How to Win a Claim for Cigna Long-term Disability

There is no guarantee that you will win any long-term disability claim. 

Up to 75% of long-term disability claims are denied. 

Do not let this keep you from applying though. 

With these tips, you will have a better chance at winning your Cigna long-term disability claim.


Review Your Cigna Long-Term Disability Policy

Reviewing your policy should be your first step.  You need to know what conditions the policy will cover as well as any deadlines you may have to apply.  It should also discuss whether or not there is a waiting period between the time you are injured and the time you can start receiving benefits.

Complete All Questions Accurately 

When filling out the form for Cigna long-term disability be sure to answer all the questions and make sure they are all answered accurately to your best knowledge. Do not leave anything out.  The more information you give on your long-term disability questionnaire, the better off you will be.

Give Detailed Information About Your Job 

This bit of advice seems like a no-brainer but sometimes people will put what their job title is but does not explain what they do for their job.  Your job title does not always paint a picture of what you do on a daily basis while you work.  If you have an injury that does not allow you to bend, but your job title is assistant, this does not explain what you do, or how your inability to bend affects your employability.   For instance, as an assistant, you may have to bend over to file folders or pick up merchandise off the floor.  The insurance company will not know this unless you give detailed information about your job.

Submit as Much Medical Evidence as Possible 

This is probably the most important thing you can do to help your claim.  You need to submit information from your primary doctor, urgent cares, and emergency rooms that have treated you for your injury or illness.  Lab results, x-rays, and even Physical or Occupational therapy reports should be included as well. You can also get written opinions of your doctors stating how your injury or illness affects your ability work.  Friends and family members can also include letters explaining how you are limited in your day to day life.

Be Truthful to Cigna

Whatever you do, do not lie or exaggerate your injury or illness. If you do this and Cigna finds out, then you will severely hurt your chances of receiving benefits.  You should only claim what is truly going on with your health and backing it up with evidence will help keep you truthful.

Remember Cigna Representatives or Nurse Consultants Are Not Your Friends

They may seem friendly and like they want to help, but this can negatively affect your claim.  If you are talking to them like they are your friends, you may divulge information that adversely affects the outcome.  When speaking to them, make sure you are answering their questions precisely and to the point.  If you ever have doubt or are confused, talk to a long-term disability attorney right away!

Consider Hiring an Attorney

Hiring an attorney that has worked with Cigna long-term disability or even just long-term disability, in general, can help make the process a little easier and less stressful.  Reach out to us today.


Why Did Hartford Deny My Long-Term Disability Claim?

Why Did The Hartford Deny My Disability Claim?

The Hartford is one of the biggest insurance providers in the United States. 

Millions are covered for short & long-term disability under Hartford policies.

However, they, like many long-term insurance providers, have a long-running history of being involved in lawsuits from claimants that accuse them of incorrectly handling and adjudicating their claims.

Reasons The Hartford Has Unfairly Denied Long-Term Disability Claims

Here are some examples we’ve seen in regards to claims and cases against the Hartford for their unfair and incorrect practices in long-term disability claims.

  • – Denying all or most claims immediately, forcing a confusing appeal for the granting of benefits. 
  • – Repetitious requests for evidence.  This means even being repeatedly asked for the same evidence that you may have already provided. As you may already know this can further delay your case getting a response on whether it is rejected or accepted.
  • – Bringing in intrusive evidence against you.  Intrusive evidence can be video surveillance or even cherry-picked videos making it appear that your disability is not debilitating.
  • – Paying physicians to evaluate your claim and records. 
  • Requiring or requesting an in-home investigation and interview by a Hartford representative. This is hardly needed if sufficient records and proof are provided so that someone dealing with a disability can receive the benefits that are due to them.
  • – The Hartford has contacted doctors without claimant knowledge. This is a way to try gaining admission from your doctors that you are still able to work.
  • – This Hartford has also been known to interview physicians that have never worked with you or your condition to rally “facts” and present them in court.
  • – The Hartford has provided benefits then later used their discretion to decide those benefits are no longer necessary.  Summarily canceling the lifeline of benefits recipients like you. 


