4 Things to Know About Family Leave and Your Income

Mother holding a baby.Becoming a parent is an extraordinary and, at times, stressful endeavor. Your life is about to fundamentally change. And as you plan the myriad dimensions of this new reality, you may be wondering how you’ll cover all the bills while you take time off work.

Family leave is a complex issue and it requires a good amount of research. Begin by reading your employer handbook or asking a co-worker how they dealt with family leave and what they were offered. Consider what will work best for you, in terms of the time you’d prefer to take off work. If you do become pregnant, make sure you let your boss know before anyone else. Embrace it enthusiastically as an opportunity for growth. As Carol Walker, president of the consulting firm Prepared to Lead tells the Harvard Business Review: “Planning for your maternity leave is an opportunity to demonstrate to everyone that you’re in the game.”

Here are a few ways you can replace your income during family leave:

Paid Family Leave

This is the ideal situation of course, but don’t hold your hopes up too high. The National Compensation Survey (NCS) conducted by the Bureau of Labor Statistics, revealed that just 14 percent of civilian workers had access to paid family leave in 2016. There are a few states who are pioneering paid leave: These include California, New Jersey, and Rhode Island, and New York joined the group in January 2018. If you work in the tech industry, you could also be in luck: Tech companies offer some of the best family leave out there. Ask your HR team or boss if they offer this benefit.

Short-Term Disability Insurance

Short-term disability insurance is another way to protect your income when you cannot work due to an illness or injury. This includes pregnancies — and it’s very commonly used for this purpose by employers. Short-term disability insurance plans often cover six weeks post-partum. It covers a portion of your income — normally around 60 percent. Several states such as New York, New Jersey, Hawaii and Rhode Island have short term disability laws in place. You can also purchase this form of insurance as an individual.

Unpaid Family Leave

The vast majority of American workers don’t have access to paid family leave (88 percent according to the NCS study). So your next step is to see if you qualify for unpaid family leave — which keeps your job intact although it doesn’t offer a salary. The federal Family and Medical Leave Act (FMLA) was signed into law in 1993 and it guarantees eligible workers up to 12 weeks of job-protected, unpaid leave per year. FMLA does have its limitations though: it only applies to companies that have more than 50 employees within 75 miles of your workplace. You also need to have worked there for at least a year and put in a minimum of 1,250 hours. Laws around this also vary from state-to-state so you’ll need to research your local situation. FMLA applies to giving birth, adopting a child, or fostering a child — and it can also be used in the cases of caring for a spouse or parent with a serious health condition. There are ways of making it work while on unpaid leave—you just need to plan well.

Paid Time Off (PTO)

Many people will use some of their PTO to cover their income for part of their leave. Your workplace may require you to use up your accumulated PTO before benefits can kick in. Others will allow the benefits to begin immediately, which may allow you to use some of your PTO to extend the length of time you can stay at home.

Take the time to educate yourself on the benefits that apply to you. Know your rights and don’t be afraid to try to negotiate a better deal. If you are just starting to think about having a child, now is a great idea to build out a financial plan to help avoid the stressors down the line. With a plan in place, you can relax and enjoy the extraordinary gift of welcoming a new life into the world.

Five Tips for First Time Disability Insurance Shoppers

Long-term disability insurance. It’s not as immediate a need as health insurance, and you probably don’t think it works into your long-term financial plan as much as life insurance does.

But it’s still really, really important.

Long-term disability insurance is, at its core, income replacement. It can help you make ends meet when you’re unable to work without needing to completely drain your emergency fund or other savings. So why isn’t it as popular as other insurance types?

If you’re a first-time long-term disability shopper, it can be easy to find yourself overwhelmed or confused with this unfamiliar topic. But if you get to the core of what a long-term disability insurance policy can do for you, and cut through the noise of agents trying to upsell you on things you don’t need, it’s pretty easy to see the benefits.

Here are five questions every first-time long-term disability insurance shopper should know the answer to before they start hunting for a policy.

Do you need long-term disability insurance coverage?

In short, yes. You should have some sort of income protection; one in four workers will become disabled at some point in their careers, usually from an illness like cancer. But the bills won’t stop, even if your paycheck does. The last thing you want is to worry about unpaid bills, on top of recovery.

The good news is that you might already have it. Disability insurance was provided by over 200,000 employers in 2014, so there’s a chance that you are either enrolled in some sort of disability insurance plan, or have the option to enroll. It’s important to know this before you start your shopping journey: If you already have an employer-sponsored disability plan, the supplemental long-term disability insurance you can buy on your own may be limiting.

The point of this guide is to give you the basics of what you need to know about long-term disability insurance.

Some coverage is better than no coverage, so the most important thing is to make sure you have protection. A licensed broker can walk you through the confusing parts and help you make the right decision for your financial situation, but you should at least know where to start.

What are the basics of long-term disability insurance?

Long-term disability insurance covers just that – long-term disabilities. This is generally defined as a period of longer than 90 days of being unable to work due to an injury or illness. It’s only available for people who work over 30 hours a week (the accepted definition of working full time).

  • Elimination period – This is how long it’ll be before your long-term disability coverage kicks in. Also called the waiting period, you’ll usually see it in periods of 60, 90, 180, or 365 days. The longer your elimination period, the lower your premiums, but policies are usually very cost-effective with 90-day elimination periods.
  • Benefit period – How long your benefits will last. You usually have the option to choose between 2, 5, and 10-year periods, or until retirement age, or until you return to work. The longer the benefit period, the higher your premiums.
  • Replacement rate – The amount of your monthly pre-tax income that you’ll be able to cover. You can choose a monthly benefit up to the maximum allowed, usually 60% of your gross pay for most policies. The higher the replacement rate, the more expensive your policy.
  • Own occupation – Generally, your disability should be “own occupation” – that is, you’re considered disabled if you can’t do your own job, as opposed to being considered disabled only if you can’t do any job (known as “any occupation” which, obviously, is a very different definition). For more information on occupation definitions when it comes to long-term disability insurance, check out our full primer here.

How do you know how much coverage you need?

When you’re trying to decide how much long-term disability coverage you need, you need to consider two things: How much money you need coming in, and how long you need it to last.

The amount of income replacement you need depends on your individual circumstances. Your lifestyle, and the amount of money you need to cover your everyday expenses, will be the biggest driver. It will also depend on how well you’re able to self-insure. For most people this comes in the form of an emergency fund. While this can help in the short-term, most emergency funds are only meant to last around six months, up to a year at the most. Many people won’t have an emergency fund that can last multiple years, and dipping into other savings, such as an IRA, comes with a penalty.

Remember those benefit period lengths we talked about in the last section? While you can get coverage that lasts all the way to retirement, the average disability claim is around three years. That means a long-term disability policy with a benefit period of five years will cover most instances of disability.

What affects the price of your long-term disability policy?

As mentioned, the elimination period, benefit period, and replacement rate will all affect your premium. However, there are some things about yourself that will also determine how much you’ll pay for a long-term disability insurance policy. Some of them will be familiar if you’ve shopped for other types of insurance products, they include:

  • Your occupation. Some jobs inherently put people more at risk of a disability than others. A landscaper will likely face higher rates than a writer.
  • Your age. Since older people are more at risk of becoming disabled than younger people, rates will increase the longer you wait to apply for long-term disability insurance. In the next section, we’ll talk about how you can lock in rates if you apply when you’re younger.
  • Your gender. Long-term disability policies for women typically end up being more expensive than for men.
  • Your health. The insurance carrier will want to know your current health and health history to predict your chances of becoming disabled. They do this through underwriting and a basic medical exam. Essentially, a short, free physical with a blood test. Pre-existing conditions may cause the insurer to shorten the benefit period. Or the insurer may include exclusions for certain conditions that won’t be covered.

What riders are available?

An insurance policy isn’t a one-size-fits-all deal. Every situation is different, and policies need to reflect this fact. That’s where riders come in.

