What Conditions Qualify For Long-term Disability


Share post:

How To Choose A Disability Policy That Fits Your Needs

Long Term Disability Insurance Claims – Pre-Existing Conditions

If your employer offers STD insurance as mandatory or voluntary part of your employee benefit package, thats great but its just a start. You should also see if they offer a long term group plan if youre self-employed you may be able to get coverage through a professional association. Either way, group insurance can be an excellent choice. The company or association is buying for a large group of people, so the premium is typically lower than for an individual policy. In addition, your HR department will likely have more expertise and leverage to negotiate favorable terms. On the other hand, youll probably have less opportunity to tailor the policy to your needs, compared to an individual policy. If the premiums are paid with pre-tax dollars then the income benefit you get down the road will typically be taxed. Finally, if you leave the company or association, in most cases youll also lose your coverage.

What If I Can Only Work Part

If your medical conditions prevent you from working full time, but you can still work part-time, youll need to check your insurance policy to make sure benefits are payable for partial disability. The exact definition of partial disability will vary between policies. Some policies may not pay any benefits for partial disability. If youre not sure if your policy includes benefits for partial disability then contact us to request a free case evaluation.

When Do Long Term Disability Policies Pay Benefits

Most long term disability policies will pay a percentage of your income when you cannot work due to health reasons. Generally, you must be out of work three to six months before the long term disability benefits will kick in.

But, beware, some long term disability policies will actually limit the length of time that you can get your long term disability benefits. So, for example, if you suffer from fibromyalgia, a psychiatric condition, or even soft tissue muscular-skeletal problems, your policy may limit the payment of those benefits to just 24 months.

You should understand your benefits package so that you can provide you and your family with peace of mind if you become disabled. You can learn more about the disability provisions that you dont want to see in your disability policy by ordering a copy of Robbed of Your Peace of Mind.

Don’t Miss: Employment Agencies For Persons With Disabilities

We May Be Able To Provide Legal Help

As a personal injury law firm in Ontario, Canada, Preszler Injury Lawyers has been assisting people with injuries and long-term disability claims since 1959. If you need legal representation to navigate a claim against your insurance company, we are the company for you. Our lawyers support you with a free initial consultation, contingency fees, and direct communication. To speak to us about your legal needs, call now at .

How Do You Obtain Long

What Medical Conditions Qualify for Social Security Disability or SSI ...

Long-term disability coverage can be obtained either by a group or individually. Group coverage can be offered through an employer, professional group or association. Individual coverage can be purchased directly from an insurance broker based upon medical underwriting.

Individual policies are usually available if you have not had any medical treatment during the past 10 years for a potentially disabling medical condition. Medical treatment includes prescription medications and physician consultations.

Recommended Reading: What Is The Difference Between Fmla And Short Term Disability

Long Term Disability Insurance

Obtaining disability coverage, such as an insurance policy for long-term disability income, is one of the best things you can do to protect yourself. These benefits are designed to act as an income replacement during the time that you are unable to work due to your impairments. If you receive long-term disability insurance benefits you can easily take care of yourself even if you become disabled and are unable to hold a full-time job.

Ial List Of Medical Conditions That May Be Covered By Long

Since there is no master list of qualifying conditions that can be approved for long-term disability, it is impossible to create a complete list of potentially disabling conditions. Remember: whether your condition is listed below or not, you can potentially receive benefitsif your condition is not on the policys list of excluded conditions, and you can show that your symptoms or condition are severe enough to meet the policys definition of disability.

Many of the long-term disability claim conditions we can handle at Bryant Legal Group are listed below. You can select any of the clickable entries to learn more about the claims process for that condition.

  • Amyotrophic Lateral Sclerosis

Also Check: Best Disability Lawyers In Michigan

What Should I Watch Out For

Along with your insurers definition of disability, the terms of your policy can also affect your coverage for certain conditions.

When youre shopping around for a policy, take note of these terms.

Own-occupation vs. any-occupation

Your disability insurance plan will fall into one of two categories:

  • Own-occupation policies pay benefits if you cant work in your usual job, but you can work a different job. Lets say your back pain prevents you from doing your construction job, but you can work in your companys office an own-occupation policy would still pay out benefits.
  • Any-occupation policies only pay out if you dont have the physical or mental capacity to do any job.

Off-the-job coverage vs. 24-hr coverage

Your disability insurance policy will either provide off-the-job coverage or 24-hour coverage.

A 24-hour policy covers you around the clock, while off-the-job coverage comes into play if you suffer a disability when you arent working. Its designed to compliment workers compensation.

What If Objective Evidence Is Not Available

What Conditions May Qualify You For Presumptive Total Disability Benefits In Your LTD Policy?

When conclusive objective evidence is unavailable, a disability may still be validated through the use of subjective evidence. Subjective evidence is a combination of the patients self-reports and the observations of friends and family. If objective evidence is unavailable to prove up a claim, we will develop subjective evidence to ensure that we stack the record with all available information substantiating disability. It is possible to qualify for benefits even if objective evidence is unavailable.

