Pre-existing conditions typically aren’t covered by disability insurance, so if you already have a diagnosed issue when you buy a policy, it will be excluded from coverage.
You can still get disability insurance if you have a serious injury or illness on your medical record, but it may be expensive, and if your pre-existing condition keeps you out of work, it won’t be covered.
What is a pre-existing condition?
Pre-existing conditions are any medical conditions or procedures, like a previous cancer diagnosis, a past elective surgery, arthritis, HIV/AIDS, asthma, and even COVID-19 and long COVID, that you already have when you sign up for disability insurance.
You have to let insurance companies know about any pre-existing conditions you have before you sign up for coverage, misrepresenting yourself or your health history can ruin your ability to make a future claim.
→ Read more about COVID-19 as a pre-existing condition
Does disability insurance cover pre-existing conditions?
No, disability insurance typically won’t cover pre-existing conditions. Insurance companies employ what’s called a look-back period.
If you make a claim during the first couple years of your policy, your insurance company “looks back” for any evidence you had a pre-existing condition when you signed up for coverage. If it finds any evidence that your illness or injury was previously diagnosed, it will deny your claim.
This is true for both short and long-term disability insurance, but even with a pre-existing condition you can still receive benefits for unrelated illnesses or injuries.
Let’s say that your insurance company excludes coverage for claims related to your previously-diagnosed chronic back pain. You can still make a claim if you injure your back in a way that has nothing to do with your previously-existing chronic pain, like if you fall off your roof and sustain a new back injury.
Every disability insurance provider has different rules for how your policy will treat future injuries or issues that may be related to a pre-existing condition, so read your policy documents carefully.
Can you get disability insurance with a pre-existing condition?
It may still be possible to get disability insurance with a pre-existing condition, but it can be complicated if you already have a diagnosis when you apply for coverage.
For example, you might not be able to get a policy if you’re in treatment for cancer when you apply, but you may be able to get coverage if you had a cancer diagnosis in the past but you’ve been in remission for a set amount of time (which varies by company).
Pregnancy is typically considered a pre-existing condition when you apply for disability insurance, so you may still be able to get a policy but it won’t cover time off due to your pregnancy.
Does group disability insurance exclude pre-existing conditions?
You usually don’t have to complete a medical exam to get group disability insurance (that’s any disability insurance you get as a work benefit). That said, your group insurance policy still won’t cover pre-existing conditions.
Your group disability insurance provider can still check to see if you were diagnosed with or treated for an injury or illness before your policy started, and will deny a claim if it’s related to a pre-existing condition.
Are exclusions for pre-existing conditions permanent?
Your disability insurance policy’s exclusions for a pre-existing condition are often, but not always, permanent. Things might change if you fully recover from a pre-existing condition, like if you had physical injury that heals.
When you’re no longer receiving treatment for your pre-existing condition and you’ve been symptom-free for a while, past injuries and illnesses may no longer affect your ability to get and use disability insurance.
