Should I Go On Disability?
Most people living with a serious or life-challenging condition grapple with deciding whether or not to stop working at least once. Unfortunately, it's difficult to know exactly if, or when, you should go on disability.
During the course of most serious health conditions, there is a period of time when working actually helps to keep you healthy. Work provides an ongoing reason to get up in the morning, human interaction, feelings of self-worth, and helps to energize people.
However, there can also come a time when continuing to work can severely harm your health. It can make your symptoms worse, and drain you of energy needed to battle your illness.
There is no formula for deciding whether or when to go on disability. However, by looking at the financial, physical and emotional issues involved, you'll have a better chance of making the decision that works best for you. Consider:
Your physical condition.
- Your health is often the main factor in deciding whether or not to go on disability.
- At the one extreme, if your medical condition prevents you from working, then there is no choice. The only questions are when and how. See Financial Planning for Disabilityfor advice on financing disability.
- At the other extreme, if your health condition permits you to continue to work, even if it requires an accommodation such as a change in work hours or even working at home (see Job Accommodations), you can only stop work if your finances permit you to live without qualifying for any private or government benefits.
- In between, there are no hard and fast rules. However, if working makes your condition worse, or if all you do is work and rest at night and on the weekend to be able to have the energy for work -- seriously consider leaving work.
- NOTE: Your diagnosis in itself will probably not automatically qualify you for disability benefits. This is especially true with health conditions that may become worse only over a long period of time, such as diabetes and many types of cancer. However, some illnesses, such as End Stage Renal Disease and ALS, will automatically qualify you medically for Social Security Disability Income ("SSDI"). If you qualify for SSDI, you will probably qualify for benefits under a private disability policy.
- Unfortunately, finances often prevent people from going on disability even when disability might be healthier. For most people on disability, income will be less than when they were working. Some people find themselves having to choose the lesser of two evils: worsening health due to the demands of continued work versus worsening health due to the inability to take proper care of yourself due to a shortage of money.
- Before deciding to go on disability, determine what your finances would be if you no longer had income from your job. Read Financial Planning for Disability and Income While On Short-term Disability to get an idea of what your income and expenses would be. Also read How To Deal With A Financial Crunch or Crisis and New Uses of Assets which can give you ideas for dealing with any short-falls, and Dealing With Creditors if things will really be tight.
- Timing when to start disability is important financially. If you go on disability too early, you might find that you run out of money or your disability benefits end before you're able to return to work.
- On the other hand, if you postpone going on disability for too long, ironically, you may find that it will be more difficult to qualify for benefits. If an insurance company or government agency sees that you have been working with your condition for a long time (even if it's very serious) they will question what they see as a "sudden" claim of being unable to work. This can make them review your case more thoroughly -- delaying your claim's approval, or requiring appeals before benefits are paid.
- For example: consider what happened to Donald L and to Mary M.
- Donald was so invested in his job, when he knew he was going to be weighed at his doctor's office he loaded his pockets with rocks to prevent his dropping weight from being detected. When his condition got so bad that even he had to admit it was time to stop working, both his private disability insurance company and Social Security insisted on a lengthy review of his claim because they couldn't believe that he could become disabled "overnight." As a result, his benefits were unnecessarily delayed for many months.
- Mary freaked out when she was diagnosed with cancer. Even though her cancer was expected to progress slowly, she equated the word "cancer" with "disabled" and, within a week of being diagnosed, applied for disability benefits -- which were approved. She planned to use her $10,000 nest egg to supplement her disability benefits. As it turned out, Mary's private disability policy only paid a benefit for two years and her Social Security Disability benefit couldn't sustain even her modest lifestyle. Her nest egg was depleted soon after her private benefits stopped. Mary had to choose between going back to work and seeking other forms of public assistance, which, even if approved, would force here to further limit her lifestyle to such an extent that she didn't even know if she could continue to afford her nutritional supplements.
- Mary chose to go back to work, even though her cancer was progressing and she had to undergo chemo treatments. Luckily, the chemo worked and her career is thriving with her cancer in remission indefinitely. However, if she had delayed making a decision to go on disability until she was able to think about it more calmly, she might have worked longer. This would have allowed to add to her savings and would have preserved her benefits for when she really needed them -- like all those mornings during treatment when she was so nauseous that all she wanted to do was go back to bed.
