Compare disability insurance for people with pre-existing conditions

Disability insurance can be purchased if you have pre-existing conditions, but there are caveats. Not all companies will offer you a policy, while others will exclude your pre-existing condition.

How can I get disability insurance with a pre-existing condition?

Getting coverage will depend on your situation and policy.

Here is a brief overview of when you can get disability insurance with a pre-existing condition, when you might be able to and when you can’t.

• When you can get coverage. State temporary disability programs will sometimes cover pre-existing conditions without a waiting period. Insurance companies are more comfortable offering broad coverage in this situation because it’s collecting a premium on a large group of people, so there’s less risk for the company.

• When you may get coverage. The insurance company will offer you a policy even though you have a pre-existing condition. However, it will exclude that pre-existing condition from any type of coverage. This means that if you have a disability that can be related to your pre-existing condition, the company will deny the claim. However, it will pay for any new covered disability that is not directly related to your pre-existing condition. The insurance company might only exclude coverage on your pre-existing condition during the probationary period, which is typically one to two years from the start of your policy.

• When you can’t get coverage. Some insurance companies will deny your application if you have a pre-existing condition. They put in place strict underwriting guidelines to avoid any risks of paying out benefits for pre-existing conditions in the long term.

How will a pre-existing condition affect my disability insurance rates?

A pre-existing condition will not usually have an impact on your rates. Charging a higher premium wouldn’t offset the benefit amount that a company would have to pay if it allowed all pre-existing conditions.

Your disability insurance rates are mainly based on age, health, plan selections and occupation.

What are the most common pre-existing conditions?

A pre-existing condition is any health issue you’ve received medical advice on, sought treatment on or took medication for. Some of the most common pre-existing conditions include:

• Heart problems. This could include previous heart attacks or heart surgery, and could affect your coverage for a separate heart attack or stroke while you have disability insurance.
• High blood pressure. If it’s too high, you could be considered at risk for things like a heart attack or stroke.
• Cancer. Insurance companies usually exclude coverage on cancer if you’ve had it in the past. Some companies might be willing to offer coverage if the cancer has gone into remission for a period of three to five years.
• Alcohol or drug abuse. A history of alcohol or drug use can cause insurance companies to deny payments for any possible related illnesses.
• Physical injuries. If you have existing or lingering injuries, such as back pain, this could later be denied if it causes you to miss work.

What are disability insurance exclusions?

Disability exclusions are specified conditions listed in your policy that the provider has stated they will not cover. Some exclusions are general and will apply to all applicants, while others can be related to a pre-existing condition. They’ll only provide coverage for conditions unrelated to listed exclusions.

An example is if you have lingering back pain. The company can offer you a disability plan that excludes any claims related to back pain.

If your back pain gets worse and you’re unable to work, the company won’t pay any benefits. But if you break your leg and have to miss work, the company will pay your disability benefit.

What is the reconsideration period?

The reconsideration period is a specified amount of time you have to try and remove an exclusion from your policy. An exclusion can be removed if you demonstrate that your condition has improved and is no longer affecting you.

You will have to provide documentation from a doctor to your insurance company stating that your condition has improved enough to have it removed as an exclusion. It can take a few months to a couple of years to determine your health status.

The reconsideration period for Social Security disability is slightly different. This is when you can appeal a disability claim denial if you believe it was wrongly denied.

Bottom line

Pre-existing conditions don’t always prevent you from purchasing disability insurance. Some insurance companies might deny your application, while others will offer you coverage on disabilities unrelated to a pre-existing condition. It might even remove exclusions if you can demonstrate that a condition has gone away or significantly improved.

To review different disability insurance providers and see how they treat pre-existing conditions, check out our disability insurance page.

Frequently asked questions

Why is it worth buying disability insurance if I have a pre-existing condition?

Many other injuries or illnesses could affect your ability to work and earn income. A disability policy can help replace a portion of lost wages if you cannot work.

What happens if the insurance company denies my claim because of the exclusion?

If you believe an exclusion shouldn’t have applied, then you can appeal the decision.

When are employer-sponsored group disability policies not enough?

Depending on how your company pays the premiums, your benefit money could be taxed when you receive it, meaning your benefit amount would be less. Thoroughly check your group policy to see if you need to buy a secondary individual policy.

What is a 3/12 pre-existing condition limitation?

This is a common look-back period found in many disability policies. It means that for disability claims filed within the first 12 months of owning your policy, insurance companies will look back three months prior to your effective date— to determine if your disability is due to a sickness or injury that you received treatment, consultation, care or services for.