Who Qualifies for Long-Term Disability?

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If a person is unable to work due to a severe illness or injury, they can qualify for long-term disability (LTD) benefits. Generally, these benefits are provided by employers through insurance companies; however, people can also purchase LTD insurance themselves. If you think you qualify for LTD benefits, you can file a claim. To learn who qualifies for long-term disability, please continue reading. 

Medical Conditions That Qualify for Long-Term Disability

These are the medical conditions that qualify for long-term disability:

Autoimmune Disorders

With an autoimmune disorder, the immune system acts against the body and damages healthy tissues, which can affect other organs and organ systems. Environmental toxins, viruses, and bacteria can trigger changes that confuse the immune system into attacking healthy cells and tissues. While some autoimmune disorders can be cured, it is possible for some to last a lifetime, making them long-term disabilities. Common autoimmune disorders include rheumatoid arthritis, multiple sclerosis, lupus, and type 1 diabetes. 

Neurological Conditions 

Diseases that affect the neurons, spinal cord, muscles, and brain are known as neurological diseases. The leading causes of these conditions include genetics, environmental pollutants, aging, and infections. Dementia, Alzheimer’s, Parkinson’s disease, epilepsy, and Huntington’s Disease are common examples of neurological disorders. Such conditions can impact a person’s cognitive and physical abilities, and in most cases, victims of life-altering neurological disorders can obtain long-term disability benefits. 

Cancer 

Cancers are diseases caused by the abnormal production and division of cells in the body that invade other tissues. Malignant tumors are generally long-term and can significantly impact an individual’s ability to live a normal lifestyle. Leukemia, lymphoma, myelofibrosis, melanoma, and sarcoma are the most common types of cancer. 

Respiratory Problems 

Chronic sarcoidosis, pneumoconiosis, bronchitis, influenza, cystic fibrosis, and additional respiratory problems can damage other organs in the body and last for several years. These respiratory disorders affect the person’s ability to breathe and perform strenuous work. 

Degenerative Diseases

Degenerative diseases impact the cells, tissues, and organs of the body, causing them to deteriorate over time, resulting in chronic pain. An unhealthy lifestyle, aging, injuries, and infections are common reasons a person can develop a degenerative disease such as osteoarthritis or ALS (Lou Gherig’s disease). An individual suffering from a degenerative disease may be able to obtain LTD benefits. 

Metabolic Disorders 

Metabolic disorders include obesity, pituitary gland disorder, thyroid gland diseases, and gout. These disorders can be caused by exposure to environmental toxins, malnutrition, or genetics. Metabolic disorders can lead to severe complications such as kidney problems, cardiovascular diseases, or strokes. 

Mental Illnesses

One in five individuals in the U.S. has a mental illness, which can cause behavioral and psychological disturbances. Common types of mental illness include schizophrenia, bipolar disorder, depression, anxiety, autism, Asperger’s syndrome, and obsessive-compulsive disorder. Mental health issues can be genetic or caused by environmental factors, stress, trauma, infections, or injuries. There are various treatments for mental illnesses, but these can be extended and affect a person’s daily life, making it a long-term disability. 

Skin Disorders

Some skin disorders can cause immense pain and discomfort, interfering with a person’s ability to perform their job. Weak immune systems, parasites, bacteria, and exposure to chemicals can lead to skin disorders. Long-term disability benefits can be granted to people who suffer from long-term skin disorders, such as severe burns, photosensitivity, cellulitis, eczema, and dermatitis.   

Musculoskeletal Disorders

Injuries or diseases that affect the bones, joints, ligaments, muscles, nerves, and tendons are known as musculoskeletal diseases. Musculoskeletal problems can restrict the body’s movement and cause chronic pain. Conditions such as sciatica, tendonitis, spina bifida, inflammatory arthritis, degenerative joint disease, and herniated disc can qualify for long-term disability benefits. 

How to Prove Long-Term Disability

If you are suffering from a type of disability, you must be able to show evidence of your injury or illness for a successful LTD claim. It is difficult for insurance companies to dispute strong evidence, such as medical reports with a final prognosis from a qualified doctor. 

When filing the application form for an LTD claim, you require a statement from your doctor or physician on your condition. It is important to remember that the statement should demonstrate the severity and long-term effects of your disability; otherwise, your claim could get denied by the insurance company.

 Insurance companies can use several tactics to deny your claim, such as dragging out the case unnecessarily. You can consult a long-term disability attorney for guidance on avoiding the common pitfalls of dealing with insurance companies. 

What are the Long-Term Disability Benefits? 

Generally, long-term disability benefits are granted to employees with disabling injuries or illnesses after their short-term disability benefits end. Some companies offer LDT benefits in their policies for the optimum financial health of their employees and to reduce employee turnover. There are different kinds of long-term disability plans, such as employee-paid plans, government-paid plans, and shared-cost plans.

Typically short-term disability benefits are only provided for the first couple of months after the person has the disability. On the other hand, long-term disability benefits can last several years, depending on the nature of the disability. 

Why Hire a Long-Term Disability Lawyer?

Here is how hiring a Los Angeles long-term disability lawyer can benefit you:

  • Get Expert Legal Guidance: One main reason to hire a long-term disability lawyer is to build a solid legal case. Representing yourself in the long-term disability claim is inadvisable because you may not be aware of all the legal aspects of the case. When you hire an attorney, they can guide you each step of the way. In addition, the attorney can also gather all necessary documentation and help you prepare for the independent medical exam (IME). 
  • Appeal Against a Denied Claim: When the insurance company sends you a denial letter, you can file an appeal against it. This may require you to submit additional evidence to obtain long-term disability benefits. Your lawyer can help you gather the required paperwork and evidence. 
  • Meet Deadlines: Long-term disability benefits claims can have strict deadlines, and your attorney can ensure that you don’t miss any of them. 

Negotiate with Insurance Companies: Insurance companies can use multiple tactics to deny long-term disability benefit claims. For example, they can hire private investigators to gather evidence against you so they can reject your claim. In some cases, the insurance companies are willing to negotiate, and having a lawyer on your side can help you achieve a favorable outcome.

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