What conditions qualify for long term disability insurance?

If you're thinking of getting long term disability insurance — or filing a claim — here are five things you should know.

Last updated November 6, 2025

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Do you have a health or medical condition and want to know if you can get long term disability benefits? A quick search for "What qualifies as a long term disability?' will show a number of sources that claim to list which medical conditions qualify for long term disability benefits. But intentionally or not, many of these sources are missing the larger point: Disability insurance generally doesn't "cover" a specific medical diagnosis – it covers your ability to work. In fact, it's sometimes called "Disability Income Insurance” because when you can’t work and earn income, it can pay monthly benefits that replace much of your income — for many years if needed — helping you meet financial obligations and maintain your lifestyle.

Disability insurance can be a powerful tool to help protect your family’s financial well-being. But whether you’re thinking about filing a long term disability claim — or buying a policy — here are five things to know about how long term disability benefits and coverage work:

1. Many disability policies don’t provide long term coverage

A lot of people get disability plans because disability benefits replace a portion of their earnings if they can't work due to a covered condition. But if you have a long-lasting disability, it's important to know that not all policies provide benefits that last for more than a year. There are two basic types of disability insurance coverage — short-term disability insurance (STD) and long-term disability insurance (LTD). Most disability is temporary, keeping a person out of the workplace for under a year. These are covered by STD policies which typically have a "benefit period" (i.e., the amount of time they pay benefits) for up to 6 months and almost never more than a year.

For benefits that last longer than a year, you need to have long term disability insurance, which is not as common as short term disability coverage. Unlike STD, which people often get through work, long term disability coverage is often purchased as an individual insurance policy, although some workplaces also offer it as a voluntary (employee-paid) benefit.

Workers’ Compensation benefits are not disability benefits

Workers’ Compensation only pays benefits for job-related conditions, like a workplace injury. However, most disability is caused by illness, not accidents. A short- or long-term disability policy generally covers a broader list of qualifying conditions — and they don't have to be job-related.

2. You need to look at the policy’s definition of disability

No one wants surprises when the time comes to make a disability claim. That’s why every disability policy is a contract that clearly defines when you can start getting benefits, how much you can get, for how long, and under what circumstances. This last part is called the definition of disability: a specific definition of what it means to be disabled in order to qualify for benefits.

Short-term plans tend to have a relatively simple definition of disability: if you can't perform the substantial duties of your present job because of illness or injury, you typically qualify for coverage. Since benefits only last a few months, the assumption is you'll go back to your regular occupation when you've recovered.

However, long term disability policies have to address another possibility: what if an injury or illness makes you unable to perform your own occupation, but won’t stop you from practicing any occupation? That’s why some long term disability policies have an own-occupation definition of disability, and others have an any-occupation definition.

Certain types of disability, such as a permanent foot injury, might keep you from doing parts of your job that require mobility. However, with a bit of retraining, you may be able to perform many kinds of desk jobs — even within the same organization — for similar pay. If so, a long-term disability insurance policy with an any-occupation definition of disability may provide adequate protection.

However, people with specialized skillsets may need more comprehensive protection. For example, a surgeon who develops arthritis might lose the ability to perform surgery, severely impacting their earning potential — even though they are physically able to do many other kinds of work. LTD plans with an own-occupation definition pay a benefit if you lose the ability to perform “your own,” i.e., regular occupation. Because these policies are more comprehensive, they also cost more than an any-occupation policy.

3. A medical diagnosis doesn’t automatically mean you qualify for benefits

A recent review of articles about how to qualify for LTD benefits included the following medical and health conditions:¹

Cancer	Bell’s Palsy	Osteoarthritis
Crohn’s disease	Depression	Parkinson’s Disease
Degenerative disc disease	Anxiety	ALS
Fibromyalgia	Bipolar disorder	Deafness or hearing loss
HIV/AIDS	Post-traumatic stress disorder	Blindness or vision loss
Lupus	Personality disorders	Certain long-term injuries
Multiple sclerosis (MS)	Asthma	Chronic pain
Stroke	Chronic lung disease	Chronic fatigue
Epilepsy	Kidney disease	Post-Traumatic Stress Disorder
Migraines	Heart disease	Huntington’s Disease
Peripheral neuropathy	no	no

These are just some examples of qualifying medical conditions that may necessitate continuous medical treatment and can cause significant functional limitations. All these conditions have the potential to seriously impact one's health and warrant ongoing monitoring or treatment. But in many cases, they won't necessarily keep you out of work – or at least keep you from working long enough to qualify for long-term disability benefits.

