What Medical Conditions Qualify for Long-Term Disability

TL;DR: Long-term disability benefits typically cover serious health conditions that prevent you from working for an extended period. Common qualifying conditions include musculoskeletal disorders like chronic back pain and arthritis, neurological diseases such as multiple sclerosis or epilepsy, severe mental health disorders, cardiovascular illnesses, cancer, respiratory conditions, autoimmune diseases, and endocrine disorders. To qualify, you must provide medical evidence showing your condition significantly limits your ability to perform your job duties.

When life takes an unexpected turn and your health starts interfering with your ability to work, long-term disability insurance can become a lifeline. Yet, many people feel lost trying to figure out whether their medical condition actually qualifies for benefits. Maybe you’re dealing with chronic pain that never seems to go away, a serious illness that has upended your daily routine, or a mental health condition that makes it impossible to focus on your job.

Understanding what qualifies for long-term disability isn’t always simple, because insurance companies don’t just look at your diagnosis; they evaluate how that condition affects your ability to perform your job. The good news is that thousands of physical and mental conditions can qualify, as long as you provide the right medical documentation and evidence showing your limitations.

Let’s break down the main categories of conditions that often qualify for long-term disability benefits, what evidence insurance providers look for, and how to strengthen your claim.

Understanding How Long-Term Disability Works

Long-term disability (LTD) insurance provides income replacement when you’re unable to work for an extended period due to illness or injury. Most policies pay around 50 to 70 percent of your salary and can continue for years, sometimes until retirement age depending on your plan.

To qualify, you must prove that your medical condition prevents you from performing the essential duties of your job. Some policies define disability as the inability to perform your own occupation, while others use a stricter any occupation definition, which means you must show you can’t perform any job for which you’re reasonably qualified.

Your eligibility depends not just on your diagnosis, but also on medical documentation, treatment history, and the severity of your functional limitations.

List of Medical Conditions that Qualify for Long-Term Disability

Here is the list of some medical conditions that qualify for long-term disability:

1. Musculoskeletal Disorders

Musculoskeletal disorders are the leading cause of long-term disability claims. These conditions affect the bones, joints, muscles, ligaments, and spine often leading to chronic pain, stiffness, or mobility issues that can make even simple tasks unbearable.

Common Conditions Include:

• Degenerative disc disease or herniated discs
• Severe osteoarthritis or rheumatoid arthritis
• Fibromyalgia and chronic pain syndrome
• Scoliosis and spinal stenosis
• Carpal tunnel syndrome and repetitive strain injuries

Why They Qualify

These conditions often cause long-term pain, limited range of motion, and difficulty sitting, standing, or lifting. People in physically demanding jobs, such as construction, nursing, or factory work, are especially vulnerable. Even office workers can struggle when back or neck pain prevents them from sitting for long hours or focusing on work tasks.

To support your claim, medical imaging like MRIs, X-rays, and detailed physician notes outlining your physical restrictions are essential.

2. Neurological Disorders

Neurological disorders disrupt the communication between your brain and body, causing unpredictable and often progressive symptoms. These conditions can interfere with motor skills, cognitive function, memory, and emotional regulation, making consistent work nearly impossible.

Examples Include:

• Multiple sclerosis (MS)
• Parkinson’s disease
• Epilepsy and seizure disorders
• Traumatic brain injury (TBI)
• Peripheral neuropathy
• Chronic migraines and post-concussion syndrome

Why They Qualify

Neurological disorders can impair coordination, speech, memory, and energy levels. Someone with MS may experience fatigue and vision issues, while a person recovering from a TBI might struggle with concentration and mood changes.

Detailed neurological evaluations, neuropsychological testing, and consistent follow-ups with a specialist help demonstrate the ongoing impact of these disorders on your ability to work safely and effectively.

3. Mental Health Conditions

Mental health disorders are increasingly recognized as valid reasons for long-term disability. These conditions can affect concentration, motivation, emotional stability, and the ability to handle workplace stress or interactions.

Common Qualifying Conditions:

• Major depressive disorder
• Generalized anxiety disorder or panic disorder
• Bipolar disorder
• Post-traumatic stress disorder (PTSD)
• Schizophrenia or schizoaffective disorder
• Obsessive-compulsive disorder (OCD)

Why They Qualify

Even though these are “invisible” disabilities, they can be just as debilitating as physical ones. Someone suffering from severe depression may be unable to get out of bed, while PTSD can cause flashbacks or panic attacks that disrupt concentration.

Insurers often require evidence of consistent therapy, psychiatric evaluations, and prescribed medication management. It’s important to note that many LTD policies impose a two-year limitation on benefits for mental health conditions unless the disorder results from a neurological cause.

4. Cardiovascular and Circulatory Disorders

Heart and vascular diseases can dramatically limit physical activity, endurance, and overall stamina. They are among the most serious and life-threatening conditions that qualify for long-term disability benefits.

