Long-Term Disability Qualifications

Long-term disability benefits help people make ends meet when they’re unable to work because of a medical condition. However, only certain conditions meet long-term disability qualifications, and insurance companies often deny valid claims. If your long-term disability claim has been denied, LawFirm.com may be able to connect you with an attorney who can help you get the compensation you’re owed.

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  • $1.36 million for a New York man whose Aetna long-term disability claim and appeal were denied
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Long-Term Disability Insurance

Long-term disability (LTD) insurance plans provide monthly benefit payouts when a covered plan member can’t work due to an injury or illness.

Depending on the specifics of your plan, you may receive long-term disability benefits until you recover from your disability or reach a certain age. While only certain medical conditions qualify for coverage, your injury doesn’t have to occur at work in order to collect benefits.

Unfortunately, some insurance companies may say you don’t meet long-term disability qualifications and deny your long-term disability claim to increase their profitability.

About 67% of disability claims are denied, according to the Social Security Administration (SSA).

LawFirm.com works with top attorneys who have helped thousands of people across the country access the compensation they deserve. See if one of our legal partners can help you with a long-term disability claim denial.

Long-Term Disability Eligibility

You may be eligible for long-term disability benefits if you:

  • Have a long-term disability insurance plan
  • Are affected by a medical condition that meets the definition of disability under your policy
  • File a claim for benefits with your insurance company

Every long-term disability plan is different, and various exclusions could apply, such as for pre-existing conditions.

How Insurers Try to Avoid Paying Long-Term Disability Claims

Even if you meet your insurer’s long-term disability qualifications, they could reject your claim and issue a disability insurance denial.

Insurers often deny long-term disability claims by:

  • Arguing that your illness doesn’t meet the definition of disability
  • Claiming that there isn’t enough medical evidence to prove you can’t work
  • Misclassifying an illness so that it doesn’t meet long-term disability qualifications
  • Saying your social media posts to show that you’re healthier than you claim
  • Using surveillance video to prove that you’re able-bodied

The disability denial lawyers in the LawFirm.com network are familiar with these and other tactics that insurers use to deny valid claims and can build an appeal to show that you meet long-term disability qualifications.

Contact our team at LawFirm.com at (888) 726-9160 to see if one of our legal partners can help you with an appeal.

What Medical Conditions Qualify for Long-Term Disability?

Certain medical conditions that prevent you from working may satisfy long-term disability qualifications. These conditions can be physical, neurological, or psychological in nature.

Medical conditions that may qualify for LTD benefits include:

  • Anxiety
  • Arthritis
  • Brain injury
  • Cancer
  • Carpal tunnel syndrome
  • Crohn’s disease
  • Degenerative disc disease
  • Diabetes
  • Epilepsy
  • Fibromyalgia
  • Multiple sclerosis (MS)
  • Post-traumatic stress disorder (PTSD)
  • Spine disorders
  • Stroke

Keep in mind that this is not a complete list, and qualifying medical conditions may vary from one long-term disability policy to another.

To find out if your policy provides insurance coverage for a certain medical condition, call your insurer directly or read your insurance policy documents.

Long-Term Disability Requirements: Categories of Medical Conditions

Many different types of medical conditions may satisfy long-term disability requirements.

The main categories of medical conditions that often qualify for long-term disability insurance are listed below.


Cancer patients usually require treatments such as radiation, surgery, and chemotherapy, which may cause fatigue and other side effects.

Long-term disability payments can offer families financial stability following the uncertainty of a cancer diagnosis.

Chronic Kidney Disease & Renal Failure

Chronic kidney disease and renal (kidney) failure can cause debilitating symptoms that may prevent you from working, like fluid retention, tiredness, and shortness of breath.

As such, these kidney issues may be covered by long-term disability insurance. Your insurer will consider any related conditions, symptoms, and complications when reviewing your LTD claim.

Digestive System Disorders

Many different digestive system disorders may qualify for long-term disability benefits.

These conditions include:

  • Chronic liver disease
  • Crohn’s disease
  • Inflammatory bowel disease (IBD)
  • Irritable bowel syndrome (IBS)

Symptoms may be so severe that they prevent a person from working.

Get a free case review to see if we can help you reverse a long-term disability denial.

Endocrine Disorder

The endocrine system is composed of the body’s hormones and controls all of the different biological processes. When the endocrine system stops working properly, many physical complications may occur.

Examples of endocrine disorders that often qualify for long-term disability coverage include hyperglycemia, diabetes mellitus, and thyroid gland disorders.

Heart & Cardiovascular Conditions

A man talks to a doctor about a heart condition Long-term disability benefits may cover heart and cardiovascular conditions.

These can include:

  • Coronary artery disease
  • Heart arrhythmias
  • Heart attack
  • Heart failure

It’s possible that your insurance company will reach out after a cardiac event and ask for information verifying that you are still unable to work.

Immune System Disorders

Immune system disorders can lead to significant physical limitations. For instance, HIV/AIDS, scleroderma, and vasculitis can cause severe pain and fatigue, making it difficult to work.

An insurance company may argue that the symptoms of an immune disorder shouldn’t prevent you from working. However, statements from your health care provider, test results, and other medical documents may satisfy long-term disability requirements.

Mental Health Disorders

A range of psychological disorders can be covered by LTD insurance.

These conditions include:

  • Anxiety
  • Bipolar disorder
  • Major depressive disorder
  • Schizophrenia

When mental health conditions are severe, they can hinder an individual’s ability to secure regular employment. Your disability insurance company will analyze your medical records and level of daily functioning in detail to determine if you qualify for benefits.

