Long-Term Disability Qualifications and Medical Conditions 


People sometimes think about how a disability might affect them physically, but many don’t think about how a disability or illness might affect them financially.

A serious, long term disability may prevent you from ever working again, and that means you may never be able to earn income again.

So what can you do to keep yourself financially afloat?

Collect disability benefits.

Here’s what you need to know about long-term disability qualifications and which medical conditions will make you eligible to collect benefits when you’re unable to work.

What is Long-Term Disability?

Long-term disability benefits are monthly payments that you can receive if you suffer a disability, injury, or illness that prevents you from working. You can collect these benefits from one of two entities:

  • The Social Security Administration
  • An individual disability insurance policy from an insurance company

To qualify for Social Security disability benefits, or SSDI, you must have worked long enough (and recently enough) to have earned a certain number of “work credits.” The number of credits needed to qualify for benefits varies depending on the age at which you developed the disability. A complete breakdown of the credits needed can be found in this SSA publication.  

SSDI is available for anyone with enough work credits and a qualifying medical condition.

To qualify for benefits through an individual insurance policy you must obtain the policy prior to developing the disability. You must also pay monthly premiums.

There are a variety of factors that contribute to the cost of monthly premiums, including:

  • Your age
  • Your current health condition
  • How much coverage you want
  • Which benefit period you select

The benefit period is the duration of time throughout which you want to collect benefits. Long-term disability insurance policies offer benefit periods ranging from two years all the way up to retirement age.

What Medical Conditions Qualify You for Long-Term Disability?

There are a variety of medical conditions that can qualify you to receive long-term disability benefits, and they don’t all have to be severe. It all depends on where you collect benefits from.

To qualify for long-term SSDI benefits you must meet a strict set of criteria and suffer a significant illness or disability that prohibits you from working in any job whatsoever. Medical conditions that qualify for SSDI include, but are not limited to:

  • Impaired hearing
  • Impaired sight
  • Chronic kidney disease
  • Parkinson’s disease
  • Cancer
  • Congenital heart disease
  • HIV
  • Sickle cell disease

It’s difficult to qualify for SSDI benefits. Qualifying for long-term benefits through an individual disability insurance policy is much easier to do.

Every disability insurance policy has its own definition of disability. You must meet the standards of this definition in order to collect benefits.

One of the most common definitions is any occupation. Similar to SSDI, to qualify for benefits you must have a medical condition that renders you unable to work in any occupation.  

The own occupation definition is a much more lenient definition.

Under the own occupation definition, you can qualify with ANY condition that prevents you from doing the job you held when you suffered your injury or received your diagnosis.

For example, a hand injury could prevent a surgeon from operating or a construction worker from operating power tools. With an own occupation disability insurance policy, these individuals would be eligible to receive benefits, even though that hand injury might not prevent them from doing other types of jobs.

Read this article to learn more about Ameritas, one of only six insurance companies that offer the true own-occupation definition of disability.

How to Receive Long-Term Disability Benefits

The first step in collecting benefits is to file a claim. Both SSDI and insurance companies require that you provide medical evidence from your physician that proves you are unable to return to work.

It is possible to collect long-term disability insurance benefits through an individual policy and through SSDI at the same time. Some insurers, however, include policy terms that allow them to reduce your individual monthly benefits by the amount you receive from SSDI.

If you have a severe disability that will qualify you to collect SSDI, file a claim for SSDI first. The approval process through the Social Security Administration usually takes between three and five months. Private insurance companies process claims much faster and sometimes approve claims in as little as a few days.

When you purchase a long-term disability insurance policy, pay special attention to the elimination period you select. The elimination period, also referred to as the waiting period, is the time frame between the date of your injury or diagnosis and the date that you can start collecting benefits. Elimination periods range from as little as 30 days up to 720 days.  

In Conclusion

Before a life-changing disability occurs, protect yourself with an individual disability insurance policy. SSDI benefits are difficult to qualify for, so having an insurance policy of your own is the best way to ensure financial stability for the long term.  

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