You Can Beat The Hartford And Get Your Disability Benefits!

When applying for your benefits through The Hartford, you need to follow their strict timelines and deadlines. If you do not, it could be cause for automatic denial. In addition to this, you should carefully review all paperwork you fill out so that you are responding to the necessary requests and providing the answers necessarily, in complete detail.   Anything missed, misleading, or factually ambiguous – even a nondated page – could be cause for the denial of your claim and keep you from receiving the benefits you deserve.
Read the list above, again…  These are not folks that will give you the benefit of the doubt. All of these are deceptive tactics exist to get you to give up. Regardless of the intention, it is unfair, and they keep those who have paid for these benefits and now need them as income. Do not let these schemes intimidate you into giving up on your case.

Your Best Option to Fight The Hartford

Your best option to prevent a denial of your disability claim, or to fight an adverse benefits determination is to seek experienced legal representation.  You need a law firm that specializes in long-term disability law, specifically ERISA.
If you have been denied Hartford long-term disability contact our office today.  We have fought on behalf of people like you against The Hartford and many other insurance providers before.


Will Unum Approve My Long-Term Disability Application?


Will Unum Approve My Long-Term Disability Application?

If you have applied for Unum Long-term disability, you are probably wondering if they will approve your application.

Let’s look at some things that will help your chances of Unum approving your long-term disability application.

Meeting Your Policy’s Definition of “Disabled” Means Making Sure Unum Has All the Evidence

First, gather all of your medical records from your current doctor, past doctors, emergency room visits, and urgent care clinic visits, and anywhere else that may have treated you for your condition.  Do not forget physical, occupation, or mental health therapists, staff or school nurses, and even your friend the EMT medic that you call on occasion for random aches and pains.  We are talking about digging deep, stack the record, do not let Unum say “no” because they did not have a particular record.   
Unum, in their consideration of your long-term disability claim, may also request you to get a letter from your current doctor or have him or her fill out a form, giving their opinion on your condition(s). If so, your doctor should include how your condition affects your ability to perform any duties at your job and whether or not he believes you can work at any occupation. You can talk to your doctor about this, so do not feel like you have to be in the passenger seat while this information gathering phase is pursued. 

Additional Considerations With Unum Long-Term Disability Claims

Full-time Work
Typically, you are required to be working full-time when you become disabled and apply for long-term disability.  Full-time is between 30 and 40 hours per week.  If you have been unable to work up to that full-time schedule for some time, presumably due to your disabling condition(s), you will have to start figuring out how to say why that is.  It is very likely that your Unum insured long-term disability policy has specific statements and requirements along these requirements. You may want to talk to a successful long-term disability benefits attorney to strategize how to approach this issue. 

Waiting Period
Your Unum long-term disability policy will have a waiting period, often referred to as an elimination period.  The waiting period is the time between when you become disabled and when you can receive long-term disability benefits.  Usually, the elimination period of these ERISA governed policies is between three and six months.  Often employers will offer a short-term disability to fill the gap between the end of employability, and the start of long-term disability benefits.  

Pre-existing Conditions
A pre-existing condition is an illness or injury that occurred 90-180 days before your long-term disability coverage began.  If you have a pre-existing condition, you may not be paid benefits for any long-term disability that happens as a result of that condition for the first 12 months of your long-term disability coverage. This is something you should contact a long-term disability benefits attorney about as well.  These situations are nuanced, and anything that might unduly delay or deny you the benefits you have paid for needs to be carefully looked at!

Excluded Conditions
Long-term disability policies do not cover all disabilities.  Many long-term disability policies have a 24-month limitation on disabilities caused by alcoholism, drug abuse, or various other situations.  If you believe your Unum policy might be in jeopardy because of these conditions or allegations of these conditions, again – reach out to an attorney today!

