What disqualifies you from long-term disability insurance?

Asked by: Giovanni Lind MD  |  Last update: October 18, 2025
Score: 4.8/5 (23 votes)

You might be disqualified from getting short-term or long-term disability insurance if insurance companies think you're too likely to make a claim because of your health or lifestyle. It can be hard to get disability insurance with a pre-existing condition, especially if it's ongoing when you apply for coverage.

Why would a long-term disability claim be denied?

Insufficient Medical Evidence

A lack of sufficient medical evidence is one of the most common reasons disability insurance claims are denied. Insurers often require objective test results, such as x-rays, MRIs, electrodiagnostic tests, lab findings, or psychological testing, to support a disability claim.

Is it hard to get approved for long-term disability?

There are a few factors that can make disability insurance claim approval an uphill battle. One of the biggest factors is also one of the most basic – how the disability insurance policy defines disability.

What not to say in a long-term disability interview?

Exaggerating the extent of your disability will not improve the odds that your application is approved. In fact, claimants who complain of chronic pain that is untreatable might make a poor impression on the ALJ. Inflated claims of pain are never a good idea during a disability hearing.

What health conditions qualify for long-term disability?

Musculoskeletal disorders like chronic back pain, arthritis, fibromyalgia, and osteoporosis. Cardiovascular diseases: Conditions such as heart disease or chronic heart failure. Neurological disorders like multiple sclerosis, Parkinson's disease, and Alzheimer's.

Long Term Disability Insurance 101 (Long Term Disability Insurance 1/2)

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What illness automatically qualifies for disability?

Neurological disorders (e.g., epilepsy, benign brain tumors) Mental disorders (e.g., bipolar disorder, anxiety, depression) Cancer (malignant neoplastic diseases) Immune system disorders (e.g., HIV infection, lupus, inflammatory arthritis)

What counts as a long term health condition?

Long-term conditions are chronic diseases or conditions for which there is currently no cure, and which are managed with medications and other treatments. These conditions can generally last for a year or longer and may impact upon a person's everyday life. Examples include: Asthma.

What is the most approved disability?

Overall, however, the most approved disability for Social Security is disabilities involving the musculoskeletal system and/or connective tissues. According to the World Health Organization (WHO), such conditions include arthritis, back pain, and lupus.

Can I lose my job while on long term disability?

It's rare, but it is possible. In many cases, a disabled individual will continue to be given long term disability benefits if they are employed or not. If you find yourself in this dire situation, you can still file for long term disability benefits with the help of a California lawyer.

What do I say to get long term disability?

To receive disability benefits, you will have to show that you cannot work in your profession and continue to earn a living. Your physician will need to provide a detailed diagnosis of your condition along with a prognosis as to how your condition will prevent you from working in the future.

What is the most common long-term disability claim?

Musculoskeletal disorders are the leading cause of long-term disability claims, according to the Council for Disability Awareness. These claims can encompass back pain, arthritis, joint disorders, and more.

What documentation is needed for long-term disability?

W-2 forms(s) and/or self-employment tax returns for last year; An Adult Disability Report that collects more details about your illnesses, injuries or conditions, and your work history; Medical evidence already in your possession. This includes medical records, doctors' reports, and recent test results; and.

How much does long-term disability pay?

The benefit amounts and benefits periods for these state disability insurance programs are as follows: California State Disability Insurance. Benefit: 60-70% of wages to a maximum of $1,620 per week. Benefit period: Up to 52 weeks.

Why do most people get denied for disability?

The most common nonmedical reason for denying a claim is insufficient number of recent work credits.

What are the cons of long term disability?

Cons:
  • Disability insurance can be expensive. Coverage costs more the older you get or the more dangerous your job is. ...
  • Policies can come with exclusions that don't cover pre-existing conditions. ...
  • Waiting period. ...
  • If you never experience a disability, you won't receive benefits.

Can an employer deny a disability claim?

Yes, certain conditions can disqualify you from disability insurance through your employer. That said, your employer can't deny you disability insurance, but the insurance company that your employer works with can.

What reduces long term disability payments?

Other kinds of income that usually reduce your long term disability benefits include Social Security retirement benefits, other federal or state disability benefits, workers' compensation, Veterans Administration benefits, retirement plan benefits funded by the employer (not tax-deferred individual retirement savings), ...

How long can an employee be out on long term disability?

Once long-term disability benefits have been approved, an employee can continue to receive benefits for the policy term or until they return to work. Common coverage durations are 36 months, although some can provide coverage for up to 10 years or even for the policyholder's life.

Can my employer replace me while on medical leave?

An employer may take into account its ability to temporarily replace or do without the employee on FMLA leave. If permanent replacement is unavoidable, the cost of then reinstating the employee can be considered in evaluating whether substantial and grievous economic injury will occur from restoration.

What is the most overlooked disability?

Q: What Is the Most Commonly Overlooked Disability? A: Generally, the most overlooked disabilities are mental health disorders. These include depression, anxiety, PTSD, and bipolar disorder, to name a few. They are often overlooked and misunderstood.

What gives 100% disability?

The 100 percent disability rating is often awarded to veterans with two or more limbs that have been amputated or paralyzed or for veterans with active service-related diseases such as cancer, severe cardiac conditions, or psychiatric conditions such as PTSD, bipolar, depression, or schizophrenia.

What is the easiest condition to get disability?

What Is the Most Approved Disability? Arthritis and other musculoskeletal system disabilities make up the most commonly approved conditions for social security disability benefits. This is because arthritis is so common. In the United States, over 58 million people suffer from arthritis.

What is the hardest chronic illness to live with?

Here's a list of debilitating diseases that significantly change the lives of millions of people:
  1. Alzheimer's and Dementia.
  2. Amyotrophic Lateral Sclerosis (ALS) – Lou Gherig's Disease. ...
  3. Parkinson's Disease. ...
  4. Multiple Sclerosis (MS) ...
  5. Scleroderma. ...
  6. Cystic Fibrosis. ...
  7. Chronic Obstructive Pulminary Disease (COPD) ...
  8. Cerebral Palsy. ...

What are the examples of long term medical conditions?

Common chronic illnesses
  • heart disease.
  • stroke.
  • lung cancer.
  • colorectal cancer.
  • depression.
  • type 2 diabetes.
  • arthritis.
  • osteoporosis.

What is a limiting long-term illness?

'Something that is more than minor or trivial and goes beyond the normal differences between people'. This might mean that someone can't do certain tasks at all or that it takes them longer or involves pain or effort.