Riders are a way for you to customize a standard policy so that it better fits your needs. There are two main caveats when it comes to riders. First, features that are riders with some insurers might be standard fare with other insurers. You might be paying more for the same features depending on the carrier.

Second, riders can increase the cost of a policy. Your choice of riders depend on your individual needs and what your budget can support. Know your options, but talk to a licensed agent about what each rider will do to your policy’s cost.

Common riders for long-term disability insurance policies include:

  • Non-cancelable rider – Looking to lock in your rates for as long as you pay your premiums? A non-cancelable rider will let you do that. That means your policy stays affordable for as long as you need it – a great incentive for getting protection early!
  • Future increase rider – We already talked about how your health affects your premiums. But what if you decide down the line that you need additional coverage? If it’s been 10 years since you first applied and your health has gotten worse. What does that mean for your options? With a future increase rider, your medical insurability is locked in. Therefore, in the future, when you need coverage that corresponds to your new earnings, you can increase it regardless of changes to your health.
  • True own occupation rider – Remember at the beginning of this guide when we talked about “own occupation” being part of the definition of disability? Well, there are actually a few different levels of own occupation (we go into them in-depth here). A true own occupation rider means that if you can’t work in your own occupation – even if you start working elsewhere – your benefit will be paid.
  • Residual disability coverage rider – Let’s say you’re still able to work but your disability has reduced your capacity to do so and you’re making less money than you were pre-disability (for example, you’re only able to work part-time now). A residual disability coverage rider will allow you to receive partial benefits. That way you can make up the difference in income amounts.

Remember, getting some long-term disability insurance coverage is better than having none at all. This guide is your introduction to the world of long-term disability insurance, and now you’re ready to get some free long-term disability insurance quotes in minutes. But there’s always a helpful Policygenius expert a call (or email, or chat) away to answer any questions you have once you start on your journey.

This article originally appeared on Policygenius.

What is the Impact of High Student College Debt?

Student loans and the increasing size of their associated debt continue to grab headlines. The ongoing political environment and upcoming presidential election is significantly increasing the discussion of various proposals and ideas.

From a historical perspective student loans are certainly not new. The debt levels, however, are even more evident when you look at the debt loads of those who continue their education beyond the traditional four-year degree. And the problems created by student debt (either from the pursuit of secondary or advanced degrees) continue to be a concern after former students enter their first full-time jobs.

In addition to all the necessary purchases you need as you embark on your life journey, carrying a large debt load hampers you the most. And if you have any type of accident or illness that takes you out of work, this debt is exacerbated. You must deal with the extra costs associated with disability and medical costs – without an income – and still repay your loan. For the vast majority of people in this situation, the loan payments still due (unless you become permanently and completely disabled), and the risk of loan default is high. This can be very detrimental to you, your families, and your financial future.


Several insurance carriers studied the significant growth in college and post-graduate debt and responded by adding riders to their traditional disability insurance policies to address the continued loan repayment requirement. These outstanding student loans, in addition to the other financial stresses a disability can create, can be mitigated by the purchase of this rider. While certainly not a panacea, having such a program might help you focus on recovery if you need to leave work if you had an accident or a health issue.

I designed the remainder of this article to ensure you have a clear understanding of the breadth of the student loan debt issue.


Quick Student Loan Statistics1
• $1.56 trillion in total U.S. student debt
• Average student loan debt per borrower: $32,731
• 11.5% of student loans are 90 days or more delinquent or are in default
• Number of student loan borrowers: 44.7 million
• Student loan debt for borrowers 60 and over has increased by 1,256% since 2004

People use student loans to meet the cost of higher education when you or your family’s personal resources, grants and scholarships are insufficient to cover the cost of attendance. For low-income students, loans are a huge factor that enable them to go to school. These loans typically cover tuition, room and board, meal plans, textbooks, and miscellaneous necessities.

During repayment of student loans, renegotiation and bankruptcy are strictly regulated.2 As with most types of debt, student debt defaults are turned over to a collection agency, which can impact your financial well-being for years.

In 1992, the federal government began directly funding student loans and also established unsubsidized Stafford loans for students whose financial needs were not fully met by the subsidized loan program. The financial turmoil of the Great Recession caused most private lenders to stop making subsidized loans, and the federal government became the main issuer of student loans. Then, in 2010, the Health Care and Education Reconciliation Act of 2010 required all federal loans to be direct loans.


It’s important to note that private lenders offer student loans, but these are generally more expensive than federal loans.3

One factor that contributes to the amount of money you have to repay is the interest rate you pay on any loans you carry. Another factor is the new guideline developed by the federal government, which now determines who qualifies for a loan and how much they can borrow.

A third factor to keep in mind when applying for student loans is that colleges and universities continue to increase the tuition and housing costs, which subsequently increases the debt you will take on. According to the American Center for Progress’ report on the Student Debt Crisis, within the past three decades the cost of attaining a college degree drastically increased by more than 1,000 percent.4


Distribution of student loan debt in the U.S. 6

To place student debt in perspective, the average undergraduate student from the class of 2016 graduated with $37,172 in debt. This amount of debt can be a major burden. Monthly loan payments average $351, limit your ability to save money, and can lessen your quality of life.

In fact, 62 percent of college graduates reported that their monthly payments on debt were affecting their ability to pay their rent or buy groceries. Those with such debt report turning down luxury expenses such as concerts, and express concern over the ability to pay an electric bill. More than half of graduates say they put off major purchases, such as buying a car or a house, due to their debt.

The above factors influence the return of new graduates to their parents’ homes. Twenty-one percent of college graduates report still living with their parents a full year after graduation. Moving out of your parents’ house – and certainly buying a home – requires savings. Again, the need to repay your student loans reduces your ability to save money. This means, in turn, that graduates don’t put money away for emergencies; and they are certainly not putting money away for retirement.


On top of all of this, studies show that student debt is a problem long after you leave college. Just two decades ago, only four percent of people aged 55 to 64 still had student loan debt. That number is rapidly growing. In 2013, 30 percent of people in the same age group reported having debt from college.7


Another interesting thing to consider is how student debt varies when you consider race and gender. While most recent graduates have a high debt load compared to their first- year income, women and blacks are disproportionately carrying debt in comparison to their paychecks after leaving college.8


The issue of student loan debt is even more pronounced when you undertake post-graduate studies and specialized training programs. Graduate level debt statistics are frightening:

  • Dental School: $260,000
  • Medical School: $180,000
  • Pharmacy School: $160,000
  • Veterinary School: $140,000
  • Law School: $140,0008


Given the breadth and depth of student loan statistics, let me leave you with the key takeaways:

  • Student loans have lifelong effects. These effects can be seen throughout a person’s life and can continue into retirement.
  • These lasting effects of student loans are important for students to be aware of and prepared for.
  • Several insurance companies have added riders to certain disability insurance policies to help pay some of your ongoing loan payments while you deal with recovering from an accident or injury and being out of work.
  • Some employers are sponsoring benefits to help their employees either fund the college costs of their offspring, or help the employee help their children pay these loans.
  • While we should applaud people for their goal of attending college, careful consideration of the debt associated with attaining a degree and ways to deal with that debt should be considered.
  • People who go on with graduate studies or continue specialized training will most likely have even greater debt burdens as they enter the workforce.




1 Federal Reserve Bank of New York, Research and Statistics Group, 2018.

2 Forbes, Student Loan Debt Statistics In 2019: A $ 1.5 Trillion Crisis, February 25, 2019.

3 Forbes, Student Loan Debt in 2017: A $ 1.3 Trillion Crisis, February 21, 2017.

4 Fortune, America’s Student Loan Debt Crisis Is About to Get Much Worse, October 17, 2018.

5 Forbes, Student Loan Debt Statistics In 2019: A $ 1.5 Trillion Crisis, February 25, 2019

6 Student Loan Hero, A Look at the Shocking Student Loan Debt Statistics for 2019, February 4 , 2019 .

7 Magnify Money, Student Loan Debt’s Effect on the U. S. Economy, February 5, 2019.

8 Value Penguin, Average Student Loan Debt in America: 2019 Facts and Figures.

9 Make Lemonade, Student Loan Dept Statistics for 2019.

How Disability Benefits Can Support You

More than 155 million U.S. workers are insured for a disability through the Social Security Disability Insurance (SSDI) program. They receive this insurance coverage through their payroll taxes, or FICA taxes, as a part of the Social Security program.

