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Partial Disability Insurance Benefits

Partial disability benefits are one of the most important aspects to an individual disability insurance policy. If you’ve been shopping for a policy, you’ve probably heard the term own occupation. While getting a policy that pays you if you can’t do the duties of your own occupation is important, it’s equally important to get a policy that has the right type of partial, or residual, disability coverage. This is often an overlooked aspect of the policy, but should be one of the first things considered. 

Many Disabilities Aren’t Total

If an accident or illness doesn’t totally disable you, it’s possible that you could be partially disabled. If you don’t have coverage for this in your policy, you may not receive any benefits. There are also multiple levels of partial disability benefits, and it’s important to know the differences.    

A policy with partial disability coverage pays you if you can only work reduced hours at your current job; aren’t able, or it takes you longer, to do some of the tasks that you used to do; or, you have recovered from your disability, but require time to get your income back to it’s pre-disability level.   

Two Types of Partial Disability Riders

Basic Partial 

The basic partial disability benefit rider pays you if you have a loss of income in your occupation of 20% or more as a result of the accident or illness that caused the disability. You must also have a loss of either time or duties in your job in order to qualify. This means that, in addition to the loss of income of at least 20%, you also need to be working fewer hours, or unable to do all the duties you did pre-disability.    

Once you’ve qualified for partial disability, benefits are payable in proportion to your loss of income up to the maximum monthly policy benefit. If your loss of income becomes more than 75% of your pre-disability income, then you’d receive 100% of your monthly benefit. Furthermore, for the first six months, under the basic partial disability rider, at least 50% of your monthly benefit is payable, even if your loss of income is not that high. 

The basic partial disability rider is a good option for people who have salary positions, and are not business owners or who work on commission. 

Enhanced Partial 

The enhanced partial disability benefit rider is a more comprehensive feature, and is designed for those professionals and business owners who have a fee-for-service compensation.   

Like the basic partial rider, the enhanced partial benefit is payable after a loss of income has occurred that was related to the accident or illness that caused the disability. Unlike the basic partial disability rider, however, the enhanced partial rider only needs a loss of income of 15% to trigger benefit payments.    Once you’ve qualified for enhanced partial benefits, the payment is slightly different than under the basic partial rider.

  • For the first 12 months, the benefit is equal to the actual loss of income, up to 100% of your monthly benefit.

  • After 12 months, benefits are paid in proportion to your income loss.

    • If the loss of income is more than 75% of your prior income in any month, they consider the loss to be 100%.

  • Even after you fully recover and return to work full time, benefits will continue to be paid as long as you have a loss of income of at least 15% of your prior income and the loss is solely the result of the injury or illness that caused the disability.

The enhanced partial disability rider differs in a couple important ways from the basic partial.

  • 1. The threshold for loss of income is lower at 15% vs. 20%, so benefits are payable sooner.

  • 2. Second, during your first year of a claim, you could receive your full monthly benefit, so long as that monthly benefit plus your working income didn’t exceed your pre-disability income.

    For example, let’s say you make $100,000 per year and have a disability policy with a $5000 per month benefit ($60,000 per year). You have a partial disability and are working fewer hours, and therefore have a loss of income of $60,000. Under the enhanced partial rider, you’d receive the full $5000 per month to go along with your $40,000 post-disability income. In effect, you’d be made whole financially for the first year.

  • 3.   Finally, the enhanced partial rider provides something very important and unique – a recovery benefit.   A recovery benefit is when you recover physically from your disability, but not financially. A business owner, or fee-for-service professional, may suffer a disability and recover from it physically, but still have a lengthy period of financial recovery while they rebuild their business. During this time, so long as there remains a 15% loss of income, partial disability benefits will still be payable, even though this person isn’t suffering a loss of time or duties in their occupation.

Here’s an example of how the basic and the enhanced partial disability benefits work in a claim:

Bike AccidentElimination
(Waiting Period)
Unable to work at allPhysical recovery allows you to return to work part timePhysical recovery allows you to return to work full timeFinancial Recovery
Enhanced PartialNo policy benefitsPolicy pays Total Disability BenefitsSuffered loss of income of 15% or greaterPolicy pays because you continue to suffer loss of income of 15% or greater due to disability even though you've returned to work full timeEarnings grow to more than 85% of pre-disability income so claim ends.
Basic PartialNo policy benefitsPolicy pays Total Disability Benefits
  • Suffered loss of income of 20% or greater; and
  • Suffered a loss of time or duties
Return to work in less than 12 months: Lump Sum payment of two times monthly benefit
Helps you regain financial strength as you regain physical strength

There are many important aspects to a disability insurance policy. Own occupation; getting a policy that is non-cancelable; AND the correct type of partial disability benefits are all things that need to be considered, but the first place I recommend you start is with making sure that you have the best partial disability coverage you can find.

William Olmsted, Registered Representative of Park Avenue Securities, LLC (PAS), 1901 Research Blvd, Suite 400, Rockville, MD 20850. Securities products and services are offered through PAS, 240-683-1400. Field Representative, The Guardian Life Insurance Company of America (Guardian) New York, NY. PAS is an indirect, wholly-owned subsidiary of Guardian. PAS is a member of FINRA, SIPC

Individual disability income products underwritten and issued by Berkshire Life Insurance Company of America, Pittsfield, MA, a wholly owned stock subsidiary of The Guardian Life Insurance Company of America (Guardian), New York, or provided by Guardian. Product provisions and availability may vary by state. Optional riders are available for an additional premium.

2017-45207 Exp 8/2019

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