Social Security Disability
Insurance and Long-Term Disability Benefits: Differences and Similarities
Many people who qualify for long-term disability benefits
may also qualify for Social Security Disability Insurance (or SSDI) benefits. The definitions of disability are similar in
most disability policies to the definition of disability used by the Social
Security Administration (SSA). However, there are some notable differences between
the two systems namely:
·
The SSA takes into account your age at
the time you apply for benefits. As a
result, the older you are, generally the easier it will be to qualify for
benefits.
·
Many disability policies separate the
definition of disability into two time periods: the “Own Occupation period” and the “Any
Occupation period.” When you first
apply for disability benefits, you are disabled if you cannot do your own job (this
is the “Own Occupation period”) and
at some point in the future, the definition often changes so that you will only
be found to be disabled if you cannot do any job (this is the “Any Occupation period”). This split
definition differs from the definition used by the SSA which is based on not
being able to do any job.
·
Both the SSA and your disability insurer
can obtain opinions from doctors they hire or consult to give an objective
opinion of your health condition and whether you are disabled. However, the SSA is supposed to give more
credit to the records and opinions of your treating doctors than to the
opinions of a doctor who is not your treating physician. In contrast, a disability insurer can
generally rely on whatever doctor the insurer deems appropriate.
·
The definitions of disability in these
two benefit systems are similar, but not exactly the same. So it is possible to qualify for one type of
benefit but not the other.
When
applying for benefits under a long-term disability plan, it is important to let
the insurance company know if you have been approved for SSDI benefits. The insurance company does not have to agree
with the SSA’s determination of disability, but a finding of disability by the
SSA is important evidence that cannot be simply ignored by an insurer when
making its own determination of disability.
If you have applied for
both SSDI and long-term disability benefits and been denied by one or the
other, you should consult an attorney with knowledge of the procedures for
appealing the denial of benefits.
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