woman with chronic pain in her wrist

What Conditions Qualify for Long Term Disability?

If a serious illness or injury prevents you from going to work, then you may be able to access short term or long term disability benefits. While short term benefits are meant to help provide income replacement immediately following the serious illness or injury, long term benefits are meant to help provide financial support should your illness or injury prevent you from returning to work past the short term disability benefit period. Long term disability may even, in some cases, be paid out to retirement, depending on your plan.

Being unable to work due to an injury or illness can be a very financially stressful situation. On top of medical bills and other cost of living expenses, not having a steady paycheck can place you in difficult circumstances. This is why many employers provide long-term disability (LTD) insurance as a benefit to employees. In the alternative, you may secure your own private LTD insurance policy. Each policy may have slightly varied terms. Additionally, different laws will be applicable depending on the type of LTD policy. For instance, ERISA usually applies when a person is covered by an employer policy. State law usually applies to private LTD insurance policies.

What Conditions Qualify for Long Term Disability?

There can be a wide range of conditions that qualify a person for LTD coverage. Whether or not a condition will be covered under LTD really depends on the specific policy or plan. Should you be considering filing an LTD claim, then starting with a review of the summary plan description in your LTD policy to review the exact definition of “disability” should be one of the first steps you take. Should you have LTD through your employer, you will likely be able to get a copy of your policy from your employer’s human resources department.

LTD policies will generally define both “totally disabled” and “partially disabled.” A total disability is generally established when an injury or illness prevents the substantial performance of duties of your job. In the alternative, a partial disability may mean that your injury or illness prevents you from working full-time at your job, but you may still be able to work full time or part-time at a different job. It should be noted, however, that many LTD policies prevent the filing of an LTD claim if a person is still on the employer’s payroll.

Some of the conditions that may be covered by an LTD policy include:

  • Blindness
  • Chronic pain
  • Deafness
  • Fibromyalgia
  • Hearing loss
  • Lung disease
  • Lupus
  • Lyme disease
  • Multiple sclerosis
  • Osteoarthritis
  • Parkinson’s Disease
  • Vision loss

Whether or not your condition qualifies you for LTD benefits will mostly hinge on your ability to prove that your condition prevents you from going to work. More often than not, proof will be centered on the opinion of your treating physician. In fact, the LTD benefits application will have a part dedicated to your doctor completing a form or writing a statement as to his or her opinion on your condition.

In addition to a statement from your treating doctor, the LTD benefits administrator will request objective evidence of your disability. This often includes things such as radiographic studies, surgical reports, and clinic notes. In addition to supporting evidence from your doctor, you should be sure to continue receiving treatment for your condition while your LTD benefits claim is pending and even after you begin receiving benefits. Failure to receive continuous treatment can jeopardize the continued receipt of benefits.

Disability Attorney

If you have been unable to work due to a disabling injury or illness, let Disability Advocates help you navigate the disability claims process. We are here to help you access critical benefits to help support you and your family during a difficult time. Contact us today.