Hire a Long-term Disability Lawyer

Hiring a long-term disability lawyer will increase your chance of being approved for Unum long-term disability.  As lawyers who specializes in long-term disability, we know the ins and outs of Unum disability claims.  We know how they deny claims, why they deny them, and how to beat them.  If you are facing the uphill battle of getting your claim approved, give us a call

The Importance of Medical Documentation in LTD Claims

The Importance of Medical Documentation in LTD Claims

When you file for ERISA long-term disability, it is extremely important to have complete and up-to-date medical documentation in your file.

There have been claims that get denied simply because one thing did not make it into the employee’s claim file.

Medical Records

Having ample medical records supporting your claim is the most important thing you can do to support your case.  If you have medical documentation from several medical professionals, make sure that when you turn in your long-term disability claim file, you include every piece of literature from them even relating to your condition(s).  
Here is a checklist to help you…Medical professionals you may need to collect medical documentation from:

  • * Primary care doctor
  • * Emergency room
  • * Urgent care
  • * Imaging
  • * Lab
  • * Psychologist/psychiatrist (if a mental condition)
  • * Physical therapist
  • * Occupational therapist
  • * Any specialist such as neurology, orthopedics, etc.


Opinion or Notes from Your Treating Doctor

Many people know that you need to submit your medical documentation but what they do not realize is that a letter from your treating doctor or even just notes is just as important. 
For example, if you regularly “walk” into your doctor’s office barely able to move due to extreme pain that is uncontrolled by prescription medication, your doctor should be documenting that. 
Or, if you are experiencing severe side effects from medication that is helping your condition, but it is severely impeding to your ability to work, your doctor should also be noting that.

Beyond observations, you should remember that you are and will be your own best advocate in working with doctors.  Not all doctors will do a complete physical exam or accurately document your conditions during your visit.  Not every condition you present with may be necessary for them to administer care in their specialty.  Regardless, you should communicate your overall condition.   You need to convey to your doctor it is important for you to have a complete physical exam and that you have accurate and thorough documentation of your physical or mental condition during your visit, regardless of the purpose of the visit. 

Be Honest and Think About the Medicine Too!

When you go in for a visit with your doctor, you need to be upfront and honest about how you are feeling and how your condition is affecting you (we just covered this above).  However, you also need to be honest about any side effects you may be having from any of your prescription medications.  If your doctor asks you how you are feeling and you say you are fine even though you may be in extreme pain, your doctor will not be able to document that and it will hurt your claim. 
If your doctor asks how you are feeling, and in response, you state that your condition or ailment has cleared up or is not bugging you anymore, that may be all they note.  But, if your medicine (used to get you to that state) has side effects, those side-effects are very important and may, in fact, be more of an impediment to working than the original condition.  An example, leg pain is your condition.  It’s difficult/impossible to work when it’s acute, but when it’s treated you don’t have any more pain.  However, the treatment doesn’t allow you to drive, makes you dizzy, and you break out in sweats occasionally.  You could argue the treatment makes it MORE impossible for you to work than your condition.  The lesson here…report beyond your condition – to include how the treatment makes you feel too.  

Visit Your Doctor Regularly

Even if your initial claim gets approved you need to continue to visit your doctor on a regular basis and follow any instructions your doctor has given you.  If at any time, the insurance company feels you have improved, they can take your benefits away.
For example, if your doctor tells you not to walk more than a few hours a day or lift anything over 10 lbs, you need to follow those instructions.  The insurance company will argue that your condition improved if they can prove that you did not follow these instructions even one time.   Then, they can discontinue your benefits.
If you have questions about what medical documentation you need for your LTD claim, or just need guidance, please feel free to contact us.


How a Functional Capacity Evaluation Affects Your Long-Term Disability Claim

How a Functional Capacity Evaluation Affects Your Long-Term Disability Claim

When you file a long-term disability claim, your insurance company will require medical proof that you are in fact unable to perform work. The tricky part of this standard is that depending on various particulars of the long-term disability policy you are covered by; you may not need to be entirely physically, mentally, or otherwise disabled to rightfully justify claiming your benefits.

So, what do long-term disability insurers do to try to figure out your level of impairment and if it genuinely bars you from being able to work at the level defined in your policy? They schedule you for a functional capacity evaluation.