Your mental attitude.
The mental and emotional baggage that accompanies going on disability is often the biggest obstacle to making an objective decision about stopping work. Following are some of the reasons we've been told by people for not going on disability, and different ways to think about each reason. You may notice that many of the reasons are based on old messages we've learned over the years, that, upon close examination, have no business being part of answering the question: "Is work hurting or helping me?"
- "I'd be giving up/giving in to my illness" Having a positive attitude is important but it shouldn't keep you from objectively seeing the impact of work on your health. Remember, even in a battle, there comes a time when you should pause, gather your strength, and prepare to fight again. In fact, if going on disability will improve your health, doing so will actually be an act of fighting your illness -- not giving in.
- "I'd be losing control" Dealing with an illness often makes people feel as if they have lost control of their life, so they fight to control everything they can. If you are able to make a rational decision about going on disability, you will actually be taking control by doing what's best for your health. If you continue working even though you are not feeling up to it, it may be that your emotions -- and not you -- are in control.
- "I would no longer be a contributing member of society"
- Many people define their self-worth by their jobs. Other people buy into a work ethic that says you must work, at any kind of work, to have any value as a person.
- Your value as a person and a member of this society is not determined by your ability to earn a paycheck -- especially when you need to be doing all you can to preserve the quality of your own life. In addition, just because you stop working, doesn't mean you can't still contribute to society, whether by volunteering, seeking further education, enriching other people's lives by spending more time with them or being a buddy to someone with your condition who isn't in as good shape as you. Depending on your health, you may even be able to train for a new career. To learn more, see On Disability.
- "This is the beginning of the end"
- Many people accept an unwritten script when they receive their diagnosis that calls for them to deteriorate and die. Leaving work and going on disability is one of the major events in that script. But no one can write the script of your life before it is completed.
- Even if people with your diagnosis do often go on disability and some may eventually die, that doesn't mean that will happen to you. In fact, people coming back from the brink happens so often that there's even a name among financial planners for the increasing number of people who were supposed to have died, but didn't. David Petersen, the financial planner who started the concept of financial planning for people with a life changing condition named it the "Lazarus Syndrome".
- "I'll get depressed with nothing to do"
- If you suddenly switch from working full-time to sitting around the house watching daytime television, this could be true. But you can avoid this if you think about all the other things you can do while on disability. Volunteering, education, and travel are among the possibilities. For ideas, see On Disability.
- Keep in mind that the essence of your personality won't change if you go on disability. If you were the type of person who kept busy before, you will also stay as busy as your health permits while on disability. In fact, when people who are on disability for a few months are asked whether they're bored without having a job to go, it's not unusual to hear: "I'm busier now than I ever was. I don't know how I found the time to work before."
- "It's not the right thing to do" Some people feel that going on disability is not morally right. This belief may have been reinforced by publicized examples of people who abuse disability insurance benefits by collecting them just because they prefer not to work. Going on disability is a decision you should make based on your health and your finances. It is not a moral decision. There is no right or wrong: only what works for you.
- CAUTION: If there are few or only mild symptoms in your records, getting disability benefits approved by an insurance company or by Social Security may cause more anguish and stress fighting for benefits than continuing to work, provided you feel like you can. Review the suggestions about your medical records in Preparing to Leave Work so they records will be likely to support your decision if later you decide to go on disability.
How people could react.
In addition to considering your own feelings, think about how others might react to your going on disability and, in turn, how their reactions might make you feel. At the same time, keep in mind that while the opinions of other people may be very important to you, this is the time to put yourself and your own health ahead of all else. Remember, this is your survival we're talking about.
- Going On Disability May Be A Disclosure About Your Health Condition
- Regardless of the reason you stop working, people might assume that you are ill -- especially if your illness has changed your appearance. In effect, your going on disability might be an act of disclosure.
- If you go on disability and tell people about your condition, they may assume that this means your condition is worsening and express pity or sympathy.
- In fact, there could be as many different reactions as the people you know. How would their reactions to your condition make you feel?