Don’t Miss: 100 Disabled Veteran Moving Assistance

List Of Conditions That Qualify For Ltd In The United States:

Again, you may be eligible for short or long term disability benefits in the U.S. even if your condition isnt listed above. Not only do many other conditions qualify, but a combination of medical conditions also can qualify. To find out more about your specific case, please do not hesitate to contact The Law Offices of Nancy L. Cavey. We can determine if your medical condition or combination of conditions qualifies you for benefits under the terms of your disability policy.

Medical Conditions That May Qualify For Long

Many people think long-term disability insurance is for people who have been physically injured in an accident and are unable to work as a result of their injury. While this may be true, its important to know there are many medical conditions that may also entitle you to receive disability payments.

Some of the medical conditions that may qualify for long-term disability benefits include:

  • Bipolar disorder
  • Multiple sclerosis

The above list of medical conditions is not exhaustive, and qualifying conditions vary from policy to policy. Before filing a long-term disability claim, its important to understand how your insurance company defines a disability. This information can be found by carefully reading your insurance policy.

Read Also: New Jersey Disability Claim Status

Individual Long Term Disability Insurance

When youre buying disability insurance for yourself either as a standalone policy or to supplement group coverage you have more freedom to tailor it to your needs. As its paid for with after-tax dollars, the replacement income it provides is also tax-exempt. Its most often bought through a financial advisor if you dont have one, or if that person doesnt have much experience with this type of coverage, a Guardian financial professional can give you a disability insurance quote. The cost of an individual LTD policy can vary greatly based on the waiting period and benefit period as well as benefit amount, age, gender, occupation and optional provisions added to your coverage. You can expect to pay between 1% to 3% of your annual salary.

When you discuss disability plans with your financial professional, be prepared to share as much as you can about your financial situation and goals, so that he or she can tailor your disability policy to your needs. Ask a lot of questions and make sure you get clear answers:

  • How much coverage can I qualify for?
  • How does the definition of disability work? Is it own-occupation or any-occupation? What conditions are covered?
  • How long will benefits be payable, and when do they begin?
  • Could my policy be changed or cancelled or could my premium increase?
  • How do I make a claim if and when needed?

Requirements For Receiving Benefits

Disability Insurance For Physicians Buying Guide

It is important for you not to let your coverage lapse for your long term disability insurance. It can do so if you fail to pay your premiums on a timely basis. If your policy is one that is provided by your employer, you may not have any required premium payments, however. If your employer does not pay for your plan, you should make certain to make your payments on time each month. If your plan is provided through your job, it likely requires that you are working full-time when you first become disabled. Full-time work may be defined under your policy as working a minimum of 30 to 35 hours each week. Your policy will contain the definition, so you can check it to make certain.

Most long term disability insurance policies have elimination periods. These are the times that last from the date of your disability and when you can start receiving your benefits. You are ineligible for disability benefits through your long term disability insurance policy until your elimination period is over. These periods often last as long as your short-term disability coverage lasts so that your long term coverage can kick in when your short-term benefits end. The insurance company is also likely to ask that you use up all of your accrued sick leave from your job before applying for short-term disability and then to use up your short-term benefits before applying for them under your long term disability policy.

Recommended Reading: Social Security Disability Over 55 Odds. Of Winning

Federal Programs Providing Long

Two programs administered by the Social Security Administration provide monthly payments based on a person being disabled. Social Security Disability Insurance or SSDI provides benefits to adults with a history of working at jobs or through self-employment and paying Social Security taxes on their income. The work history must be of a long enough duration and recent enough to satisfy the SSDI work guidelines, and you also must be disabled.

The other program, Supplemental Security Income or SSI, provides monthly payments to adults and children who are blind or disabled without regard to their work history. Recipients of SSI must meet strict income and financial resource limits to qualify and remain eligible to receive benefits.

How Do I Stay Enrolled/eligible For Long

Enrollment and eligibility requirements depend on the type of long-term disability coverage you have- group or individual. For example, if you have employer-sponsored LTD coverage, you will need to meet the active work requirement, which entails working a minimum number of hours per week. If you are unable to meet the active work requirements due to a disability, and you have passed the service wait and pre-existing condition exclusionary periods, LTD coverage may be used to replace a portion of your wages. If you have LTD coverage through a professional group or association, you will need to maintain membership to continue eligibility for benefits.

You May Like: Does Epilepsy Qualify For Disability

The List Of Covered Illnesses And Injuries Comes Down To The Type Of Policy You Have

Disability insurance is designed to protect your paycheck if you cant work due to an illness or injury but it isnt a catch-all policy. Your insurer will only pay benefits if your condition is specified in your policy, and the list of conditions differs between short-term, long-term and Social Security disability.

Mental Health & Psychological Illnesses

Does Cancer Qualify For Long Term Disability Insurance Benefits?

Suffering from a mental illness can often impact your ability to perform activities of daily living. Fortunately, most mental health and psychological illnesses can be managed so long as you are provided adequate treatment and support. For instance, long-term disability benefits, which aid those who are suffering from mental health and psychological illnesses by covering a portion of their monthly salary. That is as long as their mental illness impedes their ability to perform the regular duties of their job for an extended period of time.

