What Medical Conditions Qualify a Person for Long Term Disability?

12 February 2019

Each long-term disability example you will find has one thing in common with every other long-term disability example: The physical or mental condition leaves the person unable to work or perform normal life activities for at least 12 months. Further, the condition will be unlikely to go away. In many cases, the disabling condition will shorten the person’s life.

What Conditions Automatically Qualify You for Disability?

Insurance companies and government-run disability programs like workers’ compensation and Social Security recognize almost all the same illnesses and injuries as disabling. But some policies and programs only cover short-term disabilities while others cover nothing but long-tern disabilities. For instance, Social Security Disability Insurance is only available to children and adults who can prove that they suffer from long-tern disabilities.

To keep the rest of this discussion clear, we will focus on SSDI. Be aware, however, that many other types of benefits and assistance are available to help individuals and families deal with the financial challenges created by a disabling illness or injury. The long-term disability attorneys with the Calig Law Firm will be happy to answer questions about SSDI and non-SSDI options. Consultations can be scheduled by calling (614) 252-2300 or completing this online contact form.

So, SSDI requires applicants to prove that they suffer from a chronic or fatal health condition. The federal program actually maintains regularly updated lists of physical and mental problems it will consider disabling. That ranges from ALS and cancer to schizophrenia and depression. Being born blind is one of very few conditions that automatically qualifies a person for federal long-term disability benefits.

What Illness Qualifies for Long Term Disability

SSDI also allows applicants to petition to have an unlisted condition judged on an individual basis. In practical terms this means that while checking what illnesses qualify people for long-term disability benefits from Social Security can help with preparing an application, no one should assume he or she cannot apply simply because a rare condition is not yet on SSDI’s radar.

Importantly, the disabling condition can result from any cause. Someone who suffers a personal injury will have his or her SSDI application treated in the same way as the application from someone who was born with s genetic defect.

It is never sufficient simply to claim that a listed or unlisted disability exists. The applicant must submit diagnoses, prognoses, and results from a functional assessment performed by an expert chosen by the SSDI program. Medical records, prescription orders, and therapists’ notes submitted with the application for benefits establish the existence of a disabling condition. The functional assessment describes the extent of the disability.

Functional disabilities are impairments that negatively affect one or more of the following:

  • Speech and communication
  • Sight
  • Hearing
  • Movement
  • Strength and muscle control
  • Stamina
  • Flexibility
  • Information processing
  • Learning and memory

A determination of whether to award SSDI benefits depends heavily on the functional assessment. If a person suffers from, say, chronic obstructive pulmonary disease but can still walk and talk enough to hold a job, the person will likely be found able to work. At the same time, a person who is otherwise completely healthy but going blind from a genetic condition probably will get approved for SSDI benefits.

Contact a Disability Attorney Near You.

Anyone who has an SSDI application rejected has the right to appeal the decision. An experienced long-term disability attorney can assist with that.


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