Attorney helping man apply for long-term disability.

What Qualifies a Person for Long-Term Disability?

A long term disability policy can provide valuable benefits in the event that you become unable to work. Some choose to purchase an individual long term disability policy on their own, but some employers also offer long term disability (LTD) coverage in their employee benefit packages. Should you become unable to work, you may qualify for LTD to cover the majority of your salary. Whether or not you qualify to receive benefits, however, will largely depend on the terms of your LTD policy.

What Qualifies a Person for Long Term Disability?

One of the biggest hurdles to qualifying for long term disability will be proving that you have a disability covered under your LTD policy. It is a good idea to first review your policy’s exact definition of what constitutes a disability. The policy is likely to differentiate benefits for someone who is “totally disabled” and someone with a “partial disability.” Usually, a total disability means that you are unable to perform almost all of the duties of your occupation due to an illness or injury. Aa partial disability may mean that you qualify for benefits because you are unable to continue working full time at your current job, but may still be able to work full or part time at a different job.

Proving your disability is mostly reliant on medical evidence and, more specifically, on the opinion of your treating physician. During the process of applying for LTD benefits, your doctor will need to complete a form that includes writing a statement about his or her opinion regarding your condition. In addition to this statement from your doctor, objective medical records such as radiographic studies, lab reports, and exam findings will be sent to the LTD benefits administrator for review.

Please note that many policies have exclusions for certain conditions. For instance, there is often an exclusion for pre-existing conditions in LTD policies. A pre-existing condition is generally an illness or injury that was diagnosed or for which you received treatment within a certain time frame prior to the start of your LTD coverage. There may also be specific conditions excluded from LTD coverage under your policy. Some policies have exclusions for certain diseases or injuries incurred due to a workplace accident.

There are other requirements that must be met in order to qualify for LTD benefits above and beyond medical evidence of your disability. For instance, most policies will require that you are current on the payment of your premiums. If you are under an employer-sponsored LTD, many policies will require that you are a full time employee at the time you become disabled. There is also commonly a wait period, or “elimination period,” that must be observed between the time of incurring a disability and when you are eligible to begin receiving LTD benefits. In most cases you will be required to utilize all of your paid sick leave prior to filing for short term disability. In turn, you will likely need to exhaust short term disability prior to receive LTD benefits.

Disability Attorney

There are many hoops to jump through on the road to accessing long term disability benefits. At Disability Advocates, we help our clients navigate this process in a smooth and succinct way. We know that LTD benefits are often critical to those who are suffering from a disability preventing them from working. Contact us today.