Why Insurance Companies Use Functional Capacity Evaluations

The results of functional capacity evaluations are often controversial. When long-term disability claims get denied, the evidence used by insurance companies is often directly pulled from these evaluations.
Adding to the frustration of many on this point is the fact that in some policies the functional capacity examination is unnecessary and not required.
In short, these evaluations are meant to determine the limits of what you might be able to do for employment. The examination is often physically and mentally demanding, exhausting, and embarrassing. Moreover, depending on the conditions of the person claiming the long-term disability, the functional capacity evaluation could even lead to further injury.
If you are already being asked to schedule one of these evaluations, reach out to us as soon as possible. We will help you figure out if you even need to do one. If you are required to attend one of these exams, we will help you understand what your rights and responsibilities are before your appointment.

What Can I Expect at My Functional Capacity Evaluation?

A Functional Capacity Evaluation (FCE) uses a battery of assessments to determine whether or not you can perform your duties at work. An FCE may also measure cognitive demands as well as your mental health.
You can expect tests measuring your:  Range of motion, Physical strength, Lifting ability, Flexibility, Stamina, Ability to carry objects, & Other abilities needed to perform your job
To evaluate these, you may be asked to:  Get on a treadmill, Crawl, Move different parts of your body, Handle/manipulated objects, Undergo hand-eye coordination tests, Push or pull, Sit, Balance, Stand, Crouch, Walk, Undergo cognitive tests, Lift weights, Reach, Stoop, Grip, Stack boxes, Kneel, Perform tests of dexterity, Perform step exercises
Your evaluator may also ask you questions about your injury, your pain level and which activities you performed or have performed affect your symptoms.

What Does My Insurance Company Get From My Functional Capacity Evaluation?

Your long-term disability insurance company wants to lock down whether you can in any reasonable or conceivable way return to work in full or even diminished capacity. You might already be able to see that they are losing perspective on all how your disability could be (and is) limiting.
There’s no reason for them (insurance companies) not to contest your claim, and if you are not incredibly careful and they use these evaluations as the fulcrum to deny your claim. For example, if your job requires you to lift 50lb boxes in 8-hour shifts, you can expect that the evaluation will measure your ability to perform lifting tasks. Assuming you can lift a 50lb box a couple of times in the presence of a physical therapist at your FCE, the result of the exam may state that you are indeed able to perform work activity, such as lifting moderate weight. You are not disabled from work. However, what the FCE cannot measure is how well you can perform those tasks for eight hours a day, for five days a week, for weeks on weeks.
This example may be more straightforward and simple than an example that applies to your injury. But, the results are often the same; at an FCE you are asked to do simplified approximations of employment activity and a (questionable) profile of your employability is built from the exam. They have broken your abilities down to a set of numbers that they can use to great effect against your long-term disability claim.

How will an FCE affect your LTD claim?

There are three ways that your Functional Capacity Evaluation might affect your long-term disability claim.
1. The FCE shows that you are unable to perform any duties related to your job. (Will help your claim)
2. The FCE shows that you are unable to perform some duties related to your job, but you can still perform light duties.
(This is a tough situation, you should reach out to us directly to get some advice on moving forward here)
3. Shows that you are fully capable of performing all duties related to your job.
(Claim will be denied, even if the examination results are erroneous)

Protecting Yourself from a Functional Capacity Evaluation

Regardless of what you expect from a functional capacity evaluation, even if you think there is no way it could come back and harm your claim, you should reach out to speak with a long-term disability benefits attorney. The timelines on long-term disability benefits claims are very tight, and the window for steps in appealing wrong determinations are strict.
The absolute best thing you can do is avoid potential pitfalls in your long-term disability claim (such as submitting to an FCE). If an FCE has already burned you, the second best thing you can do is get on board with someone who knows how to fight insurance companies at their own games. Contact us today!



Additional Information:

Functional Capacity Evaluations


Do I Need Other Benefits Other Than Long Term Disability?

Do I Need Other Benefits Other Than Long Term Disability?

No matter where you are in the process of applying for long-term disability, you may be asking, “How long does long-term disability last?”

