Belleville, Ill. (PRWEB) February 20, 2013
Twenty years ago this month, the Family and Medical Leave Act of 1993 (FMLA) was signed into law, creating an important option for workers to take a leave of absence when dealing with serious health conditions for themselves or their families, according to Allsup, a nationwide provider of Social Security Disability Insurance(SSDI) representation, veterans disability and Medicare plan selection services.
Slightly more than one in 10 workers, 13 percent, took leave from work for a qualifying FMLA reason in 2012, according to the U.S. Department of Labor. FMLA guarantees up to 12 weeks of unpaid absence to employees for specific medical and family situations, such as after a surgery or childbirth, or to help a family member with a serious medical situation.
It’s crucial for workers to know their options, and many people need guidance, said Tricia Blazier, personal financial planning manager for Allsup. For some workers, short-term health concerns can grow into permanent conditions that make it impossible to return to work. However, people may not know where short-term options such as FMLA end and long-term options such as SSDI benefits begin.
“People have rights and benefits they’ve earned through their employment that they need to consider,” Blazier said. “When a medical condition becomes severe, they need to work with their employer to understand their options.”
Disability Insurance, SSDI and Employer Questions
Following are questions that people facing a severe disability can answer with the help of their employer.
1. Does the employee have short- or long-term disability insurance benefits? Many workers with private disability insurance pay a part of the premiums while employed. The length of short-term disability varies and usually is coordinated with the waiting period for long-term disability, if available. Long-term disability plans can have waiting periods from 60 to 720 days, with 90 days being common. Long-term disability insurance may replace a portion of someone’s wages for as long as five years, for example, or up to age 65; plan terms vary.
2. How many sick days, vacation or personal days has the employee accumulated? Those who have healthcare insurance through their employer may be better off depleting paid-time off days prior to leaving work. Private short- or long-term disability coverage does not cover the cost of health insurance premiums.
3. Is the employee eligible for leave under FMLA? To be eligible for FMLA, the individual must work for a company with 50 or more people working within 75 miles of the employee’s worksite. Also, the employee must have worked for the employer for at least a year and worked at least 1,250 hours in the 12 months immediately prior to the leave. While workers are on FMLA leave, their health insurance benefits must continue.
4. Does the state have additional family leave provisions? In addition to the federal FMLA, some states have enacted family leave regulations. Coverage, eligibility and leave restrictions as well as other requirements may differ at the state level from federal regulations.
5. Will the employee be eligible for health coverage under COBRA upon leaving the job? Workers who have no option but to resign as a result of their disability may be able to enroll in COBRA as a way to continue health insurance coverage. Generally, employers with 20 or more employees are required to provide COBRA. COBRA typically allows former employees and their dependents to keep the group health plan coverage for 18 months after their employment ends. There is an additional 11-month extension available when a person is determined to be disabled by the Social Security Administration (SSA).
6. When should someone apply for SSDI benefits? Eligibility for SSDI benefits is stringent, and the SSA has several criteria for applicants. They include being able to show they cannot do the work they did previously; cannot adjust to other work because of their medical condition(s); and their disability has lasted or is expected to last for at least one year or result in death. In addition, they must be under full retirement age and insured, which means they have paid into the SSDI program through payroll taxes.
That doesn’t mean that someone must wait a year to apply. In fact, many people wait too long to apply for SSDI benefits, which adds to their financial hardship. “If there’s no doubt that your disability will exceed 12 months and you will be unable to work, you want to start the SSDI process as soon as reasonable,” Blazier said.
The SSDI process requires work history, medical documentation and other information, and there are multiple levels of denial and disability appeal. Some people must wait one to two years to receive a final decision on their claims. “It’s absolutely critical to seek SSDI when you have little or no income and a severe, long-term disability,” Blazier added.
For more information about Social Security Disability Insurance benefits, contact Allsup’s Disability Evaluation Center at (800) 678-3276.
Allsup is a nationwide provider of Social Security disability, veterans disability appeal, Medicare and Medicare Secondary Payer compliance services for individuals, employers and insurance carriers. Founded in 1984, Allsup employs more than 800 professionals who deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. The company is based in Belleville, Ill., near St. Louis. Visit http://www.Allsup.com or connect with Allsup at http://www.facebook.com/Allsupinc.
The information provided is not intended as a substitute for legal or other professional services. Legal or other expert assistance should be sought before making any decision that may affect your situation.