Surprising reasons people are declined for disability insurance coverage

Disability insurance is insurance for your income. Unfortunately, many people get declined for it when they apply. Here are some of the most surprising reasons why.

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Zack SigelManaging EditorZack Sigel is a former managing editor at Policygenius who oversaw our mortgages, taxes, loans, banking, and investing verticals.

Updated|5 min read

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How will you keep paying your bills if you become injured and can no longer go to work? Not everyone has a large savings account they can rely on, and that money can deplete fast. One of the best options is to get disability insurance, which is like insurance for your paycheck.

If you become disabled, the disability insurance company will make monthly payments to you that roughly equal your paycheck after taxes. You can choose how long you want to receive these disability benefits when you take out the policy.

But not everyone is eligible to receive disability insurance. Sometimes, the insurer will decline your application. In other cases, the insurer will only cover you if you agree to a modification of your coverage, which could mean accepting some limitations on your coverage without a resulting premium discount.

There are several reasons why you might get declined for disability insurance coverage. Read on to learn some of the most surprising reasons:

You have fatigue or vertigo

Fatigue may seem like a minor nuisance, but it could actually hint at much more serious medical conditions. For that reason, many people can't get disability insurance if they have fatigue.

However, the outcome of your application could depend on the duties of your job. If you have a less physically strenuous job, such as accounting or software engineering, then you’ll probably be eligible for disability insurance as long as you agree to an exclusion for your fatigue. That means you’ll receive disability benefits for suffering a disability for any cause other than fatigue.

You may also be required to show that you’re treating the root cause of the fatigue. For example, if your fatigue is caused by sleep apnea, then you’ll need to show regular use of a CPAP machine. You may continue to be declined until you receive treatment.

The same is true for vertigo. As with fatigue, vertigo may be a sign of mental or nervous disorders or physical ailments with long-term consequences, such as a brain tumor. The disability insurance company many require you to undergo a full neurological exam to determine the cause of your vertigo, and your coverage may be contingent on accepting modifications like a shorter benefit period.

You have a pending medical procedure

You’ll have to give not only the medical conditions you’re being treated for but also the types of treatments you’re receiving.

The surgery itself is important to the insurer because complications that may result from the surgery could cause a disability. Complications include everything from sepsis to loss of motor ability.

If you have an upcoming surgery, the insurer may issue a postponement of your application until after it can be proven that you didn’t suffer any complications from the surgery.

You have a medical condition of unknown origin

Medical conditions for which no cause can be effectively established may also result in a decline for disability insurance. While the condition may seem benign, it could, like fatigue or vertigo, mask a more severe issue.

You may need to fully resolve the condition or at least have it under control before becoming eligible to receive disability insurance. You may also apply with a carrier that offers coverage for the condition. A licensed representative from Policygenius can help you find such an insurance company.

Your doctor never resolved your treatment

If your doctor does not describe your condition as “resolved” in your medical records, even if it has been successfully treated, you may be declined for coverage.

To fix this, ask your doctor to make a note in your medical records that the condition has, in fact, been resolved. You may be able to request a postponement if you’re aware that you have an unresolved condition and need time to get your doctor to resolve it.

You’re a doctor and you’ve recently written a prescription for yourself

If you’re a doctor, you may have written a prescription for yourself to treat an illness. However, this may make it impossible to get disability insurance. Self-prescribing is an automatic decline, namely because the insurer has no way of independently confirming that the prescription is for a legitimate diagnosis.

Physicians need disability insurance more than most people. Medical school is expensive, and practicing medicine is a highly physical line of work. If you need a prescription, ask another doctor to write it, because going without disability insurance could be a serious risk to your financial health.

You’re too overweight – or too underweight

Insurers use a height-weight chart similar to the well-known one for body mass index to determine certain things about your disability insurance coverage. The chart includes a baseline weight per each height. If you’re at that baseline weight, your premiums will be unaffected.

But if you exceed the baseline weight for your height, you’ll be quoted higher premiums.

The build chart also applies to people who are underweight. If you’re far below the baseline weight for your height, the insurer may decline you. That’s because being underweight could suggest nervous disorder like anorexia or other serious health conditions that could cause disability in the future.

You have a medical condition the insurer won’t cover

This one may not be as surprising as the others. If you’re already seriously ill, insurers are unlikely to cover you. Such illnesses include but are not limited to:

  • Renal disorders

  • Blood disorders

  • Cancer

  • Hepatitis

  • Arthritis

  • Multiple sclerosis

  • Parkinson’s disease

However, there are a few surprising solutions. Some substandard carriers will cover you, although you may have to accept low coverage and higher premiums.

Depending on the insurer, you may also be able to get an accident-only disability insurance policy, which only pays disability benefits if you were disabled from a sudden, physical injury. Any injury caused by your illness, such as suffering a fall because of Parkinson’s disease or multiple sclerosis, will not pay disability benefits.