Are There Conditions That Automatically Qualify You for Disability?

Posted on Tuesday, February 1st, 2022 at 11:20 pm    

Are There Conditions That Automatically Qualify You for Disability?

If your employer offers long term disability insurance, you may wonder whether to purchase it. Long term disability insurance is designed to cover a portion of your pay if you are unable to work for an extended period due to an accident or illness. Since none of us want to think about a serious or chronic disability, it may be tempting to avoid long term insurance.

There are some conditions where you might immediately qualify for long term disability insurance payments, provided you have the insurance and file the claim promptly with your insurance company. We at Abell and Capitan Law are well-versed in obtaining LTD benefits for our clients. Contact us immediately and put our professional experience to work for your case today!

What Is a Long Term Disability?

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The purpose of long term disability insurance is to provide income when you are unable to work. The disability does not have to be work-related. This is an error that workers, companies, and even insurance companies make when evaluating your claim.

You will need to review your insurance claim carefully to determine how they define “disability” and what they specifically cover, but many physical and psychiatric conditions are covered by long term disability insurance:

  • Bipolar disorder. Because this mental illness can successfully be treated for extended periods, and yet still require the individual to be out of work, it may be covered by long term insurance.
  • Crohn’s disease. The erratic nature of this disorder means the patient can have many days of efficient work in the office and many days at home or in the hospital. Long term disability insurance may provide a cushion for those out-of-work days.
  • Multiple sclerosis (MS) or ALS. Any chronic degenerative nerve disease will likely qualify for long term disability insurance, because of the progressive nature of the disease.
  • HIV/AIDS. Thankfully, treatments for advanced HIV disease mean that patients can now expect to lead nearly normal lives. But if the time comes that they cannot, they should be able to receive long term disability insurance while receiving treatment.

All conditions that are considered “qualifying conditions” for long term disability have a few things in common: they are progressive, they are chronic, and they are recurrent. In cases of traumatic or acute injury or illness, the condition is reviewed at the time of the incident.

Does This Mean My Claim Will Be Immediately Accepted?

No. Insurance companies for long term insurance will reject a claim as often as any other insurance company. However, having one of these conditions means that you will meet the criteria to apply for long term insurance without having to prove other factors about how your condition impacts your life.

Since the majority of long term disability insurance claims are not work-related, but rather are due to an inability to work because of a chronic condition, your employer and the insurance company would rather you just went back to work despite your condition. So even a progressive illness like MS will be seen as something you should be able to “get over” and not as a disability.

You will need to prove that your condition prevents you from working by presenting the documentation that the insurance company requires, according to their policy. This can vary from policy to policy, so you will have to review yours carefully. In some cases, you may have to submit to an independent medical examination by the insurer’s doctor, or another examination.

When you need income to cover your bills when you cannot work, you need it right away and don’t have time to wait for the insurance company to make up its mind about your status. You should have some knowledgeable help on your side.

How We Can Help

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Abell and Capitan will meet with you to discuss your case for free.

If you have one of the listed conditions, we understand that filing a claim with a disbelieving insurance company is frustrating. You should have someone on your side to make sure you have filled out all the forms properly and answered all the questions to get the payment you deserve. Contact us today!

Before you send in all your medical records and paycheck stubs, have one of Abell and Capitan Law’s attorneys review the documents and answer any questions you might have. We cannot guarantee that this will make the insurer accept your claim, but this will give you one less thing to worry about while you are concentrating on getting better.

Having all your documentation in order before you submit your application can prevent unnecessary delays and rejections, and we can help ensure you’ve got all the paperwork in order. Contact Abell and Capitan Law’s offices at (267) 419-7888 today if you need to file a disability insurance claim, or if you’ve already filed and your application has been rejected. We are ready to fight for you and have the results to prove it.

Written by : Erik Abell & Joe Capitan

Last Updated: April 6, 2022
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