WebMD Feature
Reviewed byLouise Chang, MD
"People tend to think about disability in terms of catastrophic events, like a terrible car accident that leaves you paralyzed or in a nursing home," says Richard Frank, PhD, deputy assistant secretary for disability, aging, and long-term care policy at the Department of Health and Human Services in Washington. "They don't think about disability caused by things that are less dramatic and much more common."
Conditions such as arthritis, back pain, heart disease, cancer, depression, diabetes, and even pregnancy are some of the leading causes of disability in the U.S.Here's the rundown of the most common disabling conditions -- along with advice about how you can protect yourself from the costs of disability.
Common Conditions that Cause Disability
- Arthritis and other musculoskeletal problems. These are the most common causes of long-term disability. They make up as much as a third of all disability cases. Arthritis is probably the biggest single cause. About one in three people say that arthritis affects their ability to do their jobs in some way, according to the CDC. Other muscle and joint problems -- bad backs, bones that never mend, bad hips -- are common causes of disability too, says Matt Tassey, past chairman of the nonprofit Life and Health insurance Foundation for Education (LIFE).
- Heart disease and stroke. While we tend to think of cardiovascular disease in terms of sudden medical events -- like a heart attack or stroke -- it's often a chronic condition. People live with heart disease for years or decades. It can severely limit their ability to work. Studies estimate that heart disease is now the reason for 17% of all health costs in the U.S.
- Cancer. While cancer itself can be disabling, treatments such as surgery, radiation, and chemotherapy can also make it difficult to work.
"Cancer is the fastest-growing cause for disability claims," Tassey says. Why? In part, this reflects a rising rate of cancer, he says. It could also result from more effective treatment. "We're doing medical miracles today," he says. "People are living much longer after a cancer diagnosis than they once did."
- Mental health problems. You might think of disability as physical, but mental health problems can make work difficult or impossible. Depression, bipolar disorder, and other conditions can be as disabling as any physical illness. Mental health problems are the most common reason that people file for Social Security disability, Tassey tells WebMD.
- Diabetes. As a cause of disability, diabetes is rising fast, Tassey says. Along with obesity, it's linked to a number of serious health problems, like heart disease. Diabetes is a costly disease to manage too, in part because of the drugs and supplies. Typically, treating it without health insurance costs between $350 and $900 a month.
- Nervous system disorders. This category includes a number of conditions -- multiple sclerosis, Parkinson's disease, ALS, epilepsy, Alzheimer's disease, and other conditions that affect the brain or nerves. MS is a leading cause of disability in young adults. It most often appears between ages 20 and 40.
- Pregnancy. You might not think about pregnancy as a disabling condition. Since most women in the U.S. don't get paid maternity leave, it effectively is. The Family and Medical Leave Act offers up to 12 weeks of unpaid leave. However, it isn't available to many women who are self-employed, work at small businesses, or who haven't worked long enough with an employer to be eligible. Some employers and a few states offer women short-term disability payments for pregnancy. The rest have to get by using sick days and vacation.
Long-term disability caused by pregnancy is relatively rare. Women who wind up needing bed rest while they're pregnant or who suffer from complications afterward -- like postpartum depression -- can face serious financial stress.
- Accidents. Although surveys show that people assume accidents are the most likely cause of disability, they are actually the cause of less than 10% of disability cases. This category includes not only accidents at home or on the road, but accidental poisoning too.
What You Don't Know about Disability and Medical Costs
People tend to have only a vague -- and often wrong -- idea about what might happen if they become disabled, says Barry Lundquist, president of the Council for Disability Awareness in Portland, Maine.
Here are some of the common notions people have about how they'd cope with the costs of unexpected disability.
- I'd use vacation time. That might work for an injury that heals quickly. But Lundquist points out that your time off might be used up in a month or less. The average length of a long-term disability is 2 1/2 years.
- My health insurance covers disability. You might be right. Are you sure? Many people have only a vague idea about what their health plans cover.
- My spouse's job will protect us. If you and your spouse both work, your household will at least have some income if you had to stop working. Even so, does your spouse really make enough that it wouldn't be a problem to lose your entire salary? For many people, the answer is "no."
- Social Security and Medicare will cover me. Social Security disability benefits are hard to get. Half of all people are declined when they first request them. The average payment is under $1,100 a month. Medicare doesn't cover long-term care unless it's deemed medically necessary. Medicaid does cover long-term care, but only for low-income people.
- Workers' compensation will cover me. Only 10% of disability cases are caused by eligible on-the-job injuries, says Lundquist.
- I don't need much to get by. Becoming disabled adds extra costs for health care, medical supplies, and support. "People don't realize that it costs more to be disabled than it does to work," Tassey says.
Protecting Yourself from the Medical Costs of Disability
"If you can't work and lose your income, your whole world can fall apart quickly," Tassey says. "If they stopped being able to work, most people are only about 90 days away from bankruptcy." Studies have found that medical problems play a role in more than 60% of bankruptcies and half of all foreclosures.What can you do to guard against the risks of disability and high medical bills? Here are some tips from the experts.
- Go over your health insurance policy. Don't just assume your coverage is good. Read the booklet your insurer sends. Ask your benefits advisor at work if you have questions. Settling health insurance issues is important before you get sick. Although the Affordable Care Act of the health care reform law will prohibit insurers from denying people coverage because of preexisting conditions, it won't take effect for adults until 2014.
- Get disability insurance. Experts say that anyone who depends on her salary needs disability insurance. See if you can get it through work. You should purchase it as soon as possible. Trying to get disability insurance when you're older -- or diagnosed with a health problem -- is a lot more difficult.
- Look into long-term care insurance. It's not right or affordable for everyone. But long-term care insurance will cover some of the costs if you become disabled and need home health care or a stay in a nursing home.
- Improve your lifestyle. Do what you know you should be doing: Exercise regularly, eat a healthy diet, lose weight, reduce stress, and get enough sleep. Improving your lifestyle could dramatically reduce your risk of heart disease, diabetes, cancer, and many other conditions. Even if you already have been diagnosed with a health problem, changing your habits can still have a big benefit.
"Your income pays for everything -- your mortgage, your savings, your kids' college, and your retirement," Lundquist says. "Your ability to work is your greatest asset. You should do what you can to protect it."
