Tag Archives: SSI

Narcolepsy can I win SSDI benefits?

Recently on our disability forum a user asked, “I have been diagnosed with narcolepsy. I have extreme drowsiness and fatigue during the day and fall asleep constantly. I have tried a variety of medications without relief. I have just been fired from my last job. I am wondering if I might qualify for Social Security Disability Insurance (SSDI)?”

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Suffered a severe head injury need help applying for SSDI

Recently on our disability legal forum a user asked, “I suffered a severe head injury in a bar fight. I have difficulty speaking and my short-term memory is gone. I need to apply for Social Security Disability Insurance (SSDI), but I am overwhelmed by the disability process and need help. Is there someone who can help me, and if so, what tasks can they help me complete?”

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Suffered major heart attack and denied SSDI?

Recently on our legal forum a user asked, “I suffered a major heart attack two weeks ago and won’t be able to return to work for a while. I talked to the SSA and they made it sound like I would not qualify for Social Security Disability Insurance. I have worked for 30 years and paid into the system so I would have SSDI when I needed it. What gives? I am confused why I won’t be able to get the disability benefits I deserve.”

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Top 5 reasons you can lose your SSDI benefits

Recently on our legal forum a user asked, “I have been receiving SSDI benefits for two years. One of my friends recently lost her benefits. I thought you could keep getting SSDI benefits forever. I am really scared that I might also lose my benefits. I have a severe back condition and cannot sit for more than 10 minutes at a time. Should I be worried? What are some reasons that I might lose my SSDI benefits?”

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Broken leg on the job why can’t I apply for SSDI benefits?

Recently on our disability forum a user asked, “I was working a construction job and a large pipe  fell on me and left me with a broken leg. I have been told that I have to apply for workers compensation. I am wondering if I can also apply for Social Security Disability Insurance, or if the fact I am going to receive workers compensation eliminates my right to SSDI benefits? The lady in Human resources did not think I could qualify for SSDI.”

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Concerns about SSA funding continue–especially for SSDI benefits

SSDI benefits exempt from many creditors, but funding hammered by high, chronic unemployment

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We’ve addressed this before, but with the debt-ceiling debate, US credit downgrade and endless political posturing, it’s probably a good time to once again discuss the financial health of Social Security overall and the SSDI and SSI programs in particular.

Experts warn of shortfalls in retirement and disability benefits

As we’ve written before, Social Security itself has been declared to be OK until about 2036; in other words, if nothing changes between now and then, the fund will be able to pay out only about 75 per cent of scheduled payments. Medicare is in slightly worse shape, but SSDI (Social Security Disability Insurance) will be busted sometime between 2015 to 2018.

SSDI could run dry as early as 2015

According to long Wall Street Journal piece on SSDI payments increasing in Puerto Rico (but also instructive for its good info on the SSDI national status), “The SSDI is set to soon become the first big federal benefit program to run out of cash—and one of the main reasons is U.S. states and territories have a large say in who qualifies for the federally funded program. Without changes, the Social Security retirement fund can survive intact through about 2040 and Medicare through 2029. The disability fund, however, will run dry in four to seven years without federal intervention, government auditors say.”

Applications have risen along with increased unemployment

According to an Aug. 22 account at Politico.com:

The Social Security disability fund is fast running out of money and may not be able to make payments starting in 2017, thanks in part to the bad economy driving claims up over the past decade, The Associated Press reported.

Applications for benefit claims have risen almost 50 percent in the past 10 years, as many people with disabilities are laid off and cannot find new jobs in the difficult job market. And, the AP added, the rush for benefits is causing a major backup for applicants currently waiting to get their cases decided.

The Congressional Budget Office estimates the disability trust fund will be exhausted by 2017 unless Congress acts. If the fund’s balance falls to zero, it cannot pay out full benefits unless the law is altered. And it’s not the only benefit fund that’s nearly insolvent: In 2040, the CBO projects, Social Security’s retirement fund will also be out of cash.

So, the exact years are in question, but the timeframes are roughly equivalent.

One concern: the ‘multiplier effect’

And it’s not only the SSDI direct benefits that add to the bill. From the NYT’s piece, which gives a dollar figure of benefits in Puerto Rico as averaging a “modest” $1,064 a month:

But the program opens up access for recipients to other government programs, multiplying the ultimate cost to taxpayers.