You may also be wondering if you need other benefits along with your long-term disability benefits.

Many different factors determine how long your long-term disability benefits will last. The first step is to figure out when they will start. 

This is most often the biggest determining factor of how long you will receive benefits.


Elimination Period

All long-term disability policies have an elimination period.  This is the time from when you make a claim to when you are eligible to start receiving benefits.  There are a few different types of elimination periods.

You also have short-term disability: If you have also have short-term disability, you will have to use this first before receiving long-term disability benefits.  This can be for up to 26 weeks before you long-term disability benefits can begin.

Your policy requires you to use all of your sick leave: Some policies will require you to use any sick leave you have accrued before you begin long-term disability.

You only have long-term disability: If you do not have short-term disability on your plan, then the elimination period can be anywhere from 6 weeks to one year before you begin collecting benefits.

Other Factors

Other factors that will determine when your benefits will start are:

  • Your health: The more health issues you have, the more medical records will need to be requested which can increase the time it takes for the insurance provider to make a decision.
  • Request for follow-ups: The insurance provider may ask you for multiple follow-ups if you do not submit everything they need.
  • Your Doctor:  If your doctor does not fill out the required paperwork promptly, it can delay your decision.
  • Your inial claim gets denied: If your initial claim gets denied, then you will need to appeal which will greatly increase the time it takes for you to start getting benefits. It can add an additional 270 days to your decision timeframe.

You can also read our article How Long Does it Take to Get Long-term Disability? for more information that may help you answer “How long does long-term disability last?”.

How Long Your Benefits Will Last After Approval

Once you are approved for benefits, the amount of time they will last is determined by what long-term disability policy you are/were covered by.
The typical choices for benefit periods are:

  1. Two years
  2. Five years
  3. Ten years
  4. To age 65
  5. To age 67
  6. To age 75 (only if you are still working full time)

On average, an individual long-term disability lasts 2-3 years.

Termination by the Insurance Provider

You could end up needing additional benefits if you do not meet the conditions outlined in your policy.  As you might have surmised this is a common reason to hire a long-term disability attorney.  Insurance companies like to deny claims after the fact, claiming that you are magically better and able to work now. 

Conditions that must be met to avoid an early insurance termination: 

  • Request for medical evidence: At any time your insurance company can request additional medical evidence.  If the insurance company feels that your medical evidence does not support your claim of total disability, your insurance company can terminate your benefits.
  • Getting treatment: If you are not seeking and attending reasonable treatment, your insurance company may terminate your benefits.
  • Not completing rehabilitation plans: If you do not follow through with any rehabilitation plans, your insurance company may terminate your benefits.


Do You Need Other Benefits?

Some insurance policies require you to apply for Social Security Disability (SSDI) to continue receiving long-term disability benefits after a certain time.  Once you are approved for SSDI, then your long-term disability insurance will pay you the difference between what you receive from SSDI and what you would receive from LTD.
To truly find the best answer, you should consult with a disability attorney who can look at your long-term disability policy and help you decide if applying for other benefits is needed.  You can contact us for help today!

Three Occupations with Higher Risk of Needing Long-Term Disability

Three Occupations with Higher Risk of Needing Long-Term Disability

The top six reasons people find themselves needing long-term disability, in order, are musculoskeletal or connective tissue (muscles, back, and joints) issues, nervous system related issues, cardiovascular or circulatory issues, cancer and neoplasms (tumors), mental disorders, and injuries and poisonings.

The cause of any of these challenges may not necessarily be related to your vocation; however, what we see when we take a step back and look at the big picture is that certain jobs correlate with higher likelihoods of workplace injuries. In fact, your profession might be a higher indicator of needing long-term disability than many of the other genetic or environmental factors you concern yourself on a regular basis.

If you are in one of the following four occupations you have a statistically higher risk of needing long-term disability benefits at some point in your lifetime.

