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Long-term disability insurance examples are a good way to show the benefits of long-term disability insurance. Because not every medical condition or injury qualifies as disabling or is considered disabling enough to trigger the payout of LTD insurance benefits examples can be used to demonstrate the types of illnesses or injuries that may qualify for benefits.
When an insurance company is evaluating whether or not your condition is considered to be a long-term disability there are many factors that go into making that decision. That’s why it’s important that you have medical records that accurately show all of your symptoms as well as medical tests and other assessments.
For example, if your pain level is high and that makes it impossible to sleep so you have fatigue in addition to other symptoms that could be more disabling than just the original injury or condition that you have.¹
As a general rule, conditions that are recognized by the Social Security Administration as disabling should also qualify as disabling conditions for long-term disability insurance purposes, although that may not be true for every condition.
The Social Security Administration (SSA) maintains a list of the conditions it considers disabling that contains more than 200 conditions and any special requirements that must be met. The conditions and requirements are published in the SSA’s Blue Book, which you can search through online to see if the condition that you have is listed in the book.²
When the Social Security Administration is evaluating whether or not a condition is disabling when the person doesn’t meet all of the requirements that are in the SSA’s Blue Book they look at factors like³:
Your age: If you’re older and become sick or injured it may be harder for you to go back to work than it would be for a younger person, so your age plays a factor in whether or not your condition is considered disabling.
Your education: If you haven’t had any formal education in any other field than the one you’re currently working in, you will be less likely to be able to pivot to another type of work. If you can’t do the work that you were educated to do, it’s more likely that you’ll be considered to be disabled.
Your work history: If you have been working in the same type of job your whole career or for more than ten years and you have no training in any other types of work when you can no longer do that kind of work, it makes your case that you are disabled stronger.
Your medical condition: If you develop a progressive illness that will only get worse as time goes on, that will impact whether or not you’re considered disabled because it means that you won’t recover and be able to go back to work.
No matter what your medical condition or injury is if it’s something that is progressive it’s disabling because there is no chance you will recover and be able to work again the way you did before your condition began.
When people think about not being able to work for a long time or becoming permanently disabled they usually think about being injured in a car crash or some other kind of accident. But there are many illnesses that are typically considered disabling, especially if they make it impossible for you to continue doing the only type of work you’ve ever known. What medical conditions qualify for long-term disability? There are dozens of health conditions that may qualify someone to receive disability benefits from their long-term disability insurance.
Autoimmune disorders like Chronic Fatigue Syndrome, Lupus, and Fibromyalgia can be permanently disabling. So can diseases like HIV/AIDS, Degenerative Disc Diseases, and Crohns’s Disease. Mental health conditions like Depression and Bi-polar Disorder also can qualify as permanently disabling if they are severe enough.⁴ There are also conditions that can directly impact someone’s ability to work, like Osteoarthritis, which are considered permanently disabling in some circumstances.
There are medical conditions in every branch of medicine that typically qualify as permanently disabling like⁵:
Traumatic Brain Injury
Alzheimer’s (early onset)
Chronic lung infections
Chronic Venous Insufficiency
Congestive Heart Failure
Coronary Artery Disease
Periphery Artery Disease
Carpal Tunnel Disorder
Other medical conditions like burns, vision loss, macular degeneration, and hearing loss may be considered to be disabling if they meet certain criteria.
There are other conditions and injuries that are considered disabling too, like some types of cancer. What illness qualifies for long-term disability depends on factors like the severity of the condition and how much medical evidence you have. Whether or not a condition is qualified as disabling often depends on the details of your unique situation. If your cancer is treatable then you might qualify for disability insurance benefits while you are in treatment and can’t work but you might be expected to go back to work once the treatment is successfully finished. But the same cancer in another person might not respond to treatment and then that person would be permanently disabled.
That’s why it’s critically important to have as much medical documentation of your condition as you can get. Make sure that you have multiple copies of any test results like MRIs, or blood tests, or PET scans. Biopsies, X-rays, and other medical test results will help prove that your condition is going to make it impossible for you to work. Save all of the medical documentation that you are given by your doctor or the hospital and request your medical history from your primary treatment facility so that you will have a copy on hand.
If your medical illness is a pre-existing condition long-term disability insurance may not pay out any benefits. It’s very important to get a long-term disability insurance policy in place as soon as you can so that if you do develop an illness, it’s not diagnosed before you buy insurance. Anything that is diagnosed before the long-term disability policy is active is considered a pre-existing condition and may not be covered.⁶
All insurance is designed to help protect you against things that might happen, but long-term disability insurance can only help you protect you against qualifying illnesses or injuries that you don’t have yet. Pre-existing conditions or injuries aren’t covered. Buying a long-term disability insurance policy now while you are healthy is the best way to prepare for a future where that might not always be the case.
If you haven’t already purchased long-term disability insurance you shouldn’t wait to get a policy. You can get a long-term disability insurance quote from Guardian Direct® so that you apply in just a few minutes with the PayGuard Plus PDQ quick application that requires no medical interview or documentation. You can also read through our library of direct-to-consumer individual long-term disability insurance articles to help you understand more about LTD insurance and how it helps protect you and your family.
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https://www.nickortizlaw.com/disabling-conditions/, (2020) accessed June 2021.
https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm, accessed June 2021.
https://www.disabilitysecrets.com/rfc-win.html, accessed June 2021.
https://www.sokolovelaw.com/disability-insurance-denial/long-term-disability-denial/medical-conditions/, (2020) accessed 2021.
https://www.nickortizlaw.com/disabling-conditions/, accessed June 2021.
https://www.nolo.com/legal-encyclopedia/can-you-work-collect-long-term-disability-benefits-the-same-time.html, accessed June 2021.
Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.(exp.Invalid Date)
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