What Conditions Qualify for Disability Insurance Benefits?

What Conditions Qualify for Disability Insurance Benefits?

No one plans to suffer an illness or an accident that would leave them disabled. When such occurrences happen, most people leave their jobs or get employed in a lesser capacity, which affects their income. To avoid being financially stranded in such a situation, it is advisable to purchase disability insurance

However, not every illness or injury qualifies for this insurance policy benefits. If your condition is not among those eligible for disability insurance, you will be unable to receive payment. So, what conditions qualify or are exempted? Keep reading to find out. 

What Conditions Qualify for Disability Benefits? 

The U.S. Social Security System (SSS) and private insurance companies provide disability insurance for workers. As such, this section will examine what conditions qualify for disability benefits under the SSS and insurance providers. 

Disability Qualifications Under the Social Security System

Social Security Disability Insurance (SSDI) insures workers and their dependents if they cannot work because of a disability. The money received covers a portion of their income. However, they must suffer from a condition listed in the Social Security Act to get the benefits. 

These conditions are:

  • Musculoskeletal disorders 
  • Special senses and speech 
  • Respiratory disorders 
  • Genitourinary disorders 
  • Neurological disorders 
  • Problems with the digestive system 
  • Congenital disorders that affect multiple body systems 
  • Mental disorders 
  • Cancer (malignant neoplastic diseases)
  • Endocrine disorders 
  • Immune system disorders 
  • Hematological disorders 

The SSA provides that any of these conditions must have lasted for a year or resulted in death to qualify for SSDI benefits. Accidental injuries also qualify for disability insurance. 

Disability Qualifications Under Private Insurance Companies 

Unlike the Social Security System, there is no definitive list of conditions that qualify for disability benefits for insurance companies. This is because each insurance company has its list. So, suppose cancer and endocrine disorder qualifies under one disability insurance policy. Another insurer may exempt it. 

Therefore, you must examine the terms of the insurance contract before signing it. It would be best if the insurer follows the list of disabilities provided by the SSA. But if they don’t, you can ask them to include any condition you want the policy to cover. However, keep in mind that it might cause your premium to go up. 

Conditions That Don’t Qualify for Disability Insurance Benefits 

Non-accidental injuries and pre-existing medical conditions do not qualify for disability insurance benefits. Also, some insurance companies do not consider mental health conditions a disability and exclude them from their policies. 

Our team at Goldstein Healthcare can guide you on the right disability insurance policy for you, your family, and your staff. We will develop customized plans and help you make informed decisions. Click here to get started.