Professions At Risk of Needing Long-Term Disability: Building and Grounds Cleaning and Maintenance

Building and grounds cleaning and maintenance workers have a higher risk of needing long-term disability due to the physical and unpredictable nature of their work. These employees are often required to walk, stand, sit, climb, stoop, kneel, crouch or crawl, and lift or move up to 100 pounds on a daily basis.
In addition to that, building, grounds, and maintenance workers use tools such as mowers, trimmers, and other powerful devices to fulfill daily functions. Even with proper training and personal protective equipment, proximity and familiarity with power tools come at increased risks of injury.
The manual labor aspect of these professions should not be overlooked either. Repetitive physical activity can cause muscle, back and joint issues from overuse or reoccurring use of the same muscles and joints.
Poisoning is another rare, but not unheard of, injury that can afflict these professions. Especially if the employees work with insecticides, fertilizers, industrial solvents, or other chemicals on a regular basis.

Professions At Risk of Needing Long-Term Disability: Transportation and Material Moving Professions
Transportation and material moving occupations range dramatically from bus drivers and flight attendants to excavating equipment, crane, and dragline operators. Many significant injuries for transportation-related jobs (bus drivers, truck drivers, flight attendants, pilots, etc.) are directly related to vehicle accidents. These injuries could also include non-accident-related muscle and joint issues for long-term sitting or position-holding. Or even cardiovascular or circulatory concerns from partially sedentary-like activity.
Air traffic controllers, transportation managers, and other similar professions may also experience mental health challenges due to the elevated stress of their jobs.
And for the transportation workers engaged in material moving occupations, they are more likely to suffer from injuries resulting from close work with large, awkward, and physically demanding tools and machinery.
Again, poisoning, respiratory issues, and cancers can be a risk for some transportation-related jobs as well. Especially those jobs that are centered around transporting hazardous waste and materials.

Professions At Risk of Needing Long-Term Disability: Personal Care, Healthcare, Nurses, and Doctors

Personal care workers take care of the elderly or disabled. Their jobs include consistent lifting (transfers), bending, kneeling etc. while performing housecleaning duties, personal hygiene duties (showering, bathing, changing). This activity can lead to musculoskeletal and connective tissue issues. Mental health challenges such as depression are also common among personal care workers and healthcare workers in general.
Healthcare workers including Nurses, Doctors, and others are consistently are on their feet, bending, kneeling, lifting, and working in austere conditions. Many healthcare professionals experience musculoskeletal and connective tissue issues, especially in their back and knees. It is also common for doctors and nurses to have injuries related to unpredictable and unforeseeable interactions with patients.
These reasons are just a brief summary of why medical professionals are among the most common workers that find themselves needing long-term disability benefits.

Are You at Risk of Needing Long-Term Disability Insurance Benefits?

Or, have you experienced an injury or illness and now are unable to work at the same level you were in the past?
If so, the unfortunate reality is that you might be in for a fight with your long-term disability insurance provider just to receive the benefits that are supposed to be guaranteed to you.
To ensure you get your long-term disability benefits claim approved or your adverse benefits determination appeal, you should reach out to an ERISA disability attorney.
In fact, contact us here, and we will help you today.



Additional Resources

BLS: Occupational Employment Statistics

Stress in Air Traffic Control

Disability and Occupation Datasheets

The Disability Disconnect 



Understanding The Different Types of Disability Claims

Understanding The Different Types of Disability Claims

If you are just dipping your toes into this world of disability claims and appeals, you might be swimming in information that is challenging to make heads or tails of.  One of the big things most people do not realize right away is that there are several different types of disability claims.  Each type of disability has its own purpose and rules for eligibility and appeals.  

Below you will find the four main types of disability claims and a breakdown of what you need to know to differentiate their purpose and applicability to your situation.

And, if you still cannot figure out how or if these apply to you, contact us today and we will be happy to help you figure it out!


