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What Medical Conditions Qualify For Long Term Disability

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What Qualifies For Long

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

The qualifications for long-term disability are usually more stringent than those for short-term disability. With short-term disability, benefits can be awarded if the employee is unable to do their job. With long-term disability, benefits will typically only be awarded if the employee is unable to do any job. What constitutes a qualifying event will be specified in the policy, so it is important to understand when benefits may apply before accepting a long-term disability policy.

Qualifying events may include chronic pain, cancer treatments, or debilitating illness or injury lasting more than 26 weeks. If an employee could qualify for another form of income replacement, such as Social Security Disability Insurance, the long-term disability policy will no longer provide benefits.

How Long Does Long

While short-term policies only last up to 6 months, long-term disability insurance is intended to provide coverage for longer periods of time, usually for several years or until you reach retirement.

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What Conditions Qualify For Long

Depending on the benefit period you choose, long-term disability replaces a portion of your paycheck for two, five or 10 years, or until you reach retirement age.

This policy typically pays out for severe or lifelong injuries and illnesses. Your insurer may cover:

  • Chronic bone, joint and connective tissue disorders like osteoarthritis, chronic back pain or slipped disks.
  • Accidental injuries such as brain trauma caused by a car accident.
  • Cardiovascular conditions including heart attacks or serious heart conditions.
  • Circulatory disorders like coronary artery disease.
  • Prolonged mental illnesses like PTSD and major depressive disorders.
  • Cancer.
  • Poisoning.

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Conditions That May Qualify For Long

A list of disabling conditions that may be considered by a long-term disability insurance company to qualify a claimant for benefits is below. These conditions often significantly interfere with one’s ability to obtain or maintain gainful employment. As a result, an individual may be eligible for disability insurance benefits.

  • Thrombocytopenia


  • Cancer, including Blood, Bone, Breast, Colon, Esophageal, Gastric, Kidney, Lung, Liver, Ovarian, Pancreatic, Prostate, Skin, Thyroid Cancer
  • Hodgkins Disease
  • Attention Deficit Hyperactivity Disorder
  • Anxiety Disorder
  • Neurocognitive Disorders
  • Obsessive-Compulsive Disorder
  • Post Traumatic Stress Disorder
  • Schizophrenia
  • Adrenal Gland Disorders, such as Addisons Disease
  • Diabetes
  • Pituitary Gland Disorders, like Cushings Disease
  • Thyroid Gland Disorders, such as Hashimotos or Graves Disease

Immune System

  • Allergic Reactions
  • Immune Deficiency Disorders, such as Ataxia-telangiectasia, Chediak-Higashi syndrome, Chronic Fatigue Syndrome, DiGeorge syndrome, Hypogammaglobulinemia, Leukocyte adhesion defects, Brutons disease, Selective deficiency of IgA, Wiskott-Aldrich syndrome, Lupus
  • Poisoning or Chemical Sensitivity

What Medical Conditions Qualify For Long

Qualifying Medical Conditions for Long

A variety of degenerative diseases, chronic illnesses, neurological disorders, and physical disabilities may qualify for coverage under long-term disability insurance plans.

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

  • Bipolar disorder
  • Missing or insufficient medical evidence
  • Not meeting the insurance policys criteria for disability

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Your Responsibilities When Illness Or Injury Prevents You From Working

Administering sick-leave benefits is complex. You need to work closely with your manager, your departmental human resources team and the Pay Centre to ensure that:

  • leave records are accurate and up-to-date
  • you receive information of your options and benefits
  • forms are filled out accurately
  • forms are sent to the appropriate organization in a timely manner

Your Impairment Does Not Have To Be On The Ssas List

If you want to apply for Social Security Disability benefits, it is important to note that your impairment does not have to appear on the SSAs list. Examples of such conditions include carpal tunnel syndrome and celiac disease, among others.

However, you must present a formal diagnosis of your condition to the SSA that shows it is a medically determinable impairment that prevents you from functioning in full capacity. This means your condition must be severe enough to prevent you from working or performing your daily activities. This reduction in capacity is known as the residual functional capacity.

If your disability meets the SSAs requirements, it might consider it to be equivalent to a listed condition. You must obtain this diagnosis from your doctor to prove your condition, but it is only the start of the process. It does not mean you will automatically receive approval for benefits.

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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
  • Lupus
  • 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.

We Will Make Sure Your Disability Benefits Application Is Error

Disabling Conditions and Long Term Disability Benefit Information

If you hire one of our attorneys for tasks related to your SSDI or SSI application, we will ensure your application is accurate and manage the appeals process as necessary. At our firm, we handle all aspects of your claim, from filing your claim to the appeals process, so that you can focus on your health and well-being.

We will help you understand the SSAs designated conditions and related medical requirements and your status regarding those. If you need further medical evaluation to establish your disability, we can advise you if that is the case.

