What is the disability insurance medical exam and drug test?

Before you receive your final disability insurance quote, you'll have to undergo a medical exam to give the carrier a better picture of your health.

When you have a disability insurance policy, you pay a premium monthly or annually to keep the policy in force. The premium is determined during the underwriting process, which almost always includes a medical exam and drug test. As with life insurance, the results of your medical exam could have a great impact on your premium rate.

The medical exam, technically called the paramedical exam, is a standard part of both life and disability insurance. The results of the exam not only confirm the health information you provided about yourself to the carrier but could also uncover new information that the underwriter may take into account.

The disability insurance medical exam is paid for by the disability insurance company. You can even keep the results and reuse them for future disability insurance applications and potentially even a life insurance application. The reverse is also true: if you’ve already taken a life insurance medical exam, the results can be used in lieu of taking a new medical exam for disability insurance.

Read on to learn more about:

What happens during the disability insurance medical exam?

The first thing you need to do is schedule an appointment for a paramedical exam with your disability insurance carrier. You should be prompted to do this during the underwriting process. You’ll be able to choose whether you go to a medical technician’s office or the medical technician comes to your home or place of employment. The exam should take no more than 30 minutes.

The disability insurance medical exam will resemble a regular check-up. As with going to your physician, the medical tech will record your height and weight to figure out your body mass index. He or she will also check your pulse and blood pressure. Unlike life insurance, the medical tech won’t perform an electrocardiogram, or EKG, on you. However, you will have to take a blood test and probably provide a urine sample.

You’ll be asked a lot of questions about your health. The answers you provide will be used to confirm the health information you gave in your original quote as well as reveal new medical concerns that may affect your eligibility for coverage or your premium rate. Expect to describe the medications you’re taking and what doctors you’ve seen recently.

Common conditions the medical exam looks for

The disability medical exam helps the carrier determine how much risk you pose by helping the underwriter assign you an insurance classification. The higher your risk, the more likely you’ll pay higher premiums. (Premium rates also increase along with the more coverage you need.) During the underwriting process, your medical records will be pored over, including a form about your health history obtained from your doctor, called an attending physician’s statement. That makes the conditions the medical exam will test for essentially limitless. Some of those conditions are as follows:

  • Diabetes and hyperglycemia
  • High blood pressure
  • Elevated cholesterol
  • Sleep apnea
  • Back injuries
  • HIV/AIDS and hepatitis
  • Mental/nervous disorders

You’ll be asked about whether you’re a smoker, and if you are, you’ll receive an insurance classification reflecting that status. Any kind of nicotine product will affect your premiums, including chewing tobacco and e-cigarettes. Additionally, the medical technician will record whether you use recreational drugs, which, if you do, could increase your premium.

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Takeaway

Disability insurance is meant to replace your income when you become disabled.

Exclusions

The pre-existing conditions uncovered by the disability insurance medical exam may not only raise your premium but could also constitute exclusions to your coverage. In disability insurance, an exclusion is anything that could potentially cause you to have a disability but for which you won’t receive disability insurance benefits should you file a claim based on that exclusion.

Preparing for the medical exam

To make the process as seamless for yourself as possible, make sure to be completely honest with the disability insurance company about any medical conditions you have before the paramedical exam. That’s because your initial quote could go up (and it’s almost always up, not down) if the medical exam reveals any new conditions during the process. Getting a more accurate quote the first time help you curb any expectations you have about the cost later down the line. It could be weeks before you take the medical exam and weeks still after that to get your results and final premium rate.

In order to make sure your premiums match your initial quote as closely as possible, be sure to avoid the following substances before the exam:

  • Alcohol.
  • Over-the-counter medication, including herbal supplements.
  • Caffeine, but if you need to have a daily coffee you should mention it to the examiner.
  • Sugar. Also tough to cut, but try your best if you think it could disproportionately affect your glucose levels.
  • Tobacco. However, quitting smoking the day before your test will hardly nudge your premium, because signs of smoking stay in your blood for up to a week. Plus, the insurer looks at your smoking habits across the last 12 months.

For the most optimal medical exam experience, try to avoid exercise for 12 hours before the exam. In fact, you may consider scheduling your appointment first thing in the morning so you don’t have to worry about how your daily activity will affect your results.

Don’t forget to wear comfortable clothing, especially a short-sleeved shirt or one where the sleeves roll up easily. ExamOne, a paramedical exam company frequently used by insurers, even recommends avoiding salty and high-cholesterol foods the day before your appointment.

Aside from the obvious, there’s not a lot you can do to really push the needle on your premiums. It’s generally a good idea to eat healthy, avoid excessive smoking and drinking, and get plenty of exercise. If you got a disability insurance quote that seems high, you might have some success getting the number down if you delay purchasing a policy until you’ve improved your health.

After the medical exam

The disability insurance company will use the results from your medical exam along with your age and information about your lifestyle, medical history, and coverage needs to determine how much you’ll pay in premiums. You’ll receive your actual quote when underwriting concludes, usually within three to eight weeks.

The record of your paramedical exam can be used to apply to other disability insurers if your application gets denied, or if you find a better quote somewhere else, for up to six months to a year, depending on the carrier. Even though one disability insurance company paid for the exam, you’re under no obligation to purchase a plan with the same company.

Your paramedical exam results do become part of your health record and could be factored into future premium quotes, including both other disability insurance applications as well as life insurance. If you’re concerned that the results of your medical exam aren’t accurate, you may be able to ask the insurance company for a redo. The results from both exams will be combined to create a composite profile of your medical health.

You may also be able to retake the medical exam at the one-year anniversary of your policy purchase. Spend the next 12 months improving your health and you may score a lower premium when you retake the exam.

Disability insurance without the medical exam

Depending on the carrier, you may be able to purchase a policy that doesn’t require you to take a medical exam, which may be especially important to you if you’re an unhealthy person. This type of disability insurance is called a simplified underwriting or simplified issue policy, and your eligibility hinges on your age and responses to the initial phone interview with the disability insurance company.

Generally, simplified underwriting policies offer low coverage amounts – somewhere in the range of $4,000 to $6,000 per month. That may be enough for many people, but disability insurance is meant to mostly replace your after-tax income, and such coverage amounts may not cut it. You’ll also pay roughly the same premium rate as someone who took out a disability insurance policy with a medical exam.

You may try to purchase a simplified issue disability policy but still find you have to take a medical exam. That can happen if, during the underwriting process, the disability insurance carrier has additional concerns about your health.

Disclaimer: Policygenius’ editorial content is not written by an insurance agent. It’s intended for informational purposes and should not be considered legal or financial advice. Consult a professional to learn what financial products are right for you.

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