Common Medical Conditions That Qualify for Long-Term Disability

If a medical condition prevents you from working for an extended time, some employers provide their workers with wage protection through a long-term disability plan offered as a benefit of employment. Many people who do not have an employer-sponsored plan available to them achieve the same protection through a long-term disability policy purchased from an insurance company.

Whether the wage protection comes in the form of an insurance policy or an employer-sponsored plan, disability eligibility depends less on the specific qualifying medical conditions and more on how they affect your ability to work. The disability lawyers at Sackett and Associates have been assisting individuals with disabilities in Northern California and throughout the United States for 45 years. Here is what you need to know about long-term disability and eligibility for disability benefits.

Terms Of The Plan Or Policy Determine Disability Eligibility

An inability to work for less than a year would not be considered a long-term disability. Instead, you may be eligible for wage-replacement benefits through a short-term disability policy or plan. Long-term disability conditions typically last for at least one year or longer. The coverage depends on the terms of the policy or plan.

The coverage details also include the definition of a “disability” to determine eligibility for benefits. For example, some disability plans or insurance policies pay benefits for medical conditions that prevent you from doing the work you did for your current employer. However, other policies employ a much broader definition, requiring evidence that you cannot perform any kind of work to be eligible for benefits.

A diagnosis that you have a medical condition is generally not sufficient to qualify for disability benefits without evidence of the condition being serious enough to keep you from working.

Long-Term Disability Eligibility Through The Social Security Administration

The Social Security Administration provides long-term disability benefits through the Social Security Disability Insurance and Supplemental Security Income programs. The disability definition for adults used by Social Security to determine eligibility requires medical records and other documentation of the following:

1. A medically determinable physical or mental impairment.
2. The impairment or impairments must be expected to result in death or last for at least 12 months.
3. You must be unable to do substantial gainful work activities because of the impairments.

You must be unable to do work you did in the past and other types of work available in the national and regional economies.

Medical Conditions That May Qualify For Long-Term Disability Benefits

Many serious health conditions satisfy the definition used by the Social Security Administration and by long-term disability insurance companies to determine eligibility for disability benefits. Some of the physical and mental health conditions that could cause a disability preventing you from working for more than one year include:

1. Musculoskeletal Disorders: Disorders of the spine or extremities may also involve tendons, ligaments, muscles, and soft tissues. Examples include lumbar spinal stenosis, nerve root disorders, amputation, abnormalities of major joints in an extremity, and non-healing or complex fractures.
2. Special Senses And Speech: Vision, speech, and hearing disorders, such as blindness, hearing loss, and loss of ability to speak.
3. Respiratory Disorders: Qualifying disorders may include chronic bronchitis, emphysema, asthma, and cystic fibrosis.
4. Cancer: Depending on the degree to which a person’s ability to work is affected by the disease, different forms of cancer could restrict a person’s ability to work for an extended period of time.
5. Mental Health Disorders: Several mental health conditions may be severe enough to interfere with a person’s ability to work, including anxiety, depression, obsessive-compulsive disorders, post-traumatic stress, intellectual disorders, and neurocognitive disorders.

Many other medical conditions also may qualify for chronic illness benefits because of their effect on a person’s capacity to perform work activities. For example, Crohn’s disease and other gastrointestinal conditions may produce symptoms ranging from mild to severe, so a diagnosis may not be enough to determine whether a patient qualifies for long-term disability benefits.

Evidence of how the condition affects the person’s performance of work activities also must be presented for a successful disability claim. Medical records containing physicians’ notes, laboratory reports, and diagnostic imaging results may need to be supplemented by statements from employers, immediate supervisors, and others to document the disabling nature of the medical condition.

Get Help From A Disability Lawyer

Having a claim for long-term disability benefits denied following a diagnosis that you have one or more serious health conditions can be a shock, but you may have options for challenging it. Start by contacting the disability benefits team at Sackett and Associates. People with disability claims in Northern California and throughout the country rely on Sackett Law for advice they can rely upon and skilled representation to fight for disability benefits.

Find out more about long-term disability and appealing a denial of claim through an insurance company or the Social Security Administration. Contact Sackett Law for a free consultation.