When those who experience a chronic health condition, injury or sudden medical crisis need support – SSDI is there to help. It’s estimated that fewer than one in three U.S. workers have private disability insurance, which means their primary means of assistance, if they experience a work-disrupting disability, is SSDI.

Health conditions such as heart disease, cancer, arthritis, stroke and Type 2 diabetes are among the chronic illnesses that can interrupt someone’s time on the job. Sudden severe health issues include heart attack, aneurysm, traumatic brain injury or spinal cord injury.

These dire circumstances are when the SSDI program is most vital for former workers. The average SSDI recipient is 54 years old and has worked 22 years before a disability occurs and they apply.

The following are the top reasons men and women apply for disability insurance benefits:

1. Income to support yourself and your family. Men and women apply for disability benefits because if they’re approved, they’ll receive important income to sustain their households while they deal with stabilization of, and possible recovery from, their health issue. For some individuals, a health crisis may require 2, 3 or 4 years of treatment and rehabilitation to reach stability before returning to work. Without the ability to earn income, the SSDI program becomes a vital financial support. In 2019, the average monthly benefit for a disabled worker is $1,234, which is about $14,800 annually. For a disabled worker with a family, it increases to $2,130 per month, or $25,560 per year.

2. Health insurance for your medical needs. Another crucial benefit for people who apply for Social Security disability benefits is healthcare coverage through Medicare. Individuals approved for benefits will become eligible for Medicare 24 months after their cash SSDI benefits begin. For some, the wait to receive approval may last 24 months or longer, as they wait for the Social Security Administration to review their claim through appeals. This means many people are immediately able to access Medicare once the SSA approves benefits. Access to healthcare is especially vital for individuals with disabilities dealing with chronic health conditions and degenerative diseases, since ongoing, expensive treatment often can be required.

3. Protect your retirement benefits. Many individuals can discover an important protection by applying for disability benefits, called the “retirement freeze.” You may be aware that the SSA tracks your reported earning over the course of your working career to calculate your Social Security retirement benefits. This includes the years that you don’t work because of a disability: Those years are counted as $0 in earnings. However, if you apply for SSDI and are approved, this means those years with $0 earnings are not factored into your retirement benefit, with the potential to receive more in retirement as a result.

4. Protect your long-term disability income. For workers who have purchased long-term disability insurance benefits, they also receive an important protection. Most LTD insurance plans are designed to integrate with SSDI, so participating workers benefit from lower LTD premiums. Individuals can also benefit from immediate access to income following a disability with their LTD coverage, and then turn to SSDI as another source of support, including income, Medicare and other program benefits. Applying for SSDI provides a protection that can help ensure LTD benefits also continue for former workers.

5. Support for going back to work again. Another advantage when applying for disability benefits is the ability to receive return-to-work protections. Individuals can access important incentives when approved for SSDI benefits. These protections include a trial work period, 9 months over the course of 60 months (5 years), to try working and earning as much as you can and still receive SSDI benefits. Following this period, you have an extended period of eligibility of 36 months to be able to work, earn money and receive SSDI benefits whenever your earnings fall below a certain level. Many other incentives are available to help those who don’t want to give up on returning to work.

Live Confidently

By Katie McCord Jenkins, President and Chairperson, Illinois Mutual.

If you were to ask me what type of business my company is in, you might be surprised with my response: We are in the business of preserving dreams and enabling people to live fearlessly in a time when so many live paycheck to paycheck.

Yes, I see the value of purchasing disability income insurance (DI, as I often refer to it), life and worksite insurance products. However, I believe those products are merely the tools that allow people to achieve and safeguard their financial security.

When you form a financial plan, you are expressing your devotion to your loved ones. If you are unable to work due to an injury, illness or pregnancy, products like disability insurance make it possible to pay your bills and keep the dreams you have for those that matter most alive. I’ve learned that those dreams vary from person to person, but the result of enrolling for or purchasing DI is the same: a sense of financial security.

Take Alan, for example. Owners of a dairy farm, Alan and his wife, Stephanie, are living the life they always wanted for their family. They are grateful for their ability to meaningfully contribute to their local community and surrounding areas through the hard work they enjoy. Choosing to be business owners, though, is something of a leap of faith that naturally comes with some apprehension. Yet, it’s what people do in order to follow the dream of owning a business. In order to reduce some of the risks of being a business owner, Alan purchased a DI policy. He understood that protecting his income is key to protecting his way of life⁠—the life he and Stephanie have built for their family.

Alan explained: “Having this insurance has given us the opportunity to enjoy the positive things in life a little more and worry a little bit less about some of the negative things that can happen in life.” He knows that having an income protection plan in place empowers small business owners to live more confidently and actively pursue their dreams.

I’m passionate about the importance of having disability insurance as part of your financial plan – as were my grandfather and father before me. There are a number of good carriers in the country who believe, as I do, that we can never forget that our job is to serve you. We work to fulfill our promise to pay claims with a sense of compassion and understanding that reflect the mountain of details that come along with experiencing a disability and being out of work.

We recently heard from a mother whose daughter, a professional single mom in her 40’s, suffered a stroke: “I bought a van with an access seat. A seat in the middle row will slowly make a 90-degree turn. It will tilt back and lower my daughter to the ground level. This van has been the most wonderful gift from God. The van was perfect. Without [the disability insurance check], I could have never afforded it. Thank you for your help.”

I am truly energized by the work my company does every day because, just like me, people are going to work every day to provide for those who depend on them. We recognize the significance of those relationships and prioritize offering DI coverage as a benefit to our qualified employees at no charge for this reason. It’s our way of honoring our employees and their commitment to those who matter most to them.

DI is an insurance product that is a critical part of financial planning, and the impact of knowing disability income insurance is in place to keep dreams alive and enable more working Americans to live confidently is truly what it’s all about.

How Paid Family and Medical Leave Policies Can Impact How You Choose Your Benefits

Annual enrollment will soon be underway for many employees. During this time, workers choose benefits they feel are most important to protect their health and financial well-being. Understanding the benefits your employer offers and their associated costs are most likely key considerations for you.


In this post, I am going to focus on one type of benefit – disability insurance – that insures your income if you can’t work for a period of time. I’ll also explain how this type of coverage interacts with a variety of paid-leave policies and programs. I hope to unravel some of the mystery and confusing terminology associated with both paid leave and income protection insurance.


Income sources if you can’t work

There are different ways to sustain an income when you can’t work due to an injury, illness or pregnancy. Personal savings, state and employer-paid medical and family leave, Social Security disability benefits, and private insurance are all sources that may be available. How do these sources help, and do they provide enough income to help you live the type of life you want to live?


Do the Research and Weigh the Facts

Disability happens! Even minor illnesses, injuries and pregnancies with a short duration of recovery (such as a knee surgery) can interfere with your ability to work and earn an income. In fact:

  • If you were to keep track of the 20 -year-olds in today’s workforce, you’d find nearly 25 percent of them will be out of work for at least one year due to heath conditions before they reach retirement. (1)
  • Almost half of American adults indicate they can’t pay an unexpected $400 bill without having to take out a loan or sell something. (2)
  • 6 percent of working Americans will experience a short-term disability (six months or less) due to illness, injury or pregnancy on average every year. (3)  


Make the Time to Increase your Knowledge

Where will you find the money to live if you lose your ability to work? Understanding the different income sources available can help you make choices during annual enrollment that fit your needs.


Employer-paid leave benefits can provide you with some kind of a paycheck when you can’t work, however, this income may not last long enough to meet your needs. And it’s up to your employer to (a) provide these benefits, (b) determine how long you can receive them, and (c) decide how much you get paid. Some paid leave programs only pay a percentage of your income – and this income is taxable. Sick leave and salary continuation benefits are examples of these benefits.


