Getting your long-term disability benefits approved can be a long, difficult and frustrating process. People often struggle with determining conditions that qualify for LTD, how severe symptoms have to be before they can be approved and which conditions are excluded. It is not surprising that you cannot figure out how the policy works, as it is quite complex in nature.
The best way to figure out which medical conditions are covered and if your condition qualifies for long-term benefits is to work with an experienced attorney. If you still want to research your claim, this blog will help you get all the information you need.
The definition of disability
Long-term disability insurance policy is usually defined in the following ways:
- Own occupation: An own occupation policy covers you if your disability prevents you from fulfilling the duties of the job that you are currently performing. You can work a different job with different duties and still receive full disability benefits.
- Any occupation: Under any occupation policy, the person is covered with long-term disability benefits when they are completely disabled and unable to perform any job. This is a much tougher standard to meet than an own-occupation disability.
What medical conditions qualify for long-term disability benefits?
Here is a list of the medical conditions that may qualify for long-term disability benefits:
- Essential tremors
- HIV/AIDS
- Heart disease
- Liver disease
- Lung disease
- Lupus
- Lyme disease
- Meniere’s disease
- Inflammatory bowel disease
- Brain injuries
- Cancer
- Carpal tunnel syndrome
- Amyotrophic Lateral Sclerosis (ALS)
- Arthritis
- Asthma
- Anxiety
- Bipolar disorder
- Chronic fatigue syndrome
- Chronic pain (including back, neck, hand, shoulder, and others)
- COPD
- Narcolepsy
- Post-traumatic stress disorder
- Rheumatoid arthritis
- Schizophrenia and schizoaffective disorder
- Nerve damage
- Parkinson’s disease
- Seizure disorders
- Sleep disorders
- Crohn’s disease
- Cystic fibrosis
- Degenerative disc disease
- Depression
- Diabetes
- Irritable bowel syndrome
- Kidney disease
- Leukemia
- Migraine headaches
- Multiple sclerosis
- Muscular dystrophy
- Spinal stenosis
- Stroke
- Tinnitus
- Post-concussion syndrome
- Post-COVID symptoms (including heart issues)
- Sciatica
- Vision impairment conditions
Automatically qualifying conditions
Under normal circumstances, a disability insurance company will evaluate your claim before approving or denying it. However, certain disabilities are automatically qualified for benefits. These include:
- Amputation
- Total deafness
- Total blindness
Still, remember that policy language can be complex and vary significantly. The insurance company could create a dispute over what is considered an automatically qualified condition. For example, total deafness could be subjective.
Moreover, there are certain limitations for specific conditions:
- Pre-existing injuries
- Mental health conditions
- Alcohol and substance abuse
- Workplace injuries