Complete a Case Evaluation form now

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The More You Earn The More There Is To Insure

Disability insurance benefits are based on a percentage of your income. Therefore, a key part of the underwriting process and a determining factor of your premium is how much you earn. This is done through financial underwriting.

For underwriting purposes, income is earned if a disability would stop or reduce it. Investment or business income that doesnât require work on your part will not be factored into your financial underwriting.

Underwriters will assess your salary, wages, regular overtime, bonus, and commissions. They may consider contributions to your retirement plan made by your employer. If you own a business, the underwriter will consider your share of the businessâs earnings.

Top 10 Medical Conditions That Qualify For Long Term Disability In 2021

July 28, 2021// by OLF//

Long-term disability can happen to anyone, whether it be the result of genetic predisposition, environmental factors, random illness, or injury. Those who suffer from disabling medical conditions might struggle to work at all after the disabling condition takes effect. Today, we discuss the top 10 medical conditions that qualify for long-term disability in 2021.

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Occurs After The Effective Date

Having a pre-existing health condition is the number-one reason short-term disability might deny your claim for benefits: even when you have a legitimate medical problem.

Once again, read your disclosure statement carefully where you might find a similar 12/12 definition.

  • If you become disabled because of a pre-existing condition, we will not pay for any loss if it begins during the first 12 months the policy is in force
  • A pre-existing condition means having sickness or physical disorder for which you were treated, received medical advice, or had taken medication within 12 months before the effective date

Your Appeal Is Correct And Complete

What Health Conditions Qualify for Long

Our lawyers will get to work adding all possible evidence for you to win or settle your case. Our team has experience preparing and filing administrative appeals with each of the major insurance companies. This includes medical records and residual functional capacity forms. We will ensure that your appeal is complete and supported by the medical evidence, which increases your chance of success.

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What Qualifies A Person To Be Disabled And Get Long Term Disability

People whose physical, mental, or emotional health makes them unable to work are considered disabled. A long-term disability is generally understood to be a condition that lasts more than 12 months or which is likely to result in death within a year or two.

Some disabilities do not automatically preclude working altogether, such as blindness, deafness, missing limbs, chronic diseases, or partial paralysis. But a condition that would be merely limiting for one person can qualify as a long term disability for another when the condition makes it impossible for the second person to do the jobs for which he or she has the appropriate education, skills, and experience. For instance, losing a leg would not necessarily stop a person from working as a teacher, but it would make a career in roofing no longer viable.

All government programs take the nature of a claimed disability into account along with a consideration of what work a person is capable of doing, has done in the past, and could do in the future.

Are You Not Sure If You Qualify Contact A Social Security Disability Insurance Attorney

It can be difficult to determine if your injury or medical condition qualifies for disability. In addition to actually disabling you, it must also meet a set of criteria. Further, you must be able to prove your disability. If you cannot do so, then you will not have your benefits approved.

Even if you can prove your disability and how it prevents you from working, it can still be difficult to fill out the forms correctly. The bad news is that even a slight error can lead to a denial. The good news is that you can appeal a denial. The better news is that you can work with an SSDI attorney who can help you fill out the forms correctly the first time.

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Your Policy Choices Matter Too

So far, weâve highlighted personal factors that influence the cost of long term disability insurance. However, there are also various policy choices that will influence how much you pay in monthly premiums.

The benefit period you select is a prime example. The longer your benefit period is, the more you can expect to pay in premium. More often than not, the most cost-effective benefit period length is 5 years.

Your elimination period, or waiting period, is another example of a policy choice that impacts long term disability insurance cost. The elimination period for disability insurance is similar to the deductible on property insurance. Itâs the part you pay out-of-pocket before benefits kick in. Cost runs the opposite of your benefit period: The longer your waiting period is, the less you will pay in premium.

Elimination periods for long term disability can be as little as 30 days or as long as a year. The standard length is 60 or 90 days.

The Insurance Company Must Prove You Do Not Qualify For Long

Does your medical condition qualify you for Social Security Disability benefits?

It is important to remember that it is up to the insurance company to prove that you do not qualify for benefits. As a result, they are going to ask for every shred of information they can get their hands on, including medical records, lab tests, and much more. You might even be denied coverage for something as simple as misclassifying your illness. For these and other reasons, it is wise to work with an attorney for these issues.

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Health Coverage For People With Disabilities

If you have a disability, you have three options for health coverage through the government.

  • Medicaid provides free or low-cost medical benefits to people with disabilities. Learn about eligibility and how to apply.

  • Medicare provides medical health insurance to people under 65 with certain disabilities and any age with end-stage renal disease . Learn about eligibility, how to apply and coverage.