State- and/or federal-provided leave programs can give you an income while you’re unable to work. These programs include worker’s compensation, Social Security Disability Income, and paid family and medical leave benefits. Worker’s compensation benefits pay a percentage of your income if you have an on-the-job accident or work-related illness that cause you to leave work. Social Security provides long-term benefits if you’re disabled for at least five months, are qualified to apply, and are unable to work at any type of job. If you are approved, you may receive benefits up to the normal Social Security retirement.


State-mandated paid family and medical leave is emerging in a growing number of states. This short-term benefit provides you with an income while you’re out of work for medical conditions, for the birth or adoption of a child, or caring for a family member. Benefits are typically provided from 12 weeks up to 1 year and can cover from 50 percent to 90 percent of your income.

Oregon is the first state in the United States to offer 100 percent income replacement for low-wage workers taking leave for family, medical or safety reasons. Oregon (and New Jersey) includes victims of domestic violence in its paid family leave law, and defines family broadly to include “any individual related by blood or affinity whose close association with a covered individual is the equivalent of a family relationship” – in other words, you get to take time off to care for someone who is like a family member to you.


It’s important for you to check whether you live and/or work in a state where paid family and medical leave is available.


State-mandated disability insurance

State-mandated disability coverage is another source of income available to residents in a limited number of states and territories, including Hawaii, California, New York, New Jersey, Rhode Island, and Puerto Rico. These statutory plans generally provide benefits for six months up to one year. They pay you 50 percent to 70 percent of your income with a weekly cap on the maximum amount you can be paid (for example, $1,216 per week in California and $113 per week in Puerto Rico).


Statutory disability plans supplement your income for a short period of time, so you may want to consider adding other insurance products if you want to receive a larger sum while you can’t work, or in case you are out of work for a longer period of time


Voluntary, worksite or supplementary benefits. Many employers provide options for you to participate in short-term and/or long-term disability insurance. These options are offered by insurance carriers and supplement benefits you may receive from your employer, state and/or federal government programs. You pay the premiums for these optional benefits, although you usually pay less than you would if you bought this insurance on your own.


Short-term disability plans provide benefits for three months up to one year (after you satisfy a waiting or “elimination” period).


It may take a long period of time to recover from certain health conditions and complicated surgeries. In order to protect yourself from this risk, you can carry long-term disability coverage. Long-term disability insurance pays you benefits after you’ve been out of work for three months up to Social Security retirement age (again, after satisfying a waiting period).


Make the Choice to Protect Yourself

It’s important to understand the benefits available to you and how they work together to provide you with an income stream when you can’t work. These benefits help you live your life the way you planned to live it should you become pregnant, ill or have an injury. Making decisions about these benefits during annual enrollment is not always easy, but it is important.


Talk with your human resources area, read the materials available to you before annual enrollment begins, ask questions to clarify your benefits and the cost to you, and learn how all benefits may work together.


Most employers provide online access to information prior to annual enrollment that you can read on your own time schedule. Many employers also offer videos prior to enrollment. And meetings with human resources and insurance professionals as well as online chat may be available to help you navigate your benefit choices.


Remember, what you decide today could affect the rest of your life. Protect yourself and plan for unexpected events. This will help you take control of your financial well-being and help you live a happier life.



1. Social Security Administration, Disability and Death Probability Tables for Insured Workers Born in 1997, Table A.
2. Ibid
3. Integrated Benefits Institute, Health and Productivity Benchmarking 2016 (released November 2017), Short-Term Disability, All Employers, Condition-specific results.


Beyond Your Benefits Package: Why Open Enrollment is a Great Time to Focus on Your Financial Wellness

By Rachel Barrow, Second VP Marketing, Individual Markets, Guardian Life Insurance Company of America.

If you’re like many Americans, your employer offers key benefits that provide valuable protection for you and your family. And you’re probably familiar with open enrollment season – that time each year when you may be able to choose your health insurance provider, explore tax-advantaged accounts like Health Savings Accounts and Flexible Spending Accounts, review and update retirement plan contributions, and elect employer-offered protection products, like disability and life insurance.


These “worksite benefits” are offered by your employer typically at a discounted group cost, with the option to further supplement those benefits with voluntary benefits (usually paid by you) that provide additional coverage for health and income. What many employees don’t realize, however, is that Open Enrollment season also offers them the perfect opportunity to look beyond their employer-sponsored benefits — to consider their entire protection strategy and financial picture.


Your financial wellness depends on a strong holistic plan that covers all aspects of your financial picture. While employer-provided benefits are a great start, it’s important to keep in mind that those benefit options are not ordinarily designed to protect all aspects of your financial well-being. Fortunately, you can also purchase individual products, such as disability insurance, life insurance and annuities, typically sold through a financial professional, that complement the benefits available through your workplace. Doing so can help to give you more complete financial protection and reduce the risks you or your loved ones could face without them.


Some risks to look out for

It’s important to concentrate on at least three risks to your financial well-being:

  • The risk of losing your income
  • The risk of losing your life
  • The risk of outliving your retirement savings


There are steps you can take to address each of these three risks. Doing so can help to protect both you and those you care the most about.


Protecting your income during your working years

The ability to earn a living is one of the most important things in life. Income is essential to your livelihood and closely linked to your overall financial well-being. But when it comes to protecting your income, many working Americans may not realize the need to make it a priority.


It’s easy to underestimate the potential effects of a disability. Yet, here’s a sobering fact: “The perfect storm of medical bills, loss of income, illness and injury — all consequences of a disability — are the leading cause of personal bankruptcy in the United States.”[i]


According to The Guardian Life Insurance Company of America® (Guardian), roughly 50 percent of people who leave work because of an illness or injury have trouble paying their bills. Not surprisingly, workers who struggled financially during and after a leave from work had lower financial wellness scores and were more likely to report that the experience had a major or devastating effect on their household.[ii]


Even if your employer offers disability income insurance, there may be an income gap. One in 5 workers who made a disability insurance claim were surprised to learn that their employer-sponsored disability plans replaced only a portion of their salary, not 100 percent, based on Guardian’s research. Higher-income employees were also dismayed to learn that bonuses and/or commissions were not included in the calculation of their disability income benefit payments.


While no disability insurance plan will ever replace 100 percent of your income, purchasing individual disability income insurance from a financial professional will boost the amount of your money you will receive if you can’t work. If this is important to you, you’ll be able to “weather the storm” a little better if you become ill or are injured.


Protecting your loved ones if something should happen to you

If you have family or others who depend on you for financial support, purchasing life insurance from a life insurance professional is among the most important steps you can take for the financial wellness of your loved ones. Even if your employer provides you with this important coverage, it may not provide enough to financially protect those you care most about. And, in many instances, you will lose that coverage when you leave your employer. That’s why purchasing your own individual life insurance policy to supplement any workplace coverage you may have is a smart move, depending on the type of policy you buy.


Keep in mind the valuable protection role that life insurance plays: If something should happen to you, your policy’s death benefit will help ensure that your survivors can maintain their lifestyle, avoid financial hardship or bankruptcy, and continue to pay essential bills such as their rent or mortgage, health insurance, college tuition and car loans. Simply put, life insurance is one of easiest and most affordable ways to protect your loved ones should they lose your salary.


Protecting your income in retirement

The risk of outliving your retirement savings is a real one. While people who qualify for Social Security benefits in retirement can expect to receive a monthly benefit for the rest of their life, 80 percent of those participating in the 2019 Retirement Confidence Survey reported they would also rely on money from an employer-sponsored retirement savings plan, such as a 401(k), for income in retirement.[iii]


One problem with that approach is these individuals risk running out of money in retirement, since the retirement income generated from a retirement savings account depends entirely on the individual’s account balance, the performance of the account’s investments and the withdrawal strategy used.


