What Conditions Automatically Qualify You as Disabled?
If you are currently suffering from a debilitating medical condition, then you may be entitled to recover disability benefits pursuant to your private disability insurance policy. As a general rule, insurers look for any possible justification to deny, delay, or undervalue disability insurance claims, but if your condition qualifies automatically for disability benefits, then you will be at a significant advantage when attempting to recover such benefits.
Normally, “automatic qualification” for disability benefits is associated with Social Security Disability Insurance (SSDI), where, if an individual is suffering from one of a long list of severe illnesses, injuries, and other conditions (known as the Compassionate Allowances List), he or she will be automatically entitled to receive benefits, and in some cases, the processing of their claim will be fast-tracked. Automatic qualification for disability benefits may apply to private disability insurance plans too, however, depending on the particular terms and provisions of one’s private policy.
Standard Definition of Disability
What constitutes a “disability” can vary from plan-to-plan, but generally speaking, your condition will qualify you for disability benefits if it renders you incapable of meeting the various duties of your existing job. Some private disability insurance plans are stricter than others and may require that you demonstrate an inability to secure alternative employment. Others may require that you are totally disabled, and not just partially.
Insurers are always on the lookout for ways to disqualify you from receiving benefits. Even if you believe that you have solid evidence of your disability, the insurer may delay and argue that you are still capable of working. In such cases, automatic qualification can be quite advantageous.
Your private disability insurance policy may include a list of severe conditions, illnesses, and injuries that qualify you automatically as “disabled,” and therefore entitle you to receive disability benefits. If your condition is explicitly listed — for example, if you have been diagnosed with advanced stage lung cancer and your policy explicitly lists the condition as automatically disabling — then you need not demonstrate how your condition is disabling. You need only show that you are actually suffering from the condition at-issue.
Conditions that may automatically qualify the policyholder for disability benefits include, but are not necessarily limited, to:
- Advanced cancer
- Organ transplantation
- Multiple Sclerosis
- Alzheimer’s disease
- Severe heart conditions
- And more
It’s important to note that — even if your condition might ostensibly qualify you for disability benefits automatically — the insurer may still attempt to having to pay out benefits by arguing that you are not, in fact, suffering from the condition at-issue. The insurer may dredge up your medical records and have their experts argue that the condition you’ve been afflicted with is not quite the same as the listed, automatically-qualifying condition. Even if the insurer succeeds in doing so, you may still qualify for benefits, but you will have to prove that you are entitled to such benefits through standard means (i.e., by showing that your condition is actually disabling).
Further, depending on the condition, the insurer may require that you give regular updates on your condition as time goes on — if the condition improves, you may no longer be entitled to receive benefits. You should never misrepresent your condition, as doing so may not only disqualify you from receiving benefits but could expose you to both civil and criminal liability.
Get in Touch With a Qualified Chicago Private Disability Attorney Today
Here at Bryant Legal Group, P.C., our attorneys have spent decades representing clients in a range of private disability insurance disputes. We are committed to providing personalized advocacy, and to that end, we work closely with clients throughout the submission, appeals, and litigation process to ensure that they are apprised of new developments in the case.
Call (312) 561-3010 today to connect with an experienced Chicago private disability attorney here at Bryant Legal Group, P.C. We look forward to evaluating your dispute and helping you move forward with your claims.