Why Changing Jobs Restarts the Pre-Existing Condition Clock on Disability Coverage

#DisabilityInsurance #LongTermDisability #ERISA Subscribe to the Income Protection Journal Podcast. Full episode notes: https://setforlifeinsurance.com/group... Three quarters of the people who reach ERISA benefits attorney Michelle Roberts had only their employer's group disability coverage, no individual policy of their own. On this episode of the Income Protection Journal Podcast, host Jamie Fleischner asks Roberts to run twenty years of case files in reverse, not what happens after a claim is filed, but which decisions made years earlier, at hire date, at a benefits enrollment window, at a job change, quietly decided how that claim would turn out. Roberts has represented disability claimants exclusively since 2005, first in plaintiff-side ERISA litigation, then as a partner at Kantor and Kantor, and now as principal of her own firm, Roberts Disability Law, in the San Francisco Bay Area. She and Fleischner walk through the pre-existing condition clock that restarts with a new job, the difference between an own occupation and an any occupation definition, why increasing an employer's coverage can reopen a waiting period a professional thought was already behind them, and what an individual policy protects that a group plan cannot. In this video: Why a new job restarts a 12 month pre-existing condition look back on group disability coverage, even for a condition already being treated Why increasing a group disability benefit through an employer's buy up option can reopen that same look back window What the own occupation and any occupation definitions in a group policy actually decide once a specialized professional can no longer do their own job Why 75 percent of the people who reach Michelle Roberts had only their employer's group coverage and no individual policy What a life insurance waiver of premium benefit protects that most professionals do not know exists until they are already disabled Why an individual disability policy travels with a professional from employer to employer while group coverage resets every time CHAPTERS 0:00 Introduction, Michelle Roberts of Roberts Disability Law on Buying Coverage Before a Claim Exists 1:10 Why a Doctor's Note Alone Does Not Guarantee a Group Disability Benefit Gets Paid 4:05 Why the Same Disability Can Get a Different Answer From a Group Plan and an Individual Policy 5:59 Own Occupation and Any Occupation, the Two Group Disability Definitions That Decide a Claim 9:04 The Disability Definition That Can Cut Off Benefits at Any Paying Job 11:43 The 180 Day Window a Group Disability Policyholder Gets After an Initial Coverage Decision 16:02 Missing a Group Disability Deadline by a Single Day Ends the Right to Respond 17:27 How Long a Group Insurer Can Take to Decide Once a Case Reaches Its Desk 23:45 How Often an Initial Group Disability Decision Gets Reversed at Roberts Disability Law 24:49 Why a Reversed Group Disability Decision Does Not Guarantee Payments Continue 28:53 Why Invisible Conditions Like Long COVID Are the Hardest Group Disability Claims to Get Paid 31:06 How Remote Work Complicated Group Disability Claims for Professionals Working From Home 33:47 The 12 Month Pre-Existing Condition Look Back on a New Group Disability Policy 38:21 Benefit Period, Waiting Period, and the State Disability Offset That Shrinks a Group Payout 41:11 The One Decision at Purchase Time That Predicts Whether a Disability Claim Gets Paid 49:50 Why Professionals Leaving an Employer to Start a Company Need Their Own Disability Policy 50:57 75 Percent of Michelle Roberts' Clients Had Only Employer Group Coverage 52:58 What a Career Representing Claimants Taught Michelle Roberts About Buying Coverage Subscribe to the Income Protection Journal Podcast for new episodes on disability insurance and income protection for high-earning professionals. #DisabilityInsurance #LongTermDisability #ERISA