Disability insurance is designed to protect an individual's ability to earn an income should the insured suffer an illness or injury that affects his or her ability to work. Disability insurance is intended to protect against illnesses and injuries which may occur in the future (that is, at any point in time after the disability insurance policy is in effect) and is really not meant to offer protection from illnesses or injuries that the insured might have upon application.

Nevertheless, there are certain illnesses and injuries which may not prevent an individual from purchasing disability insurance but might affect the premium her she will pay and perhaps the manner in which the policy is issued. Disability income insurance underwriters deal with the fact that there are a substantial number of physical impairments and conditions that will result in a substandard underwriting decision.

Some very common conditions that result in a substandard underwriting decision regarding disability insurance include joint problems such as arthritis and tendonitis. Back problems make up a very significant percentage of impaired risk cases in disability insurance underwriting. Disorders of the nervous system also give rise to substandard underwriting decisions and disorders of the nervous system may include anxiety, neurosis, and a host of other related problems. In recent years, there have been a rapidly escalating percentage of disability insurance claims resulting from psychological disabilities. Individuals suffering from relatively minor forms of anxiety and depression may find it difficult to acquire disability income insurance.*

Substandard underwriting in disability insurance may be handled in one of several ways. This could include an extra premium, a shorter benefit period, unavailability of certain riders, exclusions and other limitations and/or a combination of some or all of these approaches to underwriting disability insurance. Other modifications may be made to a disability insurance policy that are not medically related and could include hazardous or dangerous activities such as scuba diving or rock climbing, poor driving record, etc.

A considerable number of disability insurance applications result in either a decline or some sort of modification. Fortunately most applications will not require any sort of modification or be declined. Disability insurance underwriters attempt to achieve results in their impaired risk business similar to their unimpaired business.

An exclusion may be problematic insofar as the individual's perception of what may be reasonable. In other words, an individual who has had surgical repair to a herniated disc several years ago and has resumed a completely normal lifestyle might disagree with an underwriter's decision to offer a disability insurance policy with a back exclusion. However, without the ability to add an exclusion to a disability insurance policy, it is quite possible that the insured might not otherwise be able to get disability insurance. Many other things can happen to an insured and being able to purchase protection from other potential disabling threats is still most important to financial well being. The total exclusion is designed to prevent any benefits from being paid for any disability relating to the impairment.

The disability insurance policy might state that it will exclude coverage for any loss resulting from or due to any back injuries or back problems. Disabilities relating to the back are quite common. Low back pain is a prevalent form of a back impairment and is often due to mechanical strain such as heavy lifting or overexertion and often affects how a disability insurance policy may be issued. Low back pain may tend to limit motion and can create disabilities. Back problems can recur very often or may occur intermittently over the years. Another common back problem is the rupture of the disc in the lumbar area. This can create severe back pain and sometimes sciatica. Surgery is often required for ruptured disks. This normally results in a modification such as an exclusion in a disability insurance policy. Sometimes rest can allow a disc to heal, especially in cases when the rupture is not severe.

Problems with the back can involve discs, vertebra, muscles or ligaments. Due to the highly unpredictable nature of back problems and the significant possibility of recurrence, exclusions or modifications to the disability insurance policy are quite common. The factors that may of play a role in the ultimate decision include age, possible disc involvement, prior disabilities relating to the back, amount of time passed since occurrence and number of recurrences, occupation and height and weight.*

* Information taken from Disability Income Insurance the Unique Risk pp. 172-179, ©1998 The American College, ISBN 1-57996-003-0.