Eighty percent of survey respondents plan to work during retirement to supplement their income, yet only 28 percent are ultimately able to do this.


As with disability income and life insurance, there are steps you can take to help protect your income in retirement. In addition to contributing as much as possible to your employer-sponsored retirement savings plan, you may wish to consider purchasing other products from a financial professional, such as bonds and CDs, which can provide somewhat predictable returns, with possible tax advantages, and can help round out your investment portfolio.


Another option to consider is an annuity. By paying an insurance company a specified amount of money, you receive regular payments for a set amount of time, or for life. There are many different types of annuities that can provide you with cash flow right away (immediate annuities) or at some point in the future (deferred annuities).


Make the right moves for your financial future today

During open enrollment, it’s a good idea to consider your overall financial wellness, and address not only the benefits your employer provides, but protection products that can supplement those valuable benefits. Doing so will help you to address the risks to your financial well-being head-on. You have the power to make the decision to go with what you truly need based on your goals or concerns. Go through your options and be sure you can explain what you are buying. It all has to be clear and valuable for you.


If you need assistance in addressing any of these risks, a qualified financial professional can help you understand your options — and put you on the path to enhanced financial wellness.



Rachel Barrow leads the Product Marketing team for Individual Markets at The Guardian Life Insurance Company of America®. She has been with Guardian Life since 2009 and in the insurance business for over 20 years. Rachel and her team produce educational tools and resources focused on strategies to help individuals, families and small business owners achieve financial security. Check out her previous post: Time to Invest in You: Ways to Make Your Retirement a Reality


Guardian, its subsidiaries, agents and employees do not provide tax, legal, or accounting advice. Consult your tax, legal, or accounting professional regarding your individual situation.

Guardian® is a registered trademark of The Guardian Life Insurance Company of America©. Copyright 2019 The Guardian Life Insurance Company of America.



2019-86981 (exp: 9/2021)

[i] Medical Debt as a Cause of Consumer Bankruptcy, 2014 Maine Law Review (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2515321), Posted Oct. 27, 2014; last revised Nov. 11, 2015


[ii] Source: Income Protection: The Role of Disability Insurance in Financial Wellness, The Guardian Life Insurance Company of America, New York, NY, May 2019 https://www.guardiananytime.com/gafd/wps/portal/fdhome/insights-perspectives/emerging-trends/income-protection


[iii] 2019 Retirement Confidence Survey Report conducted by the Employee Benefit Research Institute and Greenwald & Associates, April 23, 2019 https://www.ebri.org/docs/default-source/rcs/2019-rcs/2019-rcs-short-report.pdf

Why Gen Z Will Receive Social Security Retirement Benefits

By Melissa Thomas, Vice President, Strategic Partnerships at Citizens Disability INTEGRATION.

Many people who are part of Generation Z (individuals born between 1995 and 2010) believe Social Security retirement benefits won’t exist when they’re ready to leave the workforce. And, they’re wrong. Chances are high that Social Security will survive for future generations — and that’s in large part thanks to the individuals who make up this generation and are contributing payroll taxes to the program.

A 2018 report from Morgan Stanley says it is more optimistic about the impact of Gen Z than the Congressional Budget Office. Its positive assessment of labor-force participation translates into a rosier view of the potential gross domestic product by 2040 (2.4 percent to 4.3 percent above the CBO). Morgan Stanley says the CBO is understating potential labor force growth by 0.2 percent to 0.3 percent per year between now and 2040.

If this analysis is accurate, the Social Security Trust Fund may not become depleted until 2062. It likely will delay the date of depletion for Medicare funds as well.

However, the most obvious benefit from millennials and Gen Z is their impact on corporate sales growth and earnings. “To the extent the rise of Gens Y and Z in the labor force supports a higher potential GDP growth rate in the U.S., this relationship would indicate a modestly higher potential longer-run growth rate for corporate sales and earnings,” the report said.

Sean Williams of The Motley Fool, like Morgan Stanley, believes Social Security Retirement is in no danger of going bankrupt, but that it’s highly likely that what Generation Z will receive each month will be less than what their parents or grandparents received on an inflation-adjusted basis.

Williams also cautions that there’s a pretty good chance that Gen Z will have to wait longer to collect their full retirement benefit than their parents or grandparents did. Since 1960, the average life expectancy in the U.S. increased by about nine years. Meanwhile, the full retirement age – the age where you become eligible to receive 100 percent of retirement benefit, as determined by your birth year – will have increased by just two years, to age 67, between 1983 and 2022. With the American public living longer, it’s only logical to expect the full retirement age to increase over time.

Concerns about Social Security’s solvency goes well beyond Gen Z. More than three-quarters of Americans are concerned Social Security will not be there for them when they are ready to retire, according to a June 2018 Transamerica survey. Another 41 percent of workers are planning to work in retirement or past age 65 because they are concerned their Social Security benefits will be less than expected.

But, in recent months, lawmakers introduced numerous bills to fix Social Security, including Connecticut Democratic Rep. John Larson’s Social Security 2100 Act. The 2100 Act would ensure Gen Z’s receipt of Social Security retirement benefits and increase Social Security benefits across the board by switching to a more accurate measure of inflation. Not surprisingly, this bill would be funded by increasing related payroll taxes.

Kathleen Romig, senior policy analyst at the Center on Budget and Policy Priorities, a progressive think tank, believes allowing Social Security’s trust funds to fall short would create massive chaos, and affect all retirees, as well as widows, children whose parents have died, and those with disabilities. “Even if it comes down to the eleventh hour, they’d fix it at the eleventh hour,” Romig said.

Gen Z workers can get an idea of how much they should expect to receive in Social Security by creating an account with the Social Security Administration.

Keep in mind that Social Security benefits are only expected to replace about 40 percent of working wages. This means Social Security should be nothing more than a Plan B in your retirement strategy, and that saving and investing should become one of your top goals during your working years.

Single Women’s Guide to Financial Wellbeing

If you’re a single woman today, you’re in good company: The number of single adults in the U.S. continues to increase—from 39 percent in 2007 to 42 percent in 2017, reports the Pew Research Center. The rise shows no signs of abating. Many people are choosing to wait until later to get married, if at all. Although there is freedom in spending your money as you wish, as a single woman you might be slightly apprehensive about your financial future. A study by MassMutual finds that indeed women are more anxious about their current and future financial status than men—more apt to worry about household finances now and less confident in their eventual retirement security. But the good news is that there are several doable steps that single women can take to feel financially confident

SIX Ways Single Women Can Watch Out for Their Own Financial Wellbeing: 

  1. Have a Plan for Retirement Savings

Most couples find it easier to save because they have two incomes coming in—and they are sharing costs such as housing expenses, which can make it easier to allocate more for savings. However, single women need to approach their savings goals as aggressively, and it seems they aren’t. The MassMutual study found that women were three times more likely than men to say that they couldn’t afford to contribute to their retirement savings plan. But, that can be catastrophic because you will potentially not have someone to share bills with now or in the future. In fact, it turns out that women need to save more for retirement in the first place—simply because they are more likely to outlive men. The Centers for Disease Control and Prevention finds that women tend to live about five years longer than men.

  1. Boost Your Financial Literacy

A survey for Merrill Lynch found that half of women lacked confidence in managing their investments—a gap of 16 percent between women and men—even though they reported feeling nearly equally capable as men in other financial tasks, including budgeting and paying bills. In fact, 61 percent of women would rather talk about their own death than money, the study reports. But learning about investing is not only necessary—it can be fun and fascinating.

Vow to sit down with a financial advisor. Discuss vehicles that might be right for you, from IRAs to mutual funds. Ask your human resources department if they offer any financial education; it’s quite likely they do as it’s a growing benefit—today 83 percent of employers offer a financial wellness program, up from only 20 percent in 2015, finds a study by the Society for Human Resource Management (SHRM).