Anyone who spends two years on SSDI qualifies for the Medicare health program, which usually is available only for those 65 years old and older. SSDI recipients tend to remain tethered to the program for years, and the government’s lifetime financial commitment averages $300,000 per person, estimates David Autor, an SSDI expert who teaches at the Massachusetts Institute of Technology. “The system has profound problems,” Mr. Autor said.

SSDI’s financial woes pose a major test for the White House and Congress, which have been reluctant to tackle the budget-busting costs of entitlements.

Analysts who track the program say the only short-term way to save it without raising taxes would be to fold it into the fund that pays Social Security. That would likely force retirees to face benefit cuts two or three years sooner than they otherwise would have done, because SSDI costs would diminish retirement funds.

SS & SSDI fundings have been combined before

Various sources agree that Social Security (retirement) and SSDI (disability payments) were, in fact, temporarily combined in 1994, as a stopgap, emergency measure. What I’ve not understood, yet–although I do get it about the “multipliers–is how can payroll-funded benefits be such a problem?

In other words, if unemployment is the prime factor, i.e. joblessness strains the system via reduced payroll-tax contributions, then why doesn’t the system seem to care more about unemployment?

Weeding out beneficiaries who ‘sneak back to work’

SSI is not funded by payroll deductions but by the general revenue fund. In other words, a work history is not required to qualify. However, it is much more restrictive. According to the AP, a chronic problem–which we’ve reported about–is lack of review that would spot beneficiaries who have gotten work but kept taking benefits:

Today, about 13.6 million people receive disability benefits through Social Security or Supplemental Security Income. Social Security is for people with substantial work histories, and monthly disability payments average $927. Supplemental Security Income does not require a work history but it has strict limits on income and assets. Monthly SSI payments average $500.

As policymakers work to improve the disability system, they are faced with two major issues: Legitimate applicants often have to wait years to get benefits while many others get payments they don’t deserve.

Last year, Social Security detected $1.4 billion in overpayments to disability beneficiaries, mostly to people who got jobs and no longer qualified, according to a recent report by the Government Accountability Office, the investigative arm of Congress.

Delays can leave unpaid bills piled high

Another concern, according this piece at credit.com, is the delay and lag-time in receiving benefits. As mentioned, the influx of applicants from the unemployed adds to the delay. So what shape are beneficiaries in when they finally begin receiving payments?

For many recipients, Social Security Disability Income (SSDI) and/or Supplemental Security Income (SSI) are their financial lifeline. Their more immediate concern may not be what happens in Washington to save the program, but what happens today to the money they receive. I couldn’t find any statistics about how many SSDI and SSI recipients have past-due bills, but if our email is any indication, plenty of them are struggling and getting calls from creditors or debt collectors threatening to take the little income they do get each month. And because it takes so long to get approved for disability these days, applicants may find themselves already in the hole by the time they start receiving benefits.

Benefits not shielded from child support, taxes or student loans

However, there’s a bright spot in that few creditors can successfully come after these benefits. Again from credit.com: “For those who rely on these benefits, the good news is that they are generally protected from creditors and debt collectors. However there are exceptions in the case of past-due child support, past-due taxes, and federal student loans. “ ‘They can chase you (for student loans) to the grave,’ warns bankruptcy attorney Cathy Moran.”

Free evaluation available

Just remember, we can help connect you with a compatible, trained attorney who can help you with your case–if nothing else, it’s possible that an experienced attorney might be able to steer your case toward a more reasonable outcome.

Help is available whether you’re fighting denied or delayed benefits or whether creditors are threatening to attach benefits you’ve already received. Consider signing up for your free evaluation today.

Syracuse-related study raises serious questions about fairness of SSA disability judges

TRAC finds wide disparity among ALJ  rulings

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No study about SSA Disability in recent memory deserves more attention than the one recently released (and subsequently pooh-poohed by the SSA) from Syracuse University’s Trans­ac­tional Records Access Clear­ing­house (TRAC), a non-profit research orga­ni­za­tion.

