Long-Term Disability Qualifications

Understanding Long-Term Disability Insurance

Long-term disability insurance plans provide monthly benefit payouts when a policyholder can’t work due to an injury or illness. You may be entitled to LTD benefits until you recover or reach retirement age, depending on your plan.

To meet long-term disability eligibility requirements, you must:

• Be a policyholder or beneficiary of an LTD plan
• Have a qualifying medical condition as per the terms of your policy
• File a claim for long-term disability benefits

However, your insurer may wrongly say you don’t meet long-term disability qualifications and deny your claim to increase their profits.

LawFirm.com works with disability lawyers who can fight back against powerful insurance companies. Together, our legal partners have secured over $133 million for those impacted by denied claims.

Get a free case review now to see if a top disability denial attorney can pursue the benefits you deserve.

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What Medical Conditions Qualify for Long-Term Disability?

Qualifying for long-term disability requires having a medical condition that prevents you from working. These conditions can be physical, neurological, or psychological.

While only certain injuries or illnesses qualify for insurance coverage, your injury doesn’t have to occur at work in order to collect benefits.

Medical conditions that may meet requirements for long-term disability include:

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

This is not a complete list — many other medical conditions are often covered by LTD policies.

Qualifying for long-term disability may vary depending on the specifics of your case and the terms of your insurance policy.

To find out if your policy provides coverage, call your insurer directly or review your insurance policy documents. A disability denial lawyer can also help you understand the benefits you’re entitled to.

Play Video Insurance companies have a duty to treat policyholders fairly. When they fail to do so, a disability attorney can step in and appeal a wrongful denial. Duration: 1 min 00 sec

Qualifying for Long-Term Disability: Categories of Medical Conditions

Many different injuries and illnesses may be considered long-term disability qualifying conditions. These health conditions are evaluated based on their severity and how they affect your ability to work.

The main categories of medical conditions that often meet long-term disability qualifications are listed below.

Alzheimer’s and Other Types of Dementias

Alzheimer’s and other forms of dementia, like vascular dementia, Lewy body dementia, and Huntington’s disease, can interfere with a person’s ability to work, qualifying for long-term disability benefits in many cases.

These patients may experience memory loss, confusion, and communication issues, making it difficult for them to perform daily work tasks safely and effectively.

Anxiety and Depression

Millions of Americans suffer from anxiety and depression, which can make it difficult for them to work. Symptoms like panic attacks, excessive worrying, and extreme fatigue can prevent them from performing their job duties.

However, insurance companies often challenge mental health claims and determine that they don’t meet long-term disability qualifications. As a result, it’s key to build a strong case with medical records and psychiatric evaluations.

Back Pain and Other Musculoskeletal Disorders

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

Cancer

Cancer patients may require treatments like radiation, surgery, and chemotherapy, which can cause fatigue and other side effects.

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

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS) is a complex condition that causes extreme fatigue, cognitive impairment, and physical limitations.

Symptoms can be difficult to measure with standard medical tests, making it difficult for policyholders to meet long-term disability qualifications. However, with strong medical evidence, individuals with CFS may qualify for LTD benefits.

Chronic Pain

About 1 in 5 adults in the U.S. lives with chronic pain, according to the Centers for Disease Control and Prevention (CDC).

Conditions commonly associated with chronic pain include:

• Arthritis
• Fibromyalgia
• Migraines
• Neuropathy

Qualifying for long-term disability can be challenging as pain is subjective and difficult to measure. A diagnosis from a specialist, imaging tests, and other medical records can help policyholders satisfy long-term disability qualifications.

When LTD benefits are unfairly denied, a disability attorney can step in and file an appeal to seek the benefits owed.

COPD and Respiratory Disorders

Respiratory conditions like chronic obstructive pulmonary disease (COPD) and asthma can make it challenging to breathe, reducing an individual’s ability to walk, talk, and even concentrate due to low oxygen levels.

Crohn’s Disease and Digestive System Disorders

Many different digestive system disorders may satisfy long-term disability qualifications, granting policyholders monthly benefit payments to help with medical bills and basic living expenses.

These conditions include:

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

“IBS is a very common disorder and scientific tests show that about 10% to 15% of people in the United States have it. IBS is more common in women with almost twice as many women having it than men.”

– American College of Gastroenterology

Symptoms like abdominal pain, digestive issues, and fatigue may be so severe that they prevent a person from working.

Diabetes and Endocrine Disorders

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, patients may experience complications.

Examples of endocrine disorders that may meet long-term disability qualifications include hyperglycemia, diabetes, and thyroid gland disorders.

Heart and Cardiovascular Conditions

Heart conditions may cause chest pain, fatigue, shortness of breath, or dizziness, qualifying them for long-term disability.