  1. Regularly Contribute to Your Emergency Fund

Planning for an emergency is wise. As we know, taking a loan or putting an unexpected expense on your credit card can just extend the pain in the form of interest rate payments. If you are single, you might need a more ample emergency fund than your married counterparts. In fact, a recent article in Kiplinger says that some financial planners recommend single women, specifically, keep between nine and 12 months of living expenses available, compared with only three to six months for couples.

  1. Take Care of Crucial Paperwork

A wedding often spurs couples to consider their financial future. From living wills to power-of-attorney forms, it forces them to focus on serious life considerations. As a single female, you should make sure you have updated sets of paperwork; you can access advance directives specific to your state here, and a sample power of attorney can be accessed here. Your doctor may also have a form you can fill out specific to that hospital and practice. Talk to a financial advisor to find out about other paperwork you should have. Be sure it is notarized as appropriate.

  1. Buy a Home If and When It Makes Sense for Your Situation

If you’re contemplating a home purchase as a single woman, you’re not alone: Women now are the second largest homebuying group following couples, surpassing single male homebuyers, finds the National Association of Realtors®’2018  Profile of Home Buyers and Sellers. Just make sure you’ve thought through all the costs related to a home, including maintenance and insurance, to ensure that it’s a financially savvy move, compared with renting.

  1. Don’t Skimp on Insurance, Including Disability Insurance

In a new survey of the awareness and ownership of disability insurance across today’s workforce, The Council for Disability Awareness (CDA), uncovered that among all single women in the U.S. whether never married, divorced or widowed – nearly 1 in 3 said they were “extremely unprepared” for any period of disability if they should lose their income. That number equates to roughly 10-million women in America. What would you do if you were forced to take a leave from your job because of an accident or extended illness?

Without a partner to cover the bills, this work lapse can be devastating to a single woman. That’s why disability insurance may be even more important for single women, considering that more than a quarter of today’s young adults aged 20 will likely be out of work for at least one year at some point in their career. Make sure to talk with your human resources department about your options as a way to safeguard your income.While single women often have more freedom with their finances, that comes with responsibility as well. Take care of your financial wellbeing is a gift you give yourself.  

Podcast: Living and Working With Endometriosis


Carol Harnett [00:00:00] Hi everyone, this is Carol Harnett. I’m the president of The Council for Disability Awareness. Welcome to our show: the Financial Health and Income Network.  I am very excited to launch what we hope will be a continuing series with people who are working and living with chronic conditions, illnesses and diseases.  I am so pleased to say that our first topic will be on endometriosis.


You can hear the full podcast or if you’d rather read than listen, we captured the transcript from the conversation below.


Carol Harnett [00:00:32] I’ve worked in and around healthcare my whole life, and worked around the data in healthcare my entire career, and I have never thought about endometriosis as a separate category.  What brought it to my attention is my guest, Tawnia Jacobson. She is a nurse who has a master’s degree in Science with a concentration in Biology, and is also a Certified Nurse Anesthetist.

I often put firewalls between the different parts of my life. This is one of those times when I let the different parts of my life blend together. Tawnia is also my CycleBar instructor, and that is how I came to know her. She did something that I think has a high degree of impact for everyone around health and particularly for women with endometriosis.

During the month of March, which is an awareness month for endometriosis, she shared publicly through her Instagram account, her experience with endometriosis along with a lot of very important facts. The one that captured me the most is that 1 in 10 women in the United States have endometriosis, which is the same as the diabetes rate in the United States.

When we think about the amount of time and energy that we put around diabetes, which we should, we don’t put any time and energy around addressing endometriosis. So, Tawnia, thank you so much for being willing to join us today and talk with us and educate us on this topic.  

Tawnia Jacobson [00:02:05.40] Absolutely Carol. Thank you so much for having me.  This is an extremely important topic for everybody, but obviously near and dear to my heart with personal experience.

Carol Harnett [0:02:18.42]: For that reason, I want to turn a lot of the show over to you. I would love you to start, if you don’t mind, first with grounding people with a definition of what endometriosis is, and then your story as it relates to that.

Defining Endometriosis

Tawnia Jacobson [02:37.08]: Endometriosis, by definition, is a systemic disease that occurs when tissue that normally lines the inside of your uterus is found elsewhere in the body, mostly in the pelvis or the pelvic cavity. But it can also appear on the bladder,  the bowel, the lungs (into the diaphragm) , and even the brain, in worst-case scenarios.

It causes pain, organ dysfunction, and infertility. The cause of endometriosis is unknown, but there are many theories surrounding it.  Genetics, stem cells, blood and lymph system distribution are all possibilities. Inflammation is a key factor, and they believe that maybe some environmental toxins may be linked to it.  Again, no definitive cause, and the diagnosis unfortunately takes a very long time. As Carol mentioned, the prevalence is extremely high, it’s 1 in 10 women. So if you yourself don’t have it, absolutely somebody you know has it or may not even know that they have it, but are experiencing signs and symptoms of having endometriosis.

A Challenging Diagnosis

Tawnia Jacobson [0:04:00.16]: A lot of people ask why it takes so long to diagnose and it’s mainly because most obstetrics and gynecology doctors themselves don’t even know that much about it. The average patient will see eight to ten doctors before they receive an actual diagnosis. After years and years of pain and suffering, many patients are told that it’s “in their head”, that it’s just “IBS” — irritable bowel syndrome — because so many of us have so many bowel symptoms that go along with this.

When it’s confused to be a GI issue, you might be sent away from your GYN (gynecologist), to a gastroenterologist and go through every process and procedure known to man for that, and really that’s not the initial cause. With a lot of confusion and pain, it becomes a mental battle and game for many patients and it’s very frustrating.

I can now back up and talk about my story.

Tawnia Jacobson | Symptoms: Pain, Heavy Menstrual Bleeding, Fatigue, Migraines

Tawnia Jacobson [0:05:05.25]: I would say that this whole thing probably started for me when I started menstruating at the age of 16. With heavy, heavy bleeding, I missed many days of high school. I was fatigued. I would get headaches. My mother actually had a history of very heavy periods as well, and had a hysterectomy at the age of 30 because of heavy bleeding. She couldn’t handle it anymore. At the time, whether they knew or not that she had endometriosis has really been left to be discovered, but it doesn’t matter. They performed a hysterectomy to treat her pain and bleeding, and that’s all I know. My mom kind of just said, “Yeah, I had really bad periods, too,” and we went about business and life. When I moved to college, the pain was worse. I would be knocked out for at least a week at a time in addition to the week of premenstrual symptoms.

One Solution | Birth Control

Tawnia Jacobson [0:06.10.01]: I finally started seeing a GYN (gynecologist) early in college who suggested birth control. She diagnosed me with menstrual migraines. She thought if we could even out my hormone swings it would prevent my migraines. Then, obviously, if I wasn’t bleeding, I wouldn’t have as much pain or symptoms of cramping and bleeding.

I went on birth control early on, probably by the time I was 19, and stayed on birth control for about 7 years. I came off birth control at about 2008; (we can talk a little bit more about how birth control can suppress endometriosis symptoms later).

Without being able to remember too much, in general, I just always felt crappy around my period. I was exhausted. There were probably days — many days — when I called out of work. But the bleeding was so intense that I would have to take extra clothes with me everywhere I went because I would easily bleed through what I had on.

Again, I was just always told it was normal. Even my GYN was like, “Yeah”, some people just get this. This is normal.” She offered me narcotics to deal with the pain. I never took them as I am not the type of person who would even take Ibuprofen regularly. So I spent a lot of time in bed, a lot of time sleeping with heating pads, and just dealing with it.  This continued for years and years.

Next Step | Trying to Conceive

Tawnia Jacobson [0:07.45.76]: I think the next step in my journey came when my husband and I decided to start trying for a family. Probably around 2014, we became more active in trying. And even though I had been off of birth control since 2008, we were obviously not preventing pregnancy, but it hadn’t happened. But 2014 is when we started to try a little bit more actively.

I was feeling a lot more left lower quadrant pain, and I think once you become hyper-focused on your schedule and looking at a calendar all the time,  you start to become very in-tune with your body. I was just noticing so many things. So I sat down and talked to my GYN about it. She said, “Let’s start by getting some labs and do an ultrasound, so that we can  rule out cysts.”