Examples Include:

• Congestive heart failure
• Coronary artery disease
• Severe hypertension (uncontrolled)
• Stroke and post-stroke complications
• Peripheral artery disease

Why They Qualify

After a heart attack or stroke, patients often experience reduced strength, chronic fatigue, and an increased risk of recurrence under stress. Even sedentary jobs can be difficult if your condition worsens with anxiety or exertion.

Supporting documentation from a cardiologist, test results such as EKGs or echocardiograms, and rehabilitation reports can strengthen your case.

5. Respiratory Disorders

Breathing difficulties can interfere with nearly every aspect of work, from physical labor to cognitive focus. Respiratory illnesses often worsen over time and can make daily functioning extremely difficult.

Examples Include:

• Chronic obstructive pulmonary disease (COPD)
• Severe asthma
• Pulmonary fibrosis
• Chronic bronchitis
• Cystic fibrosis or emphysema
• Sleep apnea (in severe, uncontrolled cases)

Why They Qualify

Respiratory conditions limit oxygen intake, leading to fatigue, confusion, and poor endurance. Even mild exertion can cause shortness of breath or dizziness.

Objective tests like pulmonary function tests (PFTs) and oxygen saturation readings, along with reports from pulmonologists, are essential for proving the severity of your symptoms.

6. Autoimmune and Chronic Illnesses

Autoimmune diseases occur when the body’s immune system attacks its own tissues, leading to widespread inflammation, pain, and fatigue. These illnesses can fluctuate in severity, making consistent work attendance difficult.

Examples Include:

• Lupus (systemic lupus erythematosus)
• Crohn’s disease or ulcerative colitis
• Chronic fatigue syndrome (CFS)
• Lyme disease
• Endometriosis
• Sjögren’s syndrome

Why They Qualify

These conditions often cause “flare-ups” that can last days or weeks, interrupting work schedules and productivity. Symptoms like brain fog, joint pain, and exhaustion can prevent even desk workers from performing effectively.

Detailed medical records showing the frequency and duration of flare-ups, lab results, and physician notes linking symptoms to your functional limits are critical to approval.

7. Cancer and Treatment-Related Disabilities

Cancer is one of the most straightforward conditions that can qualify for long-term disability, though the approval depends on the type, stage, and treatment effects.

Examples Include:

• Breast, lung, or colon cancer
• Leukemia and lymphoma
• Metastatic (spread) cancers
• Chemotherapy-induced neuropathy or fatigue
• Cognitive impairment from radiation therapy

Why They Qualify:

Even when cancer is treatable, chemotherapy, radiation, and surgeries often leave patients weak, nauseous, and cognitively drained for months or years. The recovery period and long-term side effects can make returning to work unrealistic.

Documentation from oncologists, treatment summaries, and evidence of continuing symptoms help establish medical necessity for long-term disability.

8. Endocrine and Metabolic Disorders

These disorders affect hormone production and metabolism, leading to systemic issues like fatigue, weakness, and cognitive fog that can interfere with productivity and reliability.

Examples Include:

• Diabetes with neuropathy or vision loss
• Thyroid disorders (Graves’ disease, hypothyroidism)
• Cushing’s syndrome
• Addison’s disease
• Adrenal gland disorders

Why They Qualify

When these conditions are uncontrolled or cause complications, they can lead to frequent absences, concentration problems, and physical fatigue. Regular medical evaluations, lab results, and physician assessments showing treatment resistance or severe complications can support your claim.

Proving Your Disability: What Insurance Companies Look For

Insurance companies don’t simply take your word for it. They require solid evidence showing your condition truly prevents you from working.

You’ll need:

• Comprehensive medical records outlining your diagnosis and treatment
• Statements from treating physicians describing your functional limitations
• Test results, imaging, and lab reports supporting your diagnosis
• Functional capacity evaluations (FCEs) showing how your condition affects physical or cognitive ability
• Employment descriptions explaining your job’s physical and mental demands

Maintaining consistent medical treatment is crucial. Gaps in your care can make it look like your condition has improved or isn’t severe enough to warrant benefits.

Conditions That are Harder to Prove

Some conditions especially those with subjective symptoms, can be difficult to document. Chronic pain, fibromyalgia, and certain mental health conditions fall into this category because they don’t always show up on scans or lab tests.

In these cases, detailed medical documentation, consistent specialist care, and personal statements describing how your symptoms affect your day-to-day life can make a significant difference. You can also learn about how many hours you can work on disability when you read more.

Final Thoughts

Qualifying for long-term disability is about more than just a diagnosis. What truly matters is how your condition limits your ability to perform your job duties safely and reliably. Whether you’re living with a chronic illness, recovering from a serious injury, or battling mental health challenges, thorough medical documentation and persistence are key.

If you’re unsure about your eligibility or your claim was denied, consulting an experienced disability attorney or advocate can help you navigate the process and protect your rights. If your health condition is keeping you from working, don’t wait to get the support you deserve. Learn how to qualify for long-term disability and take control of your financial future today. Contact us for free case evaluation.