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How can a preexisting condition affect a disability claim?

On Behalf of | Jul 26, 2019 | Long-Term Disability Insurance Claims | 0 comments

The state of Texas offers disability insurance in the form of the Texas Income Protection Plan or TIPP. In order to qualify for coverage under TIPP, you need to be an active employee suffering from a non-occupational or occupational illness or injury.

The Employees Retirement System of Texas states that depending on your age at the time of the disability, you may be entitled to long-term or short-term coverage. Long-term coverage can last up to full Social Security retirement age, while short-term coverage can last up to five months. However, in order to qualify for either type of coverage, you must prove that you do not have a preexisting medical condition.

What the state considers to be a preexisting condition

 A preexisting condition does not necessarily rule you out from coverage for all disabilities. However, the specific condition that is found to be preexisting would not be covered for the first six months after coverage starts, in addition to a waiting period for any benefits to be paid.

If you have a medical condition for which you received prescription medications or drugs, required medical services, sought medical advice or required medical treatment, and this took place during the three months before the beginning of the coverage, then that condition is considered preexisting.

It is important for you to enroll in disability coverage within 31 days of the date you are hired at your place of employment. As such, trying to wait through the three month period without getting medical treatment could not only be costly to your health—it would also void your eligibility for any coverage at all.

This is meant to inform you about TIPP, and is not meant to be used as legal advice.