At the time I didn’t have any signs or symptoms of ovarian cysts other than just pain which seemed to be focused in my left lower quadrant.  Labs came back and showed that I had a low AMH, which is an Anti-Müllerian hormone. This test is fairly new. They’ve been using it maybe 10 to 12 years. So again, six years ago or five years ago, or however long it was I got this information, my GYN  didn’t feel that comfortable with dealing with it. She said, “With this information, it means you have a low ovarian reserve, and I’m not really sure how to treat you moving forward. I need to send you to a fertility specialist.”

This was obviously devastating news, and not what you want to hear when you’re just starting your journey.  But I thought, “Great! This is a specialist, somebody who is going to listen a little bit more to my symptoms and put a little more thought into my cycle and what has been going on for years.”

A Specialist, and Diagnostic Laparoscopy

Tawnia Jacobson [0:09.36.93]: We went on that journey, and have been on that journey for the past four years. It has been equal parts devastating and frustrating, but it was during that time that we all, as a team, made the decision that I probably most likely had endometriosis. The only problem was, the only way to diagnose endometriosis is via invasive surgical procedure. You have to have a diagnostic laparoscopy in order to obtain a sample of tissue to send to pathology for diagnosis. It was years of frustration and a lot of changes to my cycles, (very short cycles). Another thing to add is that after we were told we wouldn’t conceive naturally, I did conceive naturally.  Unfortunately I sustained a miscarriage at about 10 to 11 weeks. It was at that point that my cycles seemed to be even more sporadic and painful. It was then that I finally said, “Okay, I have to do something, so let’s have surgery.”

In 2017 I had my first surgery by a fertility specialist who claimed that he could fix my endometriosis and get me pregnant. I trusted him and I went through surgery. Within three months, my symptoms were worse than they had been before. I was in a very ugly place mentally and emotionally, and I was begging for a birth control again because I said, “I can’t continue feeling like this. I’m not myself. It hurts every day.”  It went from being painful a week to two weeks out of the month to three to four weeks out of the month. There were very few good days. I was keeping a calendar. I was keeping food diaries. It was consuming my life and it was miserable. So I begged and pleaded for birth control, and he talked me out of it because he said, “You are looking to start a family” and I said, “I understand that but this isn’t working.” So instead he put me on Clomid.

I took a course of Clomid hoping to get pregnant, but instead I ended up getting a grapefruit-sized cyst.  Luckily it did not require surgical resection, but I endured many, many days of pain until it rectified itself. After that, I foolishly put myself on a course of DHEA hoping that would improve my egg supply for getting pregnant once again; not realizing that those are the worst things you can do for endometriosis.


Tawnia Jacobson [0:12.20.51]: By the fall of 2017,  I was just in a really bad place.  It was not good for my relationships. It was not good for my marriage. I knew that I needed to do something. I just didn’t know what I needed to do.

As fate would have it, one of my neighbors and I were talking one day. We had just built a house in a new development and she was a new neighbor. We were talking about infertility. She mentioned that she had endometriosis as well, and she led me down the path of Nancy’s Nook, which is an endometriosis education forum on Facebook that literally changed my life.

I went on there and I read for a couple of hours every day. I learned more than I ever learned about endometriosis in my entire life in about four hours, and it changed my life. It was Nancy’s Nook who educated me, who ultimately led me to my surgeon, who performed excision surgery, which is the gold standard for treatment right now. I had surgery last March and have felt like a new person ever since then.

Carol Harnett [0:13:34.05]: Wow, as I was listening, you probably heard me gasping because it’s incredible to listen to your experience in one fell swoop. I can’t imagine what that was like to live through.

Tawnia Jacobson [0:13.49.22]: I try to keep it as condensed possible, but it was many, many years of suffering, and many years going in the wrong direction.

I mentioned keeping food diaries.  I changed my diet so many times. I had tried gluten-free and dairy-free. It was around that time that I actually got pregnant. Part of me was like “Wow, is that what it takes?” Then I eventually went vegan; I had cut out all meat. If you read a little bit more about endometriosis, you realize that they encourage an anti-inflammatory diet. A lot of that means getting rid of red meat. My husband and I tried vegan for a while, and none of this was helping any of my symptoms. It was basically just torturing me more mentally because it was all-consuming.

Finally, The Right Surgeon, The Right Procedure

Tawnia Jacobson [0:14.32.20]: I talked about meeting the surgeon who basically changed my life. It was the excision surgery that changed my life. It was the appropriate treatment. My first surgery was ablation, which means they burn the tissue.  They don’t actually get rid of it, they just burn it, and hope to prevent it from growing back. The tissue, I guess it could be described as an iceberg. The tissue that you see is visible endometriosis, but lives much deeper than that. The part of the iceberg that you don’t see below the surface is actually the problem. You burn what you see, but you leave behind what you don’t see, and it will continue to grow. Since you’re in there basically irritating it, making it more angry, the endometriosis becomes worse. That’s why when I had my first surgery, within three to four months, I was feeling worse than I did before. We made it angry. Until I went to the correct surgeon and had the proper procedure done, my symptoms weren’t going to get any better.

Since having surgery, (a four-hour procedure), I was diagnosed with moderate endometriosis.
I did not have it on my diaphragm, Thank God, but  it was covering much of my pelvic orifice. It was growing on both ovaries and wrapped around ligaments. I had right leg pain that nobody ever paid any attention to but me. I would live from day-to-day, working out regularly, and then I would have to take one to two weeks off of my workouts at a time because my right leg was bothering me so much.

When I found the surgeon who ended up helping me, he didn’t even bat an eye.  As soon as I said “right leg pain down my back,” he was like, “Oh, yeah, your ligaments are involved.” And sure enough, when he went in there, the endometriosis was wrapped around my uterosacral ligaments. He had to dig down in there and clean that all out and I haven’t had any leg pain since surgery.

Carol Harnett [0:16:34.62]: You’re generous to share this. I know that when we look at data for why people go out of work and we look at their health data (we call it disability data), but it’s not the disability people think about. When we say disability data, we are almost always talking about illness or injuries that people have that prevent them from working — usually on a temporary basis.

Ablations and hysterectomies are procedures we’re seeing both in endometriosis and in perimenopausal women who are having difficulty with heavy bleeding. It’s interesting, too, because these procedures aren’t always successful in the perimenopausal population.  I did more background reading so I could ask you intelligent questions. I read about excision surgery and was disappointed to find that there’s a limited number of surgeons in the U.S. who have the expertise to do this surgery.

Tawnia Jacobson [0:17.29.92]: About 150, I think, worldwide.

Carol Harnett [0:17:33.91]: Yes, I think there’s about 100 in the U.S. When you think about it, I assume they’re clustered in bigger geographic areas. I think about women who this might be a good solution for — at least a strategy to manage it — those who may have to travel to see somebody who’s able to do this procedure. This is concerning because that may exclude women of certain means to be able to do that.  That always concerns me.

I actually didn’t ask you about this earlier when we started this show, or even when we’ve talked about this a little bit, but I think you referenced in one of your social media posts that there are some insurance limitations for some of the procedures. Did I remember that correctly?

Insurance Coverage and Financial Implications

Tawnia Jacobson [0:18.26.65]: Yeah, I’m going to be very careful with how I speak to this because I am not a professional in the industry. I can only speak to my personal experience, and I actually have a girlfriend who’s really going through a very frustrating situation herself with insurance regarding this.  I can say from my experience, yes, my surgeon was out of state. He was technically out-of-network, which is true for many women who are searching to find an endometriosis expert to treat them because they are very few and far between. Many of them are grouped together, like you said. We’re fortunate in New England to have in New York, Massachusetts and Maine certified surgeons who are experts in excision surgery but, unfortunately, your insurance does restrict you being able to go out of state. Lucky for me, my insurance at the time had an out-of-network option. The hospital, the lab and the anesthesia services were partly covered by my insurance. Now the surgeon himself is paid out of pocket simply because he doesn’t get reimbursed for the procedure.