Don’t let the system beat you down

If you (or a family member or friend) are one of the unlucky minions to feel trapped and ignored by the federal government’s program to aid disabled persons, please don’t let the findings of this admittedly bleak report stop you from pressing forward with your claim. If anything, this report should legitimize the idea that disability judges can be arbitrary in their rulings and therefore a trained, experienced disability attorney could be your best ally in this notoriously time-consuming process.

Huge disparity among judges’ approval rates

The following is from a Baltimore news site called Baltimore City Paper Blogs; it begins with a district centered in San Antonio, Texas–but the grim numbers apparently apply across the nation:

In San Anto­nio, Texas, peo­ple hop­ing to get Social Secu­rity dis­abil­ity pay­ments could see their cases assigned to any of 17 judges. The luck of this draw mat­ters a lot. One of the judges grants ben­e­fits in just 14 per­cent of cases. Another judge hands over benefits—which range from about $700 per month to about twice that—92 per­cent of the time.

That 78 per­cent dis­par­ity rate makes San Anto­nio the sec­ond most lottery-like sys­tem in the Social Secu­rity Administration’s arch­i­pel­ago of hear­ing offices, accord­ing to a data analy­sis by the Trans­ac­tional Records Access Clear­ing­house, a non-profit research orga­ni­za­tion housed at Syra­cuse Uni­ver­sity. (Dal­las is num­ber one, with 83 per­cent disparity).

“To a sur­pris­ing extent the records on dis­abil­ity deci­sions show again and again that even within the indi­vid­ual offices there is not a clear con­sen­sus among the judges about which claims should be awarded ver­sus which should be denied,” the authors of the report , David Burn­ham and Sue Long, write. “The prob­lem today is some­what worse than it was four and a half years ago.”

This study is from a group aligned with Syracuse University

In case you missed the in-line link, here it is again, the link to the report summary by TRAC, the research outfit aligned with Syracuse University, which reports studying nearly two million claims filed with the Social Security Administration. The report starts thusly:

A court-by-court analysis of close to two million Social Security Administration (SSA) claims has documented extensive and hard-to-explain disparities in the way the administrative law judges (ALJs) within the agency’s separate hearing offices decide whether individuals will be granted or denied disability benefits.

These findings — discussed in detail below — suggest that in many SSA hearing offices today, the chance a disability claim is granted or denied is often determined more by the particular judge assigned to handle it than by the facts and circumstances presented in the case. The findings further document that the problem is not simply the result of a few judges whose decisions are far out of line with those of other judges on the bench. Rather, the agency’s own case-by-case evidence demonstrates that the problem is systemic. To a surprising extent the records on disability decisions show again and again that even within the individual offices there is not a clear consensus among the judges about which claims should be awarded versus which should be denied.

Systemic.

That doesn’t sound good, as anyone with a systemic disease knows and understands. That means whatever the problem is, it’s not localized but instead spread throughout the entire system.

USA Today reports on ‘disparity’

Following is an excerpt from a recent USA Today report, illustrative of the perception of the status quo in such matters:

Congress and the agency’s inspector general have begun looking at the disparity. Yet both Social Security officials and advocates for the disabled say they are reluctant to interfere with the judges’ independence.

“Congress has been pretty enthusiastic about the idea of ALJ independence,” said Social Security Commissioner Michael Astrue, adding that only “a handful” of judges have approval ratings above or below average.

“They can’t tell an ALJ how to decide cases, but they can make sure they follow the agency’s policies.” said Ethel Zelenske, government affairs director for the National Organization of Social Security Claimants’ Representatives.

The Social Security Administration reports about 8.4 million disabled workers nationwide get an average monthly benefit of $1,069. Another 8.1 million low-income disabled people with little work history get about $500 a month in Supplemental Security Income. More than 2.9 million people applied for disability-worker benefits in fiscal year 2010, up 38% over the past five years, agency figures show.

To cope with the increase, Social Security has added about 200 judges in the past five years and streamlined the process of reviewing claims. The average wait time for a decision has steadily dropped, from a peak of 532 days in August 2008 to 354 days last month, agency data show.

TRAC responds to SSA’s response

To be fair, the SSA did respond to TRAC’s study-report, and TRAC’s response to that can be found here.

