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Archive for April, 2023

What Conditions are Covered by Long-Term Disability?

Posted on: April 28th, 2023 by Joe Cunnane
What Conditions are Covered by Long-Term Disability? - Cunnane Law - Edmonds, WA

Navigating the long-term disability process requires expert help. We’re here for you.

If a qualifying medical condition prevents you from working for an extended period of time, long-term disability (LTD) insurance may be able to help you financially. Your medical condition must fall under the insurance company’s definition of long-term disability as stated in your policy in order to be eligible for benefits.

In this article, Cunnane Law will discuss what medical conditions are generally eligible for long-term disability benefits and what you’ll want to know about obtaining the benefits you are entitled to.

Which Medical Conditions are Eligible for Long-Term Disability?

Physical or mental illnesses, severe injuries, or any chronic conditions that keep you from working for a long period of time, may qualify you for long-term disability benefits.

The following are some of the typical conditions that qualify for long-term disability benefits:

  • Cancer
  • Chronic obstructive pulmonary disease (COPD)
  • Chronic pain
  • Crohn’s disease
  • Diabetes
  • Heart disease
  • Mental health-related disorders
  • Multiple sclerosis (MS)
  • Musculoskeletal disorders
  • Parkinson’s disease
  • Stroke
  • Traumatic brain injury
  • Arthritis
  • Fibromyalgia
  • Auto immune disease

The precise eligibility requirements depend on the kind of policy and insurance company, but generally speaking, these benefits begin once your short-term disability benefits have run out.

For specific disabilities brought on by accidents or work-related injuries, some policies might also offer benefits. To find out which conditions are covered by your specific policy, it’s important to contact your provider.

What Criteria is Used to Determine Long-Term Disability Eligibility?

Age, medical history, present state of physical and mental health, and capacity to carry out essential job-related duties are typically used to determine long-term disability eligibility.

Proving Your Disability

Prior to approving your disability claim, your insurance provider will need to see proof in the form of medical records. This should also include results of any diagnostic tests and other supporting documentation.

This procedure is described in your insurance policy’s “Proof of Claim” section. To file an insurance claim, you must inform your insurance company and provide all necessary claim forms and documentation, including medical records.

The claims procedure can be quite complicated. Depending on the extent of your injury or illness, it might take a few weeks to a few months to complete.

At Cunnane Law, we are highly skilled in disability insurance law. If you need assistance understanding the details of your policy, contact us at any time.

What could give rise to the denial of a long-term disability claim?

An application for long-term disability may be denied for a number of different reasons. These include failing to provide enough proof to support the claim, not being eligible or failing to meet the definition of a disability, failing to submit a claim on time, or making an error on a claim form.

Your insurance provider may also reject your claim if they think your condition has improved or is not as severe as you claim it to be. Furthermore, they might reject it if you are doing things you would not be able to do if you had a true disability.

Finally, it’s crucial to carefully review all the documentation included with the denial. You want to make sure you fully understand the reasons your disability claim was rejected. You should also seek the advice of a skilled long-term disability attorney to decide the next plan of action.

Get Assistance Securing Your Benefits

It can be challenging and stressful to submit a long-term disability claim. Your insurance provider may reject your claim due to a number of possible pitfalls. Now is not the time to take a chance on losing the long-term care you need.

However, you’re not alone. Our team of long-term disability attorneys at Cunnane Law is here to help you win and start to heal. For assistance navigating this complex process, get in touch with Cunnane Law right away.


Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.