Consider the first condition on the list: cancer. A diagnosis is always worrisome to say the least, and if not cured or controlled with treatment, it can obviously lead to a disability that keeps a person from working. Additionally, patients dealing with cancer frequently undergo chemotherapy, which can lead to long-term disability claims due to the side effects and need for an extended period of recovery.² But there are innumerable forms of the disease, and according to the American Cancer Society, many common types have high survival rates of over 90%.³ And with advances in cancer treatment (as well as many other conditions listed), it is often possible to control or even cure a serious ailment in less time than it takes for an LTD policy to start paying benefits after the typical six-month waiting period. To cite just one example: a popular prostate cancer treatment called Stereotactic Body Radiotherapy (SBRT), also known as CyberKnife, can treat many cases in just 5 daily sessions of 20-30 minutes.⁴ That’s one week of missed work, which is generally covered by regular sick days, not disability leave.

On the other hand, if you want coverage that pays benefits based on a medical diagnosis — as opposed to your ability to work – there are two kinds of supplemental health insurance coverage you may want to look into. Cancer insurance pays benefits for diagnoses and many types of cancer treatment, and critical illness insurance pays similar benefits for a broader range of conditions, including heart disease, stroke, and other serious illnesses. However, neither type of insurance is designed to provide the kind of ongoing income replacement that disability insurance can provide.

4. You have to file a claim to get benefits. Here’s what to expect

Even if you have disability coverage through work — and your employer knows you have a disabling condition — it’s important to know that benefits never start automatically. You have to file a claim, and the sooner you do so, the sooner the disability insurance company can begin evaluating your eligibility for benefits. The policy should provide clear information on how to start a claim, and you should be prepared to sign an "Authorization to Obtain Information" form that will let the insurance company get the medical records and other information they need from your healthcare providers. Every disability situation is different, and depending on the nature of your employment and condition, other types of information may be needed as well. To better understand the claims process, you can refer to this guide to filing a disability claim with Guardian.

5. If you pay Social Security taxes, you may qualify for Social Security Disability Insurance (SSDI) benefits

SSDI is a government-sponsored disability insurance program that is paid for by a portion of your Social Security taxes. However, paying into Social Security doesn’t automatically qualify you for coverage. You also need to have earned a sufficient number of Social Security work credits over 40 quarters of work, or 10 years, although there are some exceptions for younger workers.

Assuming you’re eligible for SSDI, there are a number of issues you should know about: The Social Security Administration (SSA) has a strict any-occupation definition of disability that covers a specific and limited set of severe medical conditions listed in the SSA’s Blue Book. That means that SSDI only pays benefits for long-lasting or permanent medical issues that make you incapable of doing any work of any kind. If you’re a teacher, a plumber, or a brain surgeon, it doesn’t matter if a disability prevents you from working in your field — you will not qualify for SSDI benefits as long as you are physically able to hold any job, no matter how unskilled or low-paying.

The process of getting SSDI benefits is notably stringent. The initial application requires extensive documentation and can take months to complete — and over 60% of these claims are rejected.⁵ While the initial decision can be appealed, the process can stretch out for years. However, if your claim is accepted, you'll start receiving payments once the elimination period is over and the average monthly benefit is $1,537.⁶

How to get the disability coverage you need

If you can get disability insurance through work (especially for STD), start there. If long-term coverage isn’t offered, consider speaking with a financial advisor or broker to get the disability protection you need. Ensure that the professional is familiar with the specifics of buying individual long term disability insurance — If you don’t know one, a Guardian financial professional can help you. Tell your financial professional as much as you can about your financial situation and concerns so that they can start looking into the plans and options that cover the things that are most important to you.

Frequently asked questions about what disability insurance covers

Long-term disability isn’t a specific diagnosis. It refers to a condition that prevents someone from performing their work duties for up to a year or more. This can be due to a variety of reasons, ranging from physical injuries to mental health issues. Examples of conditions that might lead to long-term inability to perform work include, but are not limited to:

Musculoskeletal disorders like chronic back pain, arthritis, fibromyalgia, and osteoporosis
Cardiovascular diseases: Conditions such as heart disease or chronic heart failure
Neurological disorders like multiple sclerosis, Parkinson's disease, and Alzheimer's
Mental health disorders including severe depression, bipolar disorder, schizophrenia, and post-traumatic stress disorder (PTSD)Cancer, depending on the type, stage, necessary treatments, and their side effects
Chronic respiratory diseases like COPD (Chronic Obstructive Pulmonary Disease), asthma, or cystic fibrosis
Accidents and Injuries that damage the spinal cord, cause brain trauma or result in severe burns
Diabetes, when poorly controlled, can lead to disabling issues like kidney disease and vision loss
Strokes can result in paralysis, speech/language problems, and other physical or cognitive difficulties
Autoimmune diseases, including lupus, rheumatoid arthritis, and Crohn's disease

It's important to note that the impact of a given condition on someone's ability to work can vary greatly — it may lead to long-term disability in one person but not have the same effect on someone else.