- Effect On Your Social Life
- Some of us build our social lives around people we interact with at work. If you go on disability, you might lose the ties and interaction you have with co-workers since you no longer have your job or company in common with these people.
- Changes At Home
- If you go on disability and are suddenly at home more than you used to be, the dynamics of your home life are likely to change. While change could be positive or negative, it's important to think about how not working might change your home life. For example:
- If you decide to take your children out of day care since you'll be at home, your children will no longer have the experience of interacting with their day care provider or other children at a day care center.
- Teens may feel that they are losing some of their freedom and/or independence by having Mom or Dad home all the time and may, in turn, change their behavior.
- If your spouse or partner doesn't work, the fact that you are at home more could also change your relationship with him or her.
- Your Children
- Consider how your children might react if you are at home more because of your condition. Are you sending a signal to them about your health?
- If you haven't told your children about your health condition, see: Telling Children.
While you're the final authority about what works for you, input from other people can be helpful in providing different perspectives. Consider discussing whether to go on disability with:
- Your doctor While no one knows better than you how you feel physically, your doctor can help you assess your ability to continue working and/or give you an idea of if, or when, you might no longer be able to work. Some doctors may also be able to help you explore the mental and social impact of stopping work.
- Friends and family Your friends and family can help you explore some of your feelings about going on disability. Learning how they would feel about your stopping work as well as the financial and emotional support you can expect from them can also be helpful.
- A social worker Social workers are trained to help people make life-altering decisions.Social workers can help make sure you consider all of the financial, mental, social, and physical effects of your decision.
- A Financial Planner A good financial planner can help you judge your financial readiness for disability, including preparing for the changes, if any, in your standard of living. The planner may also have suggestions for methods of increasing your income or decreasing your expense that you may have overlooked.
- A mental health counselor Leaving work on disability can be a major life event. As discussed above, one of the biggest problems in deciding your best course of action is recognizing that emotions, fear of the future, childhood messages, and other subjective factors can distort your view of which reasons are valid. A mental health counselor, including a psychologist or psychiatrist, can help you explore your feelings about going on disability. Even a few sessions can help you feel more comfortable with the decision you ultimately make.
- An Advisor at work If you have someone at work to whom you can or have disclosed your condition, that person can help you assess what your benefits would be if you stopped working. The advisor might even be able to help give you an idea about your chances of being rehired if you go back to work.
Before deciding to go on or not go on disability, also consider seeking short-term mental health counseling to explore the feelings and attitudes discussed above, and any other emotions that may come to the surface when thinking about this decision.
While it's unlikely you'll be 100% sure you're making the right decision about stopping or continuing to work, if you find that you're extremely uncomfortable with your decision and can physically continue to work, consider taking a few weeks or a few months before taking any action -- such as leaving work -- that can be difficult to reverse. See Leaving Work on a Short Term Basis.
If you decide to go on disability, we suggest that you start with a short break from work and see how it goes from there. With sick leave and other short term disability benefits, and possibly the job and benefits protection of the Family and Medical Leave Act, take off 30 or 60 days. See how you do. It has been our experience that a short break can solidify which decision is "right" for you. Then decide whether to return to work or stay out. See Family and Medical Leave Act (FMLA), Short Term Disability, Paid and Unpaid Time Off. Also:
- Read Planning For Disability -- Short Term.
- Keep in mind that when you discuss your decision to go on disability with your employer or representatives of the insurance company or Social Security, speak as if there is no question about your being unable to continue to work. From their point of view, you are not disabled until there is no choice. If there is a choice, they are not likely to consider you to be disabled.
- The decision to leave work on disability is not necessarily a permanent one. When you decide to go on disability, you are not promising anyone, including yourself, that you'll never work again. If you find just the process of making this decision causes you undue stress, consider seeking some outside assistance. Or consider taking a short break rather than making an "all or nothing" decision.
If you decide to continue working,
- Revisit your decision and the issues involved whenever you feel like it, or if your physical condition changes.
- Continually monitor your medical records to make sure everything that could be useful to a determination of disability is included in case you later have to leave work. See Planning for Disability, Long Term.
- Make the process of possibly leaving work easier and less stressful by making changes to improve your financial health so that if you do go on disability it will be easier to get by.