Some of the most common mental health conditions covered under LTD are as follows:

  • Mental Retardation
  • Alcohol or Drug Disorders
  • General Anxiety Disorders

Over the years, mental health and psychological illnesses have become increasingly common within Canada. In fact, according to the Canadian Mental Health Association, close to 50% of the Canadian population will have suffered from some sort of mental illness by the time theyre 40. Whats more, because mental health issues are often considered an invisible disabilities, employers often get suspicious when their employees seek out disabilities for conditions such as depression, anxiety, or PTSD.

NOTE: Nearly every LTD policy has an outlined pre-existing condition clause, which can cause problems for mental health claims. Since insurance companies often take a more relaxed approach when determining whether or not a mental health disorder is a pre-existing condition.

Read Also: How Much Does Disability Pay In California

What Conditions Automatically Qualify You For Disability

The Social Security Disability Insurance program has the most-publicly accessible information on how it qualifies applicants to receive long-term disability benefits. Regarding which medical conditions count as long-term disabilities, SSDI maintains a frequently updated online list that is divided into the following categories:

  • Musculoskeletal system
  • Congenital Disorders that affect multiple body systems
  • Neurological disorders
  • Immune system disorders
  • Low birthweight and failure to thrive

In addition to a diagnosis, SSDI considers the results of functional assessments when deciding whether a health condition qualifies as a long-term disability. For adults, the program looks at a benefits applicants abilities to:

  • See, hear and speak
  • Perform work activities such as sitting, standing, walking, lifting, carrying, pushing, pulling, reaching, handling, stooping and crouching
  • Perform mental tasks like understanding and remembering new information, concentrating on and completing tasks, following instructions and responding appropriately to supervision, co-workers and stress
  • Adapt to changes in environmental conditions such as temperature fluctuations and the presence of fumes

The severity of a childs disability is assessed by the individuals ability to do things like learn, complete tasks, interact with other people, move and manipulate objects as well as communicate. What Medical Conditions Qualify for Long Term Disability in Ohio?

Types Of Disabilities Eligible For Long

Each long-term disability insurance policy is different as each insurance company will have its own definition of disability that determines what, if any benefits you will receive. Some may cover you regardless of the severity or type of illness or injury you are suffering from, as long as your disability prevents you from being able to perform all, or significantly all of the duties required by your current job.

However, many policies exclude certain illnesses. In these cases, to be eligible to receive LTD benefits, such as income replacement and coverage for medical treatment, your medical condition or injury must be included in the definition of disability found in your insurance policy. In addition, some policies may exclude injuries or illnesses that are covered under Workplace Safety and Insurance policies. When deciding on a long-term disability insurance plan, check with the provider or insurance agent to find out what is considered a disability under that plan.

Recommended Reading: Heart Failure Disability Living Allowance

What Else Should I Know About Long

If you reduce work hours due to a disability and the appropriate provision is included in your policy, you may be eligible to receive partial benefits. Check the summary plan description for details. Also, you may want to consider consulting a benefits planner about State Disability Insurance or Social Security disability programs such as Social Security Disability Insurance or Supplemental Security Income .

What Qualifies For Short

How Can You Qualify For Disability Benefits

To qualify for short-term disability benefits, an employee must be unable to do their job, as deemed by a medical professional. Medical conditions that prevent an employee from working for several weeks to months, such as pregnancy, surgery rehabilitation, or severe illness, can qualify to receive benefits. Since employers in most states must legally provide workers’ compensation insurance to all employees, any injuries incurred on the job are typically covered under a workers’ comp policy and are therefore not eligible for short-term disability.

While most non-work-related temporary medical conditions are covered by a short-term disability policy, there can be exclusions for preexisting conditions or intentional and foreseeable injuries . While employees can qualify for time off under the Family and Medical Leave Act to care for a sick relative, most short-term disability policies would not provide benefits if the covered employee is not the one with the illness.

You May Like: Guardian Short Term Disability Claim

Special Rules For People Who Are Blind Or Have Low Vision

We consider you to be legally blind under Social Security rules if your vision cannot be corrected to better than 20/200 in your better eye. We will also consider you legally blind if your visual field is 20 degrees or less, even with a corrective lens. Many people who meet the legal definition of blindness still have some sight and may be able to read large print and get around without a cane or a guide dog.

If you do not meet the legal definition of blindness, you may still qualify for disability benefits. This may be the case if your vision problems alone or combined with other health problems prevent you from working.

There are several special rules for people who are blind that recognize the severe impact of blindness on a person’s ability to work. For example, the monthly earnings limit for people who are blind is generally higher than the limit that applies to non-blind workers with disabilities.

In 2022, the monthly earnings limit is $2,260.

Related articles

Can’t Work Due To Disability

Can You Get Disability For Migraine ...

Back Pay For Va Disability

Who Can File A Va Disability Claim ...

Filing For Disability In Nc

The Disability Application Process VA...