What Medical Conditions Qualify for Long-Term Disability?

Long-term disability insurance helps protect workers from losing their income after they sustain a serious injury, illness, or other condition that leaves them unable to work for years at a time.

And, believe it or not, the conditions that could lead to long-term disability are more common than you’d think. Looking over the list, you might get the feeling that it could happen to any of us.

Luckily, long-term disability insurance exists. And, should we need it, it can replace up to 70% of the income we lose from being unable to work. This can help us afford our day-to-day life. It can also help us continue to save what we need for retirement.

Unfortunately, it requires an application process and extensive documentation of your injuries or conditions.

That’s why I wanted to discuss some of these conditions. When you know what to look out for, you can start that process as early as possible. That way, you’re prepared if you or someone you love ever sustains such an injury or condition.

What is long-term disability?

Long-term disability is an insurance plan that offers wage replacement when you suffer an injury or condition that prevents you from working. It often works in concordance with short-term disability. In fact, you might first apply for short-term disability, receive that until it runs out, then start receiving long-term disability.

Short-term disability is often measured in months. It typically lasts somewhere between 3-6 months.

Long-term disability is usually measured in years. It can last for 5, 10, or more years. Sometimes, it can even last until you reach retirement age.

In order to receive long-term disability benefits, you must go through the claims process. After you sustain an injury or illness, you can fill out a long-term disability claim—a sort of application describing why you need benefits. Then, you submit it to your insurance company, along with documentary evidence of your condition. They review your application along with the evidence, then determine whether you receive benefits.

If you don’t currently have a plan, you might consider whether disability insurance is right for you.

Common long-term disability conditions

There are many reasons to apply for long-term disability. Any time you suffer an injury or illness that prevents you from completing your work activities, and thus from receiving your regular wages, you might file a disability claim.

Some of the most common conditions that can lead to long-term disability include:

Arthritis

In simplest terms, arthritis is joint pain often caused by two or more bones rubbing against each other. In a healthy joint, cartilage lines the bones, preventing them from touching directly. However, the two most common types of arthritis destroy this lining.

In osteoarthritis, the cartilage wears away over time.

In rheumatoid arthritis, your immune system attacks and destroys the lining between the bones.

Common symptoms include:

• Joint pain
• Stiffness
• Limited range of motion
• Swelling

Chronic back pain

An injury or other condition can cause pervasive pain in your back. Often, these causes can destroy either the bones or the cartilage in your neck or spine. Besides injuries, some common conditions that can cause chronic back pain include:

• Spinal stenosis
• Osteoporosis
• Degenerative disc disease
• Arthritis
• Herniated discs

Symptoms depend on your specific condition or injury. However, common symptoms of chronic back pain include:

• Pain while lifting
• Inability to lift above a certain weight
• Limited mobility
• Pain radiating throughout the body (up the spine/neck, or down the buttocks and into the legs)

Cancer

There are many forms of cancer. Typically, cancer occurs when cells grow abnormally into a tumor. This can happen anywhere throughout the body, with varying levels of severity.

Cancer is often classified into different “stages” that describe how severe the cancer is. These stages range from a 1 (usually a single tumor localized to one body part) to a 4 (a cancer that spreads through to distant body parts).

The symptoms vary depending on type and severity. Treatments can also have severe and temporarily debilitating side effects.

Clinical depression

Clinical depression is a pervasive and potentially dangerous mental health condition. The symptoms can be severe enough to prevent someone suffering from depression from working. Such symptoms include:

• Extreme fatigue
• Lack of motivation
• Pervasive feelings of sadness and hopelessness
• Lack of appetite
• Suicidal thoughts

Diabetes

Diabetes is a disease of the endocrine system. It typically occurs when your body becomes unable to process the sugar in your blood. Often, this means your pancreas no longer produces enough insulin. While diabetes is often treatable, it can sometimes become so severe as to cause debilitating symptoms, such as:

• Unaccounted for weight loss
• Fatigue
• Blurred vision
• Increased risk of infections

Heart disease

Heart disease comes in many forms, all of which affect your heart’s ability to do its job. Some common forms of heart disease include:

• Heart attacks
• Arrhythmia
• Coronary artery disease
• Congestive heart failure
• Angina

Many forms of heart disease can increase your chance of heart attack and prevent blood and oxygen from circulating throughout your body. This can make working difficult, dangerous, and even deadly.

The symptoms depend on which form of heart disease you have, but some common ones include:

• Chest pains
• Shortness of breath
• Pain throughout your upper torso, back, neck, and jaw
• Pain and numbness in your extremities

Other conditions

The list goes on and on. But other common conditions that could qualify for long-term disability include:

• Lupus
• Multiple sclerosis (MS)
• Crohn’s disease
• Bipolar disorder
• HIV/AIDS

The documentation problem

While it’s easy to see how any of these conditions can hinder your ability to work (if not make it altogether impossible), the issue becomes proving it to disability insurance companies. Whether you file through a private disability company or for social security disability, the company will want to see some documentation.

Typical path to documentation

Depending on your condition, acquiring proper documentation might take a different path. But typically, your path to documentation might look like this:

• Visit a doctor at the first signs/symptoms
• Have any required tests done
• Continue seeing the doctor/undergoing tests as needed
• Report any new symptoms
• Receive a diagnosis
• Undergo any recommended treatment

Always document the following:

• Loss of income due to condition
• Potential costs of rearranging your life to suit your condition
• Ways your condition affects your ability to do tasks
• Treatments and their effects

These are important because they work as evidence for why you can’t work and need financial aid.

Types of documentation

After you’ve received test results and a diagnosis, you can compile your needed documentation. When filing a claim, make sure you submit:

• Medical diagnosis
• Relevant test results
• Employer statement confirming wages, typical weekly hours, work tasks, and last date worked
• Medical statements confirming your disability/inability to work
• Records of all treatments and any specialist visits
• Statements from friends and family detailing your disability
• Any personal records, such as a journal, that document your disability’s effects on your life

When documentation becomes difficult

In some cases, it might be difficult to get the benefits you deserve. For instance, your insurance company might not accept your diagnosis or test results as indicating a long-term disability. Or you might have a combination of conditions that only become a long-term disability when you take them all into consideration. Unfortunately, your insurance company might take each individual condition as-is, instead of considering all of them together.

In cases like these, documenting your disability can become difficult.

In these cases, you might need to continue undergoing required tests to prove your disability. You might also double-check your medical records to make sure they reflect every condition, symptom, and actual pain level. Make them a complete document of everything that makes earning a wage impossible for you.

In extreme cases, you might need to consider finding a long-term disability attorney or a law firm that specializes in disability cases.