This is where I’m going to be very careful with how I speak.  How I understand it is that there are basically no CPT codes for the excision surgery itself. They will lump it into the same category as ablation. My surgery was four hours long. My bowel was not involved, but many women do have bowel involvement which can sometimes involve a colorectal surgeon as well. So, if you’re in there 4 to 8 hours (sometimes 10 hours if you’re having diaphragm involvement as well) and you’re only getting reimbursed for an ablation procedure, which can be done in about an hour, you’re losing a lot of money.  That is a lot of time, energy and expense being put out there that you’re not getting reimbursed for. I believe that’s why many of these surgeons require out-of-pocket pay.

Carol Harnett [0:20:39.22]: You have to save!

Tawnia Jacobson [0:20.41.84]: Yeah exactly. My surgeon offered a payment plan. You spoke about people traveling; he gets patients from all over the world.  He had patients flying from India the week that I met him. He’s been doing this for 30 plus years so he is seeing people worldwide. It’s unfortunate because not everybody has the means to be able to do this.  When I was going through the process of finding a surgeon and scheduling surgery, I had befriended somebody through social media who lives in California. She was suffering so much and could not find a surgeon out there who was local and in-network for her insurance. She was fighting the good fight. She was appealing every time I turned around and she was just hoping and praying that she’d be able to find some loophole to be able to allow her to have excision surgery. I can proudly say today that she finally did get surgery! She had excision surgery in December, but I was at the point where I was like,  “Oh my God, I need to start saving money and fly her out here to see my surgeon,” because after I had surgery, I felt so much better. I want every person who is experiencing this pain to be able to find somebody who can help them because they deserve it.

Back to the insurance question -, my girlfriend is experiencing a very similar situation. She has had three ablation surgeries locally, at one of our local hospitals, and it’s not working for her. She needs excision and her insurance has denied her request, twice, to go see my surgeon in She’s still fighting, still trying to figure that out.

A Word About PPO Plans | More Options

Carol Harnett [0:22:19.74]: I’ll just add a quick point. I’ve been in and around insurance for the last ten plus years of my life, in addition to what I do at The Council for Disability Awareness., When you’re going through the open enrollment process, if your employer offers health insurance, (employers of a certain size are all required to offer health insurance) or have to go into the individual market yourself, it’s really important to make sure you’re in a preferred provider (PPO) plan.  At least when you go out of network, it’s pricey (you have a much more significant copay until you reach your out-of-pocket maximum), but at least it gives you options.

This advice applies not just for this situation, but for all situations, particularly if you want to go to what we would call a “center of excellence.” I would consider 100 surgeons in the country to be 100 separate centers of excellence for how to treat this condition — endometriosis — by excision.

This is not a push for you to buy more health insurance than you need.  A PPO health plan costs more money, but when you or one of your loved ones is impacted, you will be ever so thankful that you had options.

Carol Harnett [0:23:25.28]: I am looking at the clock and we have about 6 minutes and there are two questions I want to ask. You referenced a couple of times that when you were in high school you missed school and missed work.  Something that The Council for Disability Awareness focuses on is how illnesses, injuries and diseases can impact people’s ability to work.

The most recent research article I could find was published in 2017. The researchers studied the impact of endometriosis on work and life and said that on average (and the range is enormous), women lose about 5.3 hours per week to endometriosis. Whether that’s being absent or unable to do something, or not being able to do it in the way they normally could.

Can you talk a little bit more about how endometriosis impacted your ability to work for certain, but also your ability to do things in your own life?  I have met you as a very active person, so could you share with people what that is like.

Living and Working with Endometriosis

Tawnia Jacobson [0:24.51.98]: There were days missed from work, days where I had been up all night writhing in pain, or had a wicked headache and just felt terrible the next day and knew that I couldn’t function to my full capacity. That being said, fortunately for me, the worst of my symptoms developed about nine months before I had excision surgery and coincided with me  taking a new position at my job. It was a leadership role. It was administrative. I was putting so much time and energy into my new role, that it was depleting me to the point where between that and my symptoms, I couldn’t function in life outside of work.

I think the new job gave me the drive to get up every single day. Even though I was miserable mentally and physically, I had a purpose. I got up and would work four days a week, but I would then come home and be useless. I would be on the couch with a heat pack taking more ibuprofen than I had ever taken in my life.  Luckily, I had a husband who could pick up the pieces, but it wasn’t good for our relationship, and it was taking a toll on us. I just can’t help but think of women who are supporting themselves as single mothers, or women who are single and alone, and don’t have somebody to help them emotionally or physically.

I couldn’t cook, I couldn’t clean, and I didn’t do my own laundry. I was really kind of  useless outside of work. I had the ability to get there and do that, but that was kind of my purpose in life. I’ve often thought about if I hadn’t taken that new job, where would I be because I think I would have given up. I think I wouldn’t have wanted to get up anymore every single day. It’s funny how timing works out like that.  Prior to that position, I definitely missed a ton of work.

I definitely would call out. I said it used to be a week at a time,  and I would feel crummy, but then it became three weeks out of the month.  It was affecting me so much so that actually my words to my husband were: “I either have to find a surgeon who can help me or who believed my pain and my symptoms, or I have to be admitted to a mental institution, because something’s not right with me. I’m in a very dark place and I’m not myself.”  Those words really sent the message home, and he was like, “We have to do something.”

Fortunately for me, my something was Facebook and educating myself. I said it to you before and I have said it to other people, “It’s embarrassing. I’m a healthcare professional. I’ve studied science my entire life.” I didn’t know what endometriosis meant. I thought it just meant bad periods, painful bleeding, painful sex.  It was an excuse to me. Unfortunately, that’s what many people think and that’s the kind of the stigma you had mentioned. It’s a woman’s disease and women don’t normally talk about their reproductive systems. People don’t usually want to hear about women’s reproductive systems, and that’s unfortunate, because if we can tie this back to the beginning and talk about the prevalence being the same as diabetes. Diabetes isn’t always pretty either, and it affects every organ system in the body — just like endometriosis can affect almost every organ system in the body. Everyone’s symptoms might present a little bit differently, but they can involve major organ systems.

Carol Harnett [0:28:18.58]: I appreciate you sharing all that, particularly your comments about your mental health, because when I looked at this 2018 research study, they looked at lists of symptoms. The more symptoms you have, the more likely you are to be out of work for a period of time.  The number two symptom (pain being number one) was mental health, because people were feeling unaddressed and confused.

I am so grateful you’re talking about mental health because, by coincidence, we are live recording this on May 1st, which is the beginning of Mental Health Awareness Month, in addition to Disability Insurance Awareness Month, and I’ve committed to talking a lot about mental health.

We have 60 seconds left to our time together, so I’m going to ask for a 30 second headline. Looking back on what you know now, what’s the number one piece of advice you would give to people?

Tawnia’s Best Advice | Educate Yourself

Tawnia Jacobson [0:29.15.14]: Educate yourself. Don’t trust that the doctors know exactly what they’re talking about. I don’t say that negatively, because I work with physicians every single day, but they’re not all experts in what you’re experiencing. Be your own advocate; do your own research, and find the specialist in the area that you need.

For me, it was endometriosis; Nancy’s Nook saved my life. I wish I would have found that resource earlier. If people are struggling, go look at the documentary on endowhat.com. It is life-changing.  

Carol Harnett [0:29:48.41]: Thank you so much, Tawnia, for being our guest. In my opinion, this  is the best show we’ve ever done.

For everyone who has been listening, we hope this show has helped you.

I want to say thank you to all of our listeners. Have a great day, and there’ll be a transcript that accompanies this show so it is easier for  you to get all of the information that we referenced. We will make sure there’s links for all of it.

Thank you again, Tawnia.  

Tawnia Jacobson [0:30.11.97]: Thank you for having me –  such a great topic.