Long-Term Disability & ERISA 

Our focus is on long-term disability benefits.  These are benefits provided by an employer-sponsored benefits plan or occasionally purchased separately on your own.  Long-term disability benefits are provided by a third party insurance company and usually kick-in after 3-6 months of your being disabled from working (after short-term disability). 
Unlike Social Security Disability (SSDI), which is also available to those who have recently worked, but are unable to do so due to an injury, long-term disability insurance is governed and regulated through an entirely different process.  The regulating standard for employer-sponsored long-term disability policies is known as ERISA.  
ERISA – The Employment Retirement Income Security Act of 1974, was enacted to protect and standardize employees’ employer-sponsored insurance & pension benefit plans. 
ERISA lays out strict guidelines and deadlines that must be followed by insurance companies and the employer providing long-term disability insurance plans. ERISA is enforced and administered by the Labor Department’s Benefits Security Administrations, the Treasury Department’s Internal Revenue Service (IRS), and the Pension Benefit Guaranty Corporation.

Social Security Disability (SSDI)

SSDI is a Social Security program that pays you monthly benefits if you are unable to work due to an injury or illness.   SSDI is funded through payroll taxes and is very much like a government-sponsored insurance program designed to provide compensation to you if you become unemployable due to disability.  To be eligible for social security disability, you must meet the following requirements: 

Work Credits

You earn up to four work credits each year that you work.  How many credits you need to be eligible depends on what age you are when you become disabled.  For example, if you become disabled at age 44, you need 22 work credits (or 5.5 years of work) and at least 5 of those years must have been in the last ten years to be eligible.  A Social Security Disability Attorney can work you through the specifics of work-credits and eligibility.


Medical eligibility

SSDI benefits are only given to those who have a severe, long-term, total disability.  Severe means your disability must cause you to be unable to perform basic work-related activities.  Long-term means your disability has lasted at least one year.  Total disability means that you are unable to perform substantial gainful activity (SGA) for at least one year.  If the SSA finds you can perform SGA, then you will not be eligible.

Age requirement

You must be younger than retirement age (65) when you become disabled.

If you are approved for SSDI, you will not receive benefits until you have been disabled for a full five months.  If you are approved right away, you will need to wait until month six until you receive benefits.  If you are not approved for more than five months, then you will receive your benefits and any back pay going back to month six.  If you are denied benefits, you can appeal the decision within 60 days of receiving the denial letter.


Veterans Affairs (VA) – Service & Non-Service Connected Disability 

To receive disability benefits from the VA, you must have a disability that was caused by or made worse because of your active military service. This condition could be a physical illness or injury or even a mental-health diagnosis.  Also, you may be eligible even if your conditions do not appear until years after your service ends.
Benefits for service-connected disability are based on a disability rating.  The scale for service-connected ratings is broken up in 10% increments from 0%-100%. The overall rating is designed to compensate for wages lost caused by the injury or illness.  If you are 60% disabled through the VA – the logic is that the compensation you receive at that rating is relative to your loss of function from your injuries.
Eligibility requirements:

  • Service in the Uniformed Services on active duty OR
  • Active duty for training OR
  • Inactive duty training AND
  • Discharged under other than dishonorable conditions AND
  • At least 10% disability rating caused while on active duty or active duty for training or inactive duty training

Evidence Required

  • Medical evidence of current physical or mental disability AND
  • Evidence of service connection between your service and disability

If your disability claim is denied, you have the option to appeal.
VA non-service Connected benefits are similar to SSI (see below).  They provide a baseline level of (emergency) support for anyone who has served honorably. 

Supplemental Security Income (SSI)

SSI is a social security program that is based on needs according to income and assets.  It is funded by general taxes.  This program does not look at your work history, unlike SSDI.
Eligibility requirements:

  • Age 65 or older
  • Blind or disabled
  • Income such as wages, social security benefits and pensions must not exceed a certain amount based on the state in which you live.
  • Resources (savings/checking account, IRAs, etc.) cannot exceed more than $2000 for individuals or $3000 for a couple.
  • Citizen or eligible alien

Children under 18 may also qualify for SSI if they have certain disabilities. You can check with Social Security for a list of approved disabilities.
If you are denied benefits, you can appeal the decision within 60 days of receiving the denial letter.

Need More Clarification?

If you have questions about any of these types of disability claims or need help to apply or appeal a decision, contact us today, and we will point you in the right direction.