A variety of mental health disorders, including clinical depression, may lead to long-term disability if symptoms cannot be controlled with therapy and medication.

According to the Centers for Disease Control and Prevention (CDC), "A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions).”⁷

The purpose of disability insurance is to protect and replace a portion of your income if you suffer a disabling injury or illness that keeps you from earning a living.

Depending on the type of policy and how it is customized, a disability policy can cover almost any temporary or permanent medical condition caused on the job or off, which keeps a person from working.

Social Security Disability Insurance only covers total disability, it can be very hard to qualify for, and the average monthly benefit is just over $1,500. If that is not enough for your needs, you should consider other types of disability insurance coverage.⁸

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1 Based on a Google search of top-ranking results for the terms “What qualifies as long term disability” and “Long term disability qualifications” conducted in July 2025.

2 Disability Claims for Cancer Survivors: When Treatment Ends but the Side Effects Don’t, Disability Insurance Law Group, 2025

3 Cancer Statistics Center, American Cancer Society, 2025.

4 CyberKnife Center, NYU Langone Health, 2025.

5 Fiscal Year 2024 Workload Data: Disability Decisions, Social Security Administration, January 30, 2025.

6 Andrew Hurst, SSI vs. SSDI, Policygenius, June 24, 2024

7 Disability and Health Overview, Centers for Disease Control, 2025

8Monthly Statistical Snapshot, August 2025, Social Security Administration, September 2025.

Material discussed is meant for general informational purposes only and is not to be construed as tax, legal, or investment advice. Although the information has been gathered from sources believed to be reliable, please note that individual situations can vary. Therefore, the information should be relied upon only when coordinated with individual professional advice. Guardian, its subsidiaries, agents, and employees do not provide tax, legal, or accounting advice. Consult your tax, legal, or accounting professional regarding your individual situation. This material is intended for general use. By providing this content The Guardian Life Insurance Company of America and your financial representative are not undertaking to provide advice or make a recommendation for a specific individual or situation, or to otherwise act in a fiduciary capacity.

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Guardian, its subsidiaries, agents and employees expressly disclaim any responsibility for and do not maintain, control, recommend, or endorse third-party sites, organizations, products, or services and make no representation as to the completeness, suitability, or quality thereof.

What conditions qualify for long term disability insurance?

1. Many disability policies don’t provide long term coverage

Workers’ Compensation benefits are not disability benefits

2. You need to look at the policy’s definition of disability

3. A medical diagnosis doesn’t automatically mean you qualify for benefits

4. You have to file a claim to get benefits. Here’s what to expect

5. If you pay Social Security taxes, you may qualify for Social Security Disability Insurance (SSDI) benefits

How to get the disability coverage you need

Frequently asked questions about what disability insurance covers

Already have Guardian Disability Insurance?

Need more information?

Do I need long term disability insurance? Things to consider.

How much coverage should you have? Try our disability insurance calculator.

Other products you may be interested in

Cancer insurance

Hospital indemnity insurance

Critical illness insurance

2. You need to look at the policy’s definition of disability

3. A medical diagnosis doesn’t automatically mean you qualify for benefits

4. You have to file a claim to get benefits. Here’s what to expect

5. If you pay Social Security taxes, you may qualify for Social Security Disability Insurance (SSDI) benefits

How to get the disability coverage you need

Frequently asked questions about what disability insurance covers

Already have Guardian Disability Insurance?

What conditions qualify for long term disability insurance?

1. Many disability policies don’t provide long term coverage

Workers’ Compensation benefits are not disability benefits

2. You need to look at the policy’s definition of disability

3. A medical diagnosis doesn’t automatically mean you qualify for benefits

4. You have to file a claim to get benefits. Here’s what to expect

5. If you pay Social Security taxes, you may qualify for Social Security Disability Insurance (SSDI) benefits

How to get the disability coverage you need

Frequently asked questions about what disability insurance covers

What are examples of long term disability?

Can depression be a long term disability?

What conditions are considered a disability?

What is disability insurance used for?

What do disability insurance policies usually cover?

If I have Social Security Disability Insurance, do I still need disability coverage?

Already have Guardian Disability Insurance?

Need more information?

Do I need long term disability insurance? Things to consider.

How much coverage should you have? Try our disability insurance calculator.

Other products you may be interested in

Cancer insurance

Hospital indemnity insurance

Critical illness insurance

Disclaimer8541412.1•Exp 11/27angle down

2. You need to look at the policy’s definition of disability

3. A medical diagnosis doesn’t automatically mean you qualify for benefits

4. You have to file a claim to get benefits. Here’s what to expect

5. If you pay Social Security taxes, you may qualify for Social Security Disability Insurance (SSDI) benefits

How to get the disability coverage you need

Frequently asked questions about what disability insurance covers

Already have Guardian Disability Insurance?