While the American with Disabilities Act (or ADA) protects those American citizens with disabilities, the Act does not list every disability that qualifies for protection. Obviously, those people with clear disabilities are fully protected under the law, though those who may have disabilities that are less immediately apparent may have a harder time getting their disability or disabilities covered.
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To understand better how health insurance coverage works, you need to understand what the government and doctors define as a disability.
What is defined as a disability?
One main point of the American with Disabilities Act is to define a disability. Title I defines it as physical or mental impairment that keeps a person from performing one or more of what is known as “major life activities.” One part of the definition requires the individual to have a record—medical or otherwise—of the impairment. In other words, the person needs to be regarded as having the disability.
A “major life activity”, which is also sometimes referred to as an Activity of Daily Living (usually by insurance companies) refers to the various activities that relate to ones ability to care for oneself. These activities include being able to:
- Bathe yourself
- Feed yourself
- Walk on your own
- Lift things (including yourself)
- Interact with others (among many others)
These activities are defined by the United States Equal Employment Opportunity Commission. Not all courts have agreed with this definition, though it is the standard.
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The ADA defines an impairment or disability as a condition that is based in a mental, psychological, or physiological problem. The definition includes the loss of limbs or the loss of senses (sight, sound, etc). It also includes major conditions that are caused by respiratory, cardiovascular, musculoskeletal, skin and endocrine problems, as well as problems with the hemic or lymphatic systems. Other issues included in the definition include cosmetic disfigurements, mental issues (including mental retardation as well as mental and emotional illnesses), brain disorders, and some specific learning disabilities.
What limitations are in the ADA?
The Act has some pretty set limits used to determine if someone’s disability actually qualifies for protection. For one, the impairment or disability has to “substantially” (their word) keep a person from being able to perform one or more of those major life activities. Even if that requirement is met, there are still others that must be met.
On a case-by-case basis, the individual’s disability (and subsequent protection under the ADA) is determined by how long they are expected to be disabled; the severity of the disability and its nature; and the condition’s long-term expected impact. Using this criteria, it is absolutely possible that one person with a form of a disease may qualify while another person may not, depending on the severity of the disease in each case.
What things are never covered by the ADA?
Some conditions can cause a person extreme difficulty in daily life, but they will still never be considered covered disabilities under the ADA. These include:
- Weight conditions, including obesity
- Cultural- or economic-based problems
- Drug use
At some point, someone also thought to exclude “being left-handed.” Hmm…
How does disability insurance work?
Disability insurance is designed to help replace the income for individuals who are no longer able to earn an income because of an illness. There are many different kinds of disability insurance policies, and every company has different terms. It is not always wise to simply buy the cheapest policy, because that policy may not ultimately do much—most people look for their policies to replace between 45% and 60% of their income.
Disability insurance regularly includes paid sick leave for a set amount of time as well as benefits for both long-term and short-term disabilities. Some employers offer this type of insurance, particularly if they provide other forms of insurance.
Even if your employer does not provide it, however, there are many types of private disability insurance available to you. Many companies on the open market will offer a wide variety of packages. You can purchase High Limit Disability Insurance if you make over a certain amount. This kind of insurance is usually on top of your basic disability insurance, and increases the benefit limit for those who make a lot of money.
The best way to find the best policy for you is to simply do your research! Use the free online quote tool to see what kind of policies and rates are available to you in the case that you become disabled or already are.
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