Just remember, we can help connect you with a compatible, trained attorney who can help you with your case–if nothing else, it’s possible that an experienced attorney might be able to steer your case toward a more reasonable outcome.

 

 

Three recent books address ‘mental health epidemic’

Numbers of reported afflicted great cause for concern

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A disturbing trend

A June 23 review of recent books at The New York Review of Books begins with this startling observation:

It seems that Americans are in the midst of a raging epidemic of mental illness, at least as judged by the increase in the numbers treated for it. The tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007—from one in 184 Americans to one in seventy-six. For children, the rise is even more startling—a thirty-five-fold increase in the same two decades. Mental illness is now the leading cause of disability in children, well ahead of physical disabilities like cerebral palsy or Down syndrome, for which the federal programs were created.

The review, entitled “The Epidemic of Mental Illness: Why?,” addresses three new works:

 

‘Astonishing 46 %’ meet criteria

You’ll have to read the whole thing to decide whether these books might be useful to you or someone you’d like to help, but we’ll leave you with one more passage from the review, before more commentary on the same:

A large survey of randomly selected adults, sponsored by the National Institute of Mental Health (NIMH) and conducted between 2001 and 2003, found that an astonishing 46 percent met criteria established by the American Psychiatric Association (APA) for having had at least one mental illness within four broad categories at some time in their lives. The categories were “anxiety disorders,” including, among other subcategories, phobias and post-traumatic stress disorder (PTSD); “mood disorders,” including major depression and bipolar disorders; “impulse-control disorders,” including various behavioral problems and attention-deficit/hyperactivity disorder (ADHD); and “substance use disorders,” including alcohol and drug abuse. Most met criteria for more than one diagnosis. Of a subgroup affected within the previous year, a third were under treatment—up from a fifth in a similar survey ten years earlier.

If any of this is close to the target, these are trends we can not ignore. The stats on children have to be particularly disturbing, even for the most hard-hearted among us.

Skepticism: ‘Researchers come up empty-handed’

However, what may be most disheartening for those whose loved ones suffer from these ailments is that all the modern hoo-haw about science and pharmacology might be just that: hoo-haw. Writing about the same three books, and the review itself, Jacob Sullum writes June 13 at Reason.com:

As those questions suggest, Angell seems to share the skepticism of the authors whose books she reviews: University of Hull psychologist Irving Kirsch, who in The Emperor’s New Drugs shows that antidepressants are only slightly more effective than placebos, so slightly that the difference may be attributable to stronger expectations of improvement primed by the drugs’ side effects; the journalist Robert Whitaker, who in Anatomy of an Epidemic argues that the “astonishing rise of mental illness in America” can be understood largely as an outgrowth of the desire to sell psychiatric drugs; and Daniel Carlat, a Boston psychiatrist who confesses his profession’s shortcomings in Unhinged: The Trouble With Psychiatry. Angell notes that “none of the three authors subscribes to the popular theory that mental illness is caused by a chemical imbalance in the brain.” She adds that “the main problem with the theory is that after decades of trying to prove it, researchers have still come up empty-handed.”

None of this can be comforting to anyone connected to a friend or loved one affected by mental illness. Imagine being stuck “in the system” trying to get SSI or SSDI benefits for someone so afflicted.

Delays in system back in the news

The system in general is infamous for its delays and backlog, although some announced efforts we’ve covered here have been targeted at reducing the wait times, which can linger from many months to years. Sadly, recent reports indicate those efforts are losing headway. According to a June 22 report in Baltimore City Paper:

The Social Security Administration (SSA) may be losing its battle against the backlog of disability cases, according to an analysis of its data by a New York-based nonprofit.

“In particular, the data show that while progress had initially been made, the hoped for reduction in backlogged matters ground to a halt in the last 12 months,” a report by the Transactional Records Access Clearinghouse (TRAC) says. “Since then the number of pending cases grew by 5 percent. More success has been achieved in reducing average wait times.”

We can help find an attorney

That’s good news about reducing wait times, but the backlogged cases is definitely not improvement. If you’re feeling “stuck in the system” after having trying to make a go of it by yourself, we understand. And we can help. Perhaps it’s time you reach out to a trained, experienced attorney who can guide you through the maze of federal bureaucracy. If so, please scroll down and, under the heading “Need Help With Your Disability Case?” please complete the online form to get a personal response to your case.

