Social Security Disability Insurance and Long-Term Disability Benefits: Differences and Similarities

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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