Examples include:

• Arrhythmias
• Coronary artery disease
• Heart failure
• Hypertension (high blood pressure)
• Stroke

Medical evidence like EKGs, stress tests, and reports from a cardiologist can confirm that you’re unable to perform your job and meet long-term disability qualifications.

HIV/AIDS and Immune System Disorders

HIV/AIDS and other immune system disorders can cause chronic fatigue, infections, neuropathy, cognitive issues, and other complications that impact daily functioning and work performance.

Kidney Disease and Renal Failure

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

Qualifying for long-term disability may require medical evidence like blood tests, imaging scans, and doctor reports. Dialysis or the need for a kidney transplant can further support a disability claim.

Mental Health Disorders

A range of psychological disorders may be considered conditions that qualify for long-term disability, depending on the terms of your policy.

These mental health conditions may include:

• Anxiety
• Bipolar disorder
• Major depressive disorder
• Schizophrenia

Symptoms like concentration problems, fatigue, and cognitive issues may prevent you from performing your job duties. Diagnoses from mental health professionals, therapy notes, and treatment records can help with a claim.

Parkinson’s Disease and Other Neurological Conditions

Parkinson’s disease is a progressive neurological disorder that affects movement, causing symptoms like tremors, stiffness, and balance problems. These symptoms can significantly impair a person’s ability to function at work.

Other neurological disorders that may meet long-term disability qualifications include epilepsy and Amyotrophic Lateral Sclerosis (ALS, or Lou Gehrig’s Disease).

Rheumatoid Arthritis and Other Autoimmune Disorders

Rheumatoid arthritis (RA) and other autoimmune disorders, like lupus and multiple sclerosis (MS), can limit a person’s ability to work.

These conditions can cause:

• Chronic pain
• Fatigue
• Inflammation
• Mobility issues

Your insurance company may argue that your symptoms don’t meet long-term disability qualifications, but statements from your health care provider and test results can help build a strong claim.

Traumatic Brain Injuries

Individuals with traumatic brain injuries (TBIs) may experience cognitive impairments, memory loss, headaches, and more, impacting daily functioning and the ability to work.

“More than 75% of all TBIs are mild. But even mild TBIs may cause significant and long-term issues. People with a mild traumatic brain injury may have trouble returning to their daily routines, including being able to work.”

– Cleveland Clinic

Qualifying for long-term disability benefits may require medical evidence like your diagnosis, CT scans or MRIs, and treatment records.

Vision and Hearing Loss

Patients with vision and hearing loss may qualify for long-term disability coverage if their impairments affect their 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.

Get a free case review now to see if one of the law firms in our network can file an appeal on your behalf.

Get the Compensation You Deserve

Take the first step toward compensation and justice for a wrongful disability insurance claim denial.

Get a Free Case Review

Steps to File For Long-Term Disability

Filing for long-term disability benefits can be complex, but by taking a few important steps, you can increase your chances of a successful outcome.

Here is the basic process involved in meeting long-term disability qualifications and accessing the benefits you’re entitled to.

1. Review your disability policy: By understanding your policy’s LTD qualifications, like eligibility, waiting periods, and definition of disability, you’ll know if your health condition is covered and what to expect moving forward.
2. Obtain medical documentation: Collect doctor’s reports, test results, and treatment records documenting your condition and how it impacts your ability to work.
3. Inform your employer: Notify your employer that you plan to file for LTD benefits. They may need to provide additional paperwork, like job descriptions or workplace accommodations.
4. Complete the LTD application: Fill out the application provided by your insurance company completely and accurately to avoid a long-term disability denial.
5. Submit your claim: Submit the application and supporting documents to your insurance company. Make copies for your records.
6. Follow up: Stay in contact with the insurance company to ensure your claim is being processed. You may need to provide additional information or documents.
7. Prepare for an appeal: If your claim is denied, you have the right to appeal. A disability lawyer can strengthen your case by submitting additional evidence and medical records.

With a lawyer handling every step of the appeals process, you’ll have peace of mind — and a better chance of getting the compensation you deserve.

Ways Insurers Dispute Long-Term Disability Eligibility

Even if you meet your insurer’s requirements for qualifying for long-term disability, 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 it doesn’t meet long-term disability qualifications
• Tracking your social media posts to show 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.

Get Help From a Long-Term Disability Lawyer

The insurance claims process can be confusing and frustrating. By letting a long-term disability attorney handle your appeal and fight the insurance company for you, you’ll have time and energy to focus on what’s truly important – your health.

If you’re facing a long-term disability claim denial, LawFirm.com may be able to help. The lawyers in our network strive to make the appeal process as easy and stress-free as possible.

The disability lawyers we work with never charge any upfront costs or hourly fees and can help families in all 50 states.

Call (888) 726-9160 right now or fill out our form to see if we can help you get everything you deserve.