 

If you’re contemplating either a SSI or SSDI claim, you simply must read this

03-31-2011

By Mike Hinshaw

A recent post at Digital Journal underscores the importance of retaining a trained, experienced attorney if you’re fighting for disability claims, regardless of whether it involves an SSI item or an SSDI claim:

At this moment, the Social Security Administration (SSA) is faced with the largest case backlog in history, due to the struggling economy and the corresponding rise in claims, which makes it more important than ever to handle your Social Security Disability Insurance (SSDI) claim with careful attention to detail, according to Disability Group, Inc., a leading national firm of SSDI attorney representation.

Because there are so many Social Security Disability Insurance or Supplemental Security Income (SSI) cases that need to be reviewed by the SSA, applicants now have the opportunity to influence how quickly claims are reviewed, and increase the likelihood of claims getting approved, in two critically important steps.

“So many people make the mistake of not doing two simple things,” says Patrick Ryan, Director of Operations for Disability Group, Inc. “There are two to-dos of applying for Social Security Disability Benefits, which any firm will tell any client.”

The Two To-Dos of Applying for Social Security Disability

    1. Securing Medical Records

When a disability claim is first handled, either at the initial level (when there has been no decision yet) or at the reconsideration level (after a social security disability denial), it is processed by a disability examiner at Disability Determination Services.

But the disability examiner at DDS is not always successful in obtaining all the necessary medical records. In fact, it is not unusual for disability examiners to make decisions on claims even if not all of the medical evidence is in the file. This will happen if a disability examiner simply has no success in getting the records from a particular doctor’s office, clinic, or hospital.

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    2. Respond to ALL Social Security Disability letters and notices promptly

A social security disability case can easily run into trouble if an official notice goes unanswered, especially if it requires some type of response with time constraints. In some cases, this means the difference between a denied claim and an awarded claim.

In all instances, a claimant for benefits based on disability should respond promptly to notices sent by either the Office of Hearings and Appeals (OHA) (the office of hearings and appeals), DDS (disability determination services), or the Social Security Field Office or District Office, where the claimant originally applied for benefits).

Surprisingly, a very large percentage of disability claimants do not respond to notices from these offices. Failure to respond causes delays and puts your social security disability claim in jeopardy. Always respond promptly to letters and notices sent by any office connected to the Social Security Administration. “It is easy to respond quickly to notifications from the OHA and the DDS when you have representation helping you through each step of your claim,” says Patrick Ryan, Director of Operations at Disability Group, Inc.

Agreed–that sounds like very good advice.

It’s also good to read the whole article, if you’ve got time. We realize you may not have the inclination. But, if nothing else, it shows the importance of retaining a trained, experienced attorney. This stuff can be overwhelming.

For a return to basics, here’s a post from February:

What is the difference between Social Security disability and SSI disability?

Social Security is responsible for two major programs that provide benefits based on disability:  Social Security Disability Insurance (SSDI), which is based on prior work under Social Security, and Supplemental Security Income (SSI).  Under SSI, payments are made on the basis of financial need.

Social Security Disability Insurance (SSDI) is financed with Social Security taxes paid by workers, employers, and self-employed persons.  To be eligible for a Social Security benefit, the worker must earn sufficient credits based on taxable work to be “insured” for Social Security purposes.  Disability benefits are payable to blind or disabled workers, widow(er)s, or adults disabled since childhood, who are otherwise eligible.  The amount of the monthly disability benefit is based on the Social Security earnings record of the insured worker.

Supplemental Security Income (SSI) is a program financed through general revenues.  SSI disability benefits are payable to adults or children who are disabled or blind, have limited income and resources, meet the living arrangement requirements, and are otherwise eligible.  The monthly payment varies up to the maximum federal benefit rate, which may be supplemented by the State or decreased by countable income and resources.  See Understanding Supplemental Security Income for an explanation of SSI benefit payment rates.

God bless–we understand that anybody reading this information may be in serious trouble. All we’re doing is trying to help.

Take advantage of all resources when researching, planning for disability

When you enter the world of disability benefits, it’s easy to become confused. The variety of agencies, bureaus and offices; the forms, paperwork, and regulations: together, everything can seem like a maze.

