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What's your height?

ft

in

* What's your current weight?

Have you lost more than 10 lbs. in the last year?YesNo

Now some questions about your profession and income. Disability insurance companies care about your profession because different professions have different risks.

What's your profession? Examples: physician, private equity investor, lawyer, chef, teacher, police officer

* What's your current job title?

What is the name of your employer? Why we ask: there may be discounts available to you, and some employers have workplace plans limiting how much coverage you can get.

* Approximately how many people report to you (direct and skip-level)?Why we ask: sometimes this helps us advocate for the best pricing possible for you.None1-45-2021 or more

How do you receive your income? Disability insurance companies have different rules for different sources of income.

W-2 (typical for salaried employees)

1099 (typical for contractors)

Owner in a business

Do any of the following apply to you? Check all that apply.

I have given notice of my intention to quit my current job

I am receiving a severance package

I have accepted an offer letter to start a new job

None of the above

Optional but highly recommended: please share a link to your professional profile if you have one (LinkedIn, bio on employer's webpage, etc). Why we ask: our goal is to get you the best rate available. We advocate on your behalf by putting your professional profile in the best light possible. Details like your years of work experience, an advanced degree, etc., can help us get you the best rate.

What's your approximate annual income from working? We just need a ballpark estimate. Include things like salary, bonus, wages and commissions. Do NOT include things like rental income, dividends or interest income.

* Do you know how much monthly benefit you need?YesNot really, I'd like AboveBoard to suggest some options

* Do you have any long-term disability coverage at work?YesNoI don't know

Now some brief questions about your health.

Remember it's 100% confidential, and I'm only asking so I can give you the best advice! This questionnaire is just to get you quotes - you'll have the chance to clarify any answers before you apply.

* Do you smoke or use any tobacco or nicotine, including e-cigarettes?YesNo, neverNo, quit within the last 12 monthsNo, quit 1 or more years ago

Have you used any recreational drugs (marijuana, etc)?Remember, everything is 100% confidential. When you apply, carriers will have the right to review your medical records. Some carriers treat marijuana usage more favorably than others, and we want to guide you to the right insurance company.YesNo

Have you ever been treated for or diagnosed with any of the following?

Disability Insurance | Request a Quote