stop working almost five years ago and we would have been ruined financially had I not opted into short-term disability insurance, long-term disability insurance, and supplemental disability insurance. This is all insurance to pay your SALARY if you have to stop working due to illness. This is completely separate and unrelated to health insurance, which pays for your medical bills.

Here is an overview of all your disability insurance options:

• Short-term disability (STD) insurance: Pays 60% of your salary for the first 90 days of sick leave. It’s a private insurance policy. The premium is either paid for by you or by your company as part of your benefits package.

• Long-term disability (LTD) insurance: Pays 60% of your salary after being on sick leave for 90 days; pays until you are 65 years old (if you have a permanent condition – otherwise they cover until you are well enough to work a full time job again; if you have a psychological disorder most will only pay for 2 years of disability). It’s a private insurance policy. The premium is either paid for by you or by your company as part of your benefits package.

• Supplemental disability insurance: Pays remaining 40% of your salary. Starts on day one of sick leave and will pay until you are 65 years old if you have a permanent condition. It’s a private insurance policy. The premium is either paid by you or by your company as part of your benefits package

• Social Security Disability Insurance (SSDI): Pays about 25% of your salary (determined based on your tax contributions to social security). Anyone who works and has paid taxes can apply for SSDI. This is a Federal government benefit.

So here’s how it all works

• If you have all these policies and you need to stop working for health reasons, you could get 100% of your salary from the first day you’re sick until you are 65 (if a permanent condition). For me, I applied for short-term disability (60% of salary) and supplemental disability (40% of salary) and was approved for both. While on short-term disability – during the first 90 days, I applied for long-term disability and was approved. So after 90 days, my short term policy transitioned into a long-term policy. Since I left work nearly five years ago, I’ve continued to receive 100% of my salary. This was paid to me from the insurance companies. My former employer has no role and my claims had no impact on the company.

• The private insurance policies (short-term, long-term and supplemental) are all unrelated to Social Security Disability Insurance (SSDI).
• You can and should apply for SSDI, but it pays only a small portion of your salary (mine is ~25%).
• It’s harder to get approved for SSDI than for STD/LTD and supplemental private disability insurance policies. It can be hard to get approved for complex issues like mine, and if you’re younger, like I was (I was 37 when I took leave).
• If you get approved for LTD, your primary LTD insurance company (the one that pays 60%) will make you file for SSDI. This is because if you get SSDI, your LTD insurance company doesn’t have to pay you as much. They look for every opportunity to pay you less, or not at all. — Here’s how it works. Whatever you get paid from SSDI is subtracted from what the LTD company is paying you. For example, if your LTD policy pays you $5000 a month and you then start receiving $2000 from SSDI monthly, your LTD income will be reduced by the SSDI income, bringing your LTD income down to $3000 per month. Your total net income stays flat if you get SSDI – it doesn’t increase what you’re paid every month. You’ll still be paid $5000 per month but it will now come from two sources – the LTD company and from SSDI.
• The LTD company will pay a law firm to help you apply for SSDI. The law firm I worked with was very good. My SSDI application was denied at first, and I had to work with the law firm to appeal. I think we may have appealed twice. SSDI required me to have neuropsychology testing to evaluate me for cognitive impairment. Finally, they had a hearing on my case. I had to attend in person and answer questions about my conditions and my professional skills. After two years, they finally approved me for social security disability. At that time, SSD gave me a retroactive payment that totaled what they would have been paying me for the last two years had I been approved right away when I originally applied. I, in turn, had to give that straight to the LTD company. It’s essentially paying them back in part for what SSDI would have been paying and therefore reducing the LTD’s responsibility. So using the example above… if I had been approved by SSDI from the start, I would have been receiving $2000 of SSDI and only $3000 from LTD. But because I hadn’t been approved by SSD, they had been paying me $5000. So again, they want to pay you as little as possible so you have to give them that retroactive payment. It’s almost like they fronted you the $2000 per month until SSD got on the same page.
• If you are declined for SSDI, your LTD company will be responsible for the 60%. Your approval for SSD doesn’t determine anything about your approval for the LTD company. That said, I personally think it’s much harder for your primarily LTD to say you aren’t disabled permanently if SSD says you are.

Ok so here are a few VERY IMPORTANT DETAILS:

• When you first apply for STD or LTD, to get approved, you must be unable to work full time in YOUR occupation. But, after 2 years, most LTD policies change their requirements. At that point, you must be deemed unable to perform in ANY occupation full time. Meeting this threshold is hard and many people lose their LTD coverage at this time. So after 2 years, your LTD insurance company may determine you are able to work full time in some sort of job. At this point, you could lose the payment that was 60% of your previous salary. At this point, if you don’t have supplemental insurance (providing the other 40%) and weren’t approved for SSDI, you will no longer have any disability pay coming in. — For some people, that two years may be long enough to get some new skills, to improve your condition or management of the condition, or save and reduce expenses so you can live on a reduced income. Or maybe it’s just better than nothing.
• If you need to file for STD, LTD and LTD supplemental, I also highly recommend getting a lawyer that specializes in private disability insurance. There are some important things to know when you fill out your paperwork that can make or break your case. It’s hard to afford one when you’re already dealing with health costs and the threat of losing your salary, but it can make the difference between getting approved or not. Some lawyers will take their payment after you’re approved.
• Be careful about psychological issues. Insurers may try to decline your claim by saying that your inability to work is really due to your psychological issues. And if you actually are approved because of a psychological issue, they will only cover you for up to two years (rather then until you’re 65). Frankly, I think this is absolute bullshit – anyone who has chronic pain or is newly disabled is going to have psychological issues, at least as they adjust to their new conditions and the new limitations in their life. Having psychological issues shouldn’t allow them to mitigate the seriousness of your other conditions. Also, many serious psychological conditions are life-long, but somehow the LTD companies are able to get away with saying you should only be disabled by it for 2 years. It’s insulting and insensitive to people with things like schizophrenia, or severe OCD, or bipolar. (I’m not saying all people with these conditions aren’t able to have functional and productive lives – I’m speaking to those who are unable to manage their conditions for whatever reason.)

It’s good to hope for minimal effects long-term, but much of it is out of our control. Once I recovered, I didn’t think having had cancer would effect me besides maybe having some dental issues and some thyroid issues that I’d manage with meds. I was living my life, happy and contented. And then slowly I started having these issues and they became more intensified and the duration was longer until I was struggling to function day-to-day and struggling at work because of it. I didn’t even really understand what was happening because it was such a slow boil. I hope this is helpful to even just one person who is adjusting to life after cancer. Your life may look very different after you’ve had cancer, but financial security doesn’t have to jeopardized too.

Please share your stories in the comments, or ask me any questions! I may not be able to answer all of them, but I’ll do my best! Sending you all joie de vivre and health.