We have a wealth of resources available at this site, plus our blogs often link to useful, informative external sites.

Glossary more useful than one might think

A sometimes overlooked resource is our glossary, where you can find often used terms, perform a glossary search, or browse by alpha-sorted topics. When researching disabilities, symptom or benefits, it’s pretty common to encounter unknown or confusing terms. If that happens, the glossary is a good first place to start because it’s not limited to simple definitions–you can also learn about related items or processes.

SSA rules the benefits world

For anyone needing information on any program or benefits overseen by the Social Security Administration, the obvious starting place is the SSA’s homepage, which has many useful links, such as:

Apply for benefits

Apply for Medicare

Estimate your retirement benefits

Get help with your situation

Strict criteria

However, there are also more specific, targeted pages. Here’s the SSA’s main disability page, including this intro copy:

The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. [Although] these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.

Social Security Disability Insurance pays benefits to you and certain members of your family if you are “insured,” meaning that you worked long enough and paid Social Security taxes.

Supplemental Security Income pays benefits based on financial need.

When you apply for either program, we will collect medical and other information from you and make a decision about whether or not you meet Social Security’s definition of disability.

Use the Benefits Eligibility Screening Tool to find out which programs may be able to pay you benefits.

Everyone needs to consider the possibility of disability

The main SSDI page contains this important insight (emphasis added): “Disability is a subject you may read about in the newspaper, but not think of as something that might actually happen to you. But your chances of becoming disabled are probably greater than you realize.

“Studies show that a 20-year-old worker has a 3-in-10 chance of becoming disabled before reaching retirement age.

“[Although] we spend a great deal of time working to succeed in our jobs and careers, few of us think about ensuring that we have a safety net to fall back on should we become disabled . . . .”Another helpful site is that of the CDA, the Council for Disability Awareness. Its “Chances of Disability” page mirrors the language on the SSDI page:

You, disabled? What are your chances?

Higher than you probably think. You can ignore the problem, but it’s hard to ignore the facts:

  • Almost one-third of Americans entering the work force today (3 in 10) will become disabled before they retire.
  • Freak accidents are NOT usually the culprit. Back injuries, cancer, heart disease and other illnesses cause the majority of long-term absences.

Are you prepared if it happens to you? Probably not. If you’re like most Americans, you don’t have disability insurance. Or enough emergency savings to last 2½ years. Yes, that’s the duration of the average long-term disability.

Statistically speaking, disability planning makes sense

The site also has some interesting statistics on this page:

Disability statistics

It happens more often than you’d imagine:

  • Almost one-third of Americans entering the work force today (3 in 10) will become disabled before they retire.
  • Over 51 million Americans – 18% of the population – classify themselves as fully or partially disabled.
  • 8 million disabled wage earners, over 5% of U.S. workers, were receiving Social Security Disability (SSDI) benefits at the conclusion of June, 2010.
  • In June of 2010, there were nearly 2.5 million disabled workers in their 20s, 30s, and 40s receiving SSDI benefits.

Chances of becoming disabled:

The following statistics come from CDA’s PDQ disability risk calculator:

  • A typical female, age 35, 5’4″, 125 pounds, non-smoker, who works mostly an office job, with some outdoor physical responsibilities, and who leads a healthy lifestyle has the following risks:
    • A 24% chance of becoming disabled for 3 months or longer during her working career;
      • with a 38% chance that the disability would last 5 years or longer,
      • and with the average disability for someone like her lasting 82 months.
    • If this same person used tobacco and weighed 160 pounds, the risk would increase to a 41% chance of becoming disabled for 3 months or longer.
  • A typical male, age 35, 5’10″, 170 pounds, non-smoker, who works an office job, with some outdoor physical responsibilities, and who leads a healthy lifestyle has the following risks:
    • A 21% chance of becoming disabled for 3 months or longer during his working career;
      • with a 38% chance that the disability would last 5 years or longer,
      • and with the average disability for someone like him lasting 82 months.
    • If this same person used tobacco and weighed 210 pounds, the risk would increase a 45% chance of becoming disabled for 3 months or longer.

It’s really never too early to plan for the future. That includes retirement planning as well as at least considering what we would do in the event of even a short-term disability.