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What Conditions Qualify for Long Term Disability?
If you have been contributing to long term disability benefits through private insurance or through your employer's benefits package, you should be able to rely on them to pay out monthly benefits to you when you're too sick or injured to work.
But what conditions qualify for long term disability, and how is eligibility determined? We answer these questions to help you understand your rights and the benefits available to you if you cannot work.
Do you have more questions about what conditions qualify for long term disability? Share Lawyers’ experienced team can answer your questions.
What Conditions Qualify for Long Term Disability?
Long term disability (LTD) insurance is designed to replace a portion of your income when you cannot work for an extended period due to an injury or illness. Before filing a claim, you need to understand what conditions qualify for long term disability.
Any condition can qualify for long term disability if the symptoms are severe enough to prevent you from performing the essential duties of your job. There is a non-exhaustive list of common disabilities that often qualify for long term disability insurance.
Does My Condition Qualify for Long Term Disability? | |
If your symptoms are severe enough, the answer should be YES. | |
Chronic Pain | Yes, if it significantly impairs daily functioning and ability to work. |
Mental Health Disorders (e.g., depression, anxiety) | Yes, if the condition is severe and substantially limits work performance. |
Musculoskeletal Disorders (e.g., arthritis, back pain) | Yes, if the condition is severe and affects the ability to perform work duties. |
Cardiovascular Diseases (e.g., heart disease) | Yes, if the condition severely restricts physical capacity and work capabilities. |
Neurological Disorders (e.g., multiple sclerosis, epilepsy) | Yes, if the condition is severe and impairs work functionality. |
Respiratory Diseases (e.g., chronic obstructive pulmonary disease) | Yes, if the condition severely impacts breathing and overall work performance. |
Cancer | Yes, if the condition or treatment side effects significantly impair work ability. |
Autoimmune Diseases (e.g., lupus, rheumatoid arthritis) | Yes, if the condition is severe and affects daily work activities. |
Diabetes | Yes, if complications are severe enough to impair work performance. |
Environmental Sensitivities | Yes, if the sensitivity is severe enough to impair work performance. |
Important Considerations:
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Why is it the Severity of the Symptoms and Not the Condition Itself?
In Canada, LTD eligibility depends upon the severity of the symptoms rather than the condition itself. Benefits provide financial assistance when a significant impairment prevents you from performing the primary duties of your role.
- Impact on Functionality: LTD benefits are designed to help those whose conditions severely impair their ability to perform essential work functions. The focus is on how a condition affects a person’s capacity to work and carry out daily activities.
- Individual Variability: Not all individuals experience the same condition with the same degrees of severity. One person with arthritis may have mild symptoms that do not interfere with their ability to work, while another may have severe symptoms that they can’t perform their job duties.
- Objective Assessment: Insurance providers assess the severity of the condition based on medical evidence from sources such as doctors’ reports, medical tests, and treatment history.
- Consistency and Fairness: Emphasizing the severity of conditions rather than the conditions themselves allows for fairness. It ensures that benefits are provided based on the actual impact of a condition rather than the diagnosis alone.
While the above is true, it’s worth noting that insurance companies often do not assess the severity of medical conditions straightforwardly. Instead, they may downplay conditions that do not seem severe on paper, such as severe allergies, to minimize their costs.