Musculoskeletal Disorders

Musculoskeletal disorders can lead to physical limitations and chronic pain that limit people from working over an extended period. Examples of these disorders include arthritis, back pain, and joint disorders.

Did you know?

Musculoskeletal disorders are the number one cause of long-term disability claims, according to the Council for Disability Awareness.

Neurological Conditions

Neurologic disorders like epilepsy and Parkinson’s disease can affect a person’s cognitive abilities. They can also affect physical functioning and the activities of daily living, such as dressing and bathing, so they may also be covered by long-term disability insurance.

Respiratory Conditions

Respiratory conditions such as severe asthma and chronic obstructive pulmonary disease (COPD) make it challenging to breathe, reducing an individual’s ability to engage in physically demanding activities at work.

Vision and Hearing Loss

A man sees a doctor about hearing lossVision and hearing loss may qualify for long-term disability coverage. This is because severe hearing and vision impairment can significantly affect your ability to work and communicate effectively.

If you’ve been diagnosed with a serious medical condition and your insurer says that you’ve failed to meet long-term disability qualifications, LawFirm.com may be able to help.

Chat with one of our case managers right now to see if one of the law firms in our network can file an appeal on your behalf.

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Get Help From a Long-Term Disability Lawyer

The insurance claims process can be confusing and frustrating. Oftentimes, policyholders don’t know what different insurance terms mean or what to do in the event of a claim denial.

Plus, appealing a claim denial can be challenging, especially if you don’t have the energy, expertise, or time.

By letting a long-term disability attorney handle your appeal and fight the insurance company for you, you’ll have time to take care of your health and well-being.

If you’re facing a long-term disability claim denial, LawFirm.com may be able to help. The lawyers in our network can handle an appeal on your behalf and show that you meet long-term disability qualifications if you’re eligible.

The lawyers that we work with never charge any upfront fees, and they can handle cases in all 50 states.

Get a free case review now to see if we can help.

What Conditions Qualify for Long-Term Disability FAQs

What qualifies for long-term disability?

Many different types of medical conditions meet long-term disability requirements.

These conditions may include:

  • Anxiety
  • Arthritis
  • Brain injury
  • Cancer
  • Carpal tunnel syndrome
  • Crohn’s disease
  • Degenerative disc disease
  • Diabetes
  • Epilepsy
  • Fibromyalgia
  • Multiple sclerosis (MS)
  • Post-traumatic stress disorder (PTSD)
  • Spine disorders
  • Stroke

How do you qualify for long-term disability insurance?

You may meet long-term disability qualifications if you have a long-term disability insurance plan and are impacted by a medical condition that is considered a disability under your policy.

To get benefits, you’ll need to file a claim with your insurance company.

What should I do if my insurance company denied my claim for long-term disability benefits?

If your insurer denied your claim for long-term disability benefits, an experienced attorney can file an appeal on your behalf. Attorneys are familiar with the tricks insurance companies use to deny legitimate claims and can use that knowledge to get your claim denial overturned.

LawFirm.com may be able to connect you with a disability insurance attorney who can handle the appeals process for you. See if you qualify by getting a free case review.

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Written by: LawFirm.com

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  1. Cleveland Clinic. “Endocrine System.” Retrieved August 24, 2023, from https://my.clevelandclinic.org/health/articles/21201-endocrine-system
  2. Cleveland Clinic. “Ichthyosis Vulgaris.” Retrieved August 24, 2023, from https://my.clevelandclinic.org/health/diseases/21069-ichthyosis-vulgaris
  3. Council for Disability Awareness. “Chances of Disability.” Retrieved September 26, 2023, from https://disabilitycanhappen.org/common-causes/
  4. HealthCare.gov. “Grandfathered health plan.” Retrieved August 23, 2023, from https://www.healthcare.gov/glossary/grandfathered-health-plan/
  5. Mayo Clinic. “Fibromyalgia.” Retrieved August 23, 2023, from https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780
  6. NIH News in Health. “Understanding Autoimune Diseases: When Your Body Turns Against You.” Retrieved August 24, 2023, from https://newsinhealth.nih.gov/2023/01/your-bodys-disease-defenses
  7. NHS. “Selective mutism.” Retrieved August 24, 2023, from https://www.nhs.uk/mental-health/conditions/selective-mutism/
  8. Penn Medicine. “What is Bullous Pemphigoid?” Retrieved August 24, 2023, from https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/bullous-pemphigoid
  9. Social Security. “How You Qualify.” Retrieved August 23, 2023, from https://www.ssa.gov/benefits/disability/qualify.html
  10. Sokolove Law. “Long-Term Disability Qualifications.” Retrieved August 23, 2024, from https://www.sokolovelaw.com/disability-insurance-denial/long-term-disability-denial/medical-conditions/
  11. Stanford Medicine. “Kidney Failure Symptoms.” Retrieved August 24, 2023, from https://stanfordhealthcare.org/medical-conditions/liver-kidneys-and-urinary-system/kidney-failure/symptoms.html
  12. U.S. Department of Labor. “Disability Insurance Denial.” Retrieved August 23, 2023, from https://www.dol.gov/general/topic/safety-health/disabilityins
  13. Wisconsin.Gov: Department of Workforce Development. “Independent Medical Examination.” Retrieved August 23, 2023 from https://dwd.wisconsin.gov/wc/medical/ime.htm#:~:text=An%20independent%20examination%20may%20be,or%20loss%20of%20earning%20capacity.
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