You can still get disability insurance if you have a pre-existing condition, you just won’t receive coverage if your pre-existing condition keeps you from working. You can still use your disability insurance if you can’t work because of another injury or illness, as long as it’s unrelated.
What is a pre-existing condition?
A pre-existing condition is an injury, disease, or surgery that you’ve had or been diagnosed with before starting a health or disability insurance plan. Some common pre-existing conditions include cancer, a past elective surgery, arthritis, HIV/AIDS, asthma, and even long COVID-19.
You have to let insurance companies know about any pre-existing conditions you have before you sign up for coverage. Not revealing a pre-existing condition can prevent you from getting any benefits later on.
Can you get disability insurance with a pre-existing condition?
You can get disability insurance with a pre-existing condition, but it can get complicated. Some disability insurance companies won’t cover you if you have a pre-existing condition, especially if you have symptoms when you apply for coverage.
For example, a disability company may not offer you a policy if you have cancer at the time of your application. You may have to show that you’ve been in remission for a set amount of time (which varies by company) before you can get covered.
Insurance companies may also offer you disability insurance with a look-back period. If you make a claim during the first year of your policy, your insurance company looks to see if you had a pre-existing condition in a set amount of time before your coverage. Your claim would be denied if you did.
Does disability insurance cover pre-existing conditions?
No, disability insurance usually excludes pre-existing conditions from coverage. This means that if you make a disability insurance claim that’s related to a pre-existing condition instead of a new injury or illness, it will be denied.
But an exclusion for a pre-existing condition may not keep you from collecting disability insurance benefits.
Let’s say that your insurance company excludes you from making any disability claims for your previously-diagnosed chronic back pain. You can still make a claim if you injure your back another way, like if you rupture a disc, as long as it’s not related to your pre-existing back pain.
Every disability insurance provider has different rules around defining exclusions for pre-existing conditions. How you’re covered depends on your policy’s definitions. If you’re not sure how your policy covers a potential disability and you want to make a claim, it may be a good idea to speak with a lawyer or insurance expert.
Does group disability insurance exclude pre-existing conditions?
You usually don’t have to complete a medical exam to get group disability insurance through an employer. That doesn’t mean your group disability policy will cover pre-existing conditions, whether it’s a long-term or short-term policy.
Your group disability insurance provider can still check to see if you were diagnosed with or treated for an injury or illness before your policy started, and will deny a claim if it’s related to a pre-existing condition.
Are exclusions for pre-existing conditions permanent?
Your disability insurance policy’s exclusions for a pre-existing condition are often permanent, but not always. Things might change if you fully recover from a pre-existing condition, like a physical injury.
When you’re no longer receiving treatment for your pre-existing condition and you’ve been symptom-free for a while, you may be able to revisit the terms of your policy.
Frequently asked questions
What is a pre-existing condition for disability insurance?
A pre-existing condition is an injury or illness that you have before applying for disability insurance. You usually need to have been treated for the injury or illness in the 90 to 180 days before applying for it to be considered a pre-existing condition.
Can disability insurance be denied?
Yes, insurance companies can deny claims if your injury or illness is a pre-existing condition. But you’re still allowed to make claims for a disability as long as it wasn’t caused by your pre-existing condition.
Does short-term disability cover pre-existing conditions?
Short-term disability insurance won’t cover disabilities that are caused by a pre-existing condition. Even if you get a policy through your employer and don’t need to take a medical exam, your coverage still probably excludes pre-existing conditions.