  • Affordable Care Act Marketplace offers options to people who have a disability, dont qualify for disability benefits, and need health coverage. Learn about the .

Medical Reasons For Short

Qualifying short-term disability medical reasons are accidents or illnesses that satisfy five universal eligibility requirements that might read as follows in your policy.

  • Occurs after the effective date
  • It happens while coverage is in force
  • It is not explicitly excluded
  • Causes a loss of income
  • Under the care of a doctor
  • Applying for short-term disability benefits by filing a claim form is the most reliable route to an answer. Only the insurance company or state agency administering your policy can make a final determination.

  • Is Not Specifically Excluded
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    Adults Disabled Before Age 22

    An adult who has a disability that began before age 22 may be eligible for benefits if a parent is deceased or starts receiving retirement or disability benefits. We consider this a “child’s” benefit because it is paid on a parent’s Social Security earnings record.

    The disabled “adult child” including an adopted child, or, in some cases, a stepchild, grandchild, or step grandchild must be unmarried, age 18 or older, have a disability that started before age 22, and meet the definition of disability for adults.


    It is not necessary that the disabled “adult child” ever worked. Benefits are paid based on the parent’s earnings record.

    • A disabled “adult child” must not have substantial earnings. The amount of earnings we consider “substantial” increases each year. In 2021, this means working and earning more than $1,310 a month.

    Working While Disabled: How We Can Help

    Get Help With Securing Your Benefits

    What Medical Conditions Make You Qualify for Successful ...

    Filing a disability claim can be a confusing and stressful process. There are many potential pitfalls that can lead to your claim being denied. It is not the time to gamble on losing the continued care you need.

    You are not alone. Our compassionate and caring team of long-term disability attorneys is here to help you win and heal.

    Contact Roy Law Group today for help with navigating this complicated process.

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    Types Of Disability Policies

    There are two types of disability policies.

    • Short-term policies may pay for up to two years. Most last for a few months to a year.

    • Long-term policies may pay benefits for a few years or until the disability ends.

    Employers who offer coverage may provide short-term coverage, long-term coverage, or both.

    If you plan to buy your own policy, shop around and ask:

    • How long do benefits last?

    • How much money will the policy pay?

    Listed And Unlisted Conditions Must Be Severe

    Whether the SSA has or hasnt listed your impairment, you will need more than a diagnosis to qualify for disability benefits. For listed conditions, your diagnosis and medical records must match the SSAs requirements for that specific condition. The medical evidence you present must align with the symptoms, signs, and other criteria for that impairment. If you dont meet all the requirements of a listed condition, you can still present your medical evidence. The SSA can review it and determine if its severity is equal to an impairment it considers severe.

    For a legal consultation, call

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    What Does Long Term Disability Insurance Cover

    Here are the top five reasons for filing long term disability claims:

  • Musculoskeletal disorders
  • Mental health issues including depression and anxiety
  • Injuries such as fractures, sprains, and strains of muscles and ligaments
  • As you can see, the scope of disabling events is wide. That’s why perhaps the most important factor when considering long term disability insurance is a policy’s definition of disability.

    How a policy defines disability will determine how much, and even if, you collect benefits following an injury or illness. Some policies will pay out a monthly benefit if an injury prevents you from working at your normal job, but allows you to do other types of work that will nonetheless reduce your income. Other policies will not pay benefits if you are able to work in another type of profession, even if you earn less money.

    A policyâs definition of disability is based on your capacity to work. Maybe youâre unable to work in your chosen profession, but can do other work. A disability may allow you to work in a reduced capacity. Serious ailments can prevent you from working in any job.

    To collect on a claim, you must meet the policyâs definition of disability. This can vary greatly by company and policy. The broader the definition, the more it will cost.

    What If I Can Only Work Part

    Your Eligibility For Short And Long-Term Disability Benefits For Scoliosis

    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.

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    Medical Conditions That Qualify For Ltd

    The medical conditions that may qualify you for LTD coverage vary. However, they must be severe enough to cause you to become unable to perform your occupation, and for some policies, any occupation if you continue to be disabled. Most LTD claimants do not attribute disability to a single illness or injury. Instead, it is generally a combination of factors that cause the body to break down.

    Another complication in disability claims is that you may experience chronic pain, adverse reactions to medications, and fatigue. These elements combined can create a breeding ground for total disability. Insurance companies should consider the overall impact of your condition.

    Since each condition carries its own symptoms, its essential to understand the impact your medical condition has on your daily life. Demonstrating how they affect your ability to work is critical.

    There are a wide range of medical conditions, illnesses and disabilities that may qualify you for long-term disability benefits in New Jersey or Pennsylvania. Whether your medical condition qualifies for LTD coverage will depend on the policy or plan documents. At Bross & Frankel, we have helped our clients obtain LTD benefits for conditions such as:

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