Whats the Difference Between Long-Term Disability and SSDI in Pennsylvania?

If you’ve recently been diagnosed with a condition that prevents you from working, learning the differences between long-term disability and Social Security Disability (SSDI) can help you. Depending on your situation, one benefit type may be more appealing than the other.

Social Security Disability and long-term disability differ in many ways. They often have different eligibility requirements and allow for varying medical conditions. Long-term disability benefits are granted through an insurance policy, while SSDI benefits are available to those with a sufficient work history. The two benefit types have different monthly maximum payment amounts and different restrictions for benefit recipients. Depending on your case, you may qualify for both SSDI and long-term disability insurance, which may benefit your family. To weigh the pros and cons of SSDI versus long-term disability, turn to an experienced lawyer.

Our attorneys are here to help you take advantage of the disability benefits available to you. For a free case evaluation with the Pennsylvania disability lawyers at Young, Marr, Mallis & Deane, call today at (215) 515-2954 or (609) 557-3081.

What Are the Eligibility Requirements for Long-Term Disability and SSDI?

One of the main differences between Social Security Disability and long-term disability is way they are funded. SSDI is a social program, funded by taxpayers (including its recipients). Long-term disability is private insurance you can purchase independently or through an employer. Because of that, the criteria you have to meet to qualify for payments will depend on the type of benefit you wish to use.

Long-Term Disability

Before qualifying for long-term disability benefits, you must purchase an insurance policy. You can either purchase long-term disability insurance on your own or through your employer. Some employers also include these policies as part of a benefits package. Once you have a long-term disability insurance policy, you must be diagnosed with an injury, medical condition, or disability that leaves you totally disabled and incapable of earning a sufficient income. Depending on your carrier, certain disabilities may make you eligible for benefits, and others may not. To learn whether your disability qualifies you for benefits under your insurance policy, speak to a Philadelphia disability lawyer. Understanding which medical conditions your plan covers and which it doesn’t can be confusing.

Social Security Disability

To qualify for Social Security Disability benefits, you must meet certain criteria. First, you must have paid into the system through your work history or have a parent with sufficient work history to qualify for SSDI benefits. If you plan on getting benefits through a parent, speak to a disability lawyer, as you may have to meet additional eligibility requirements, such as age requirements.

It’s your employer’s responsibility to take taxes out of your paychecks for Social Security. This allows you to pay into the system and qualify for SSDI. Generally, ten years of work, or 40 “work credits,” can make you eligible for SSDI benefits. The second piece of the puzzle is having a disability. The Social Security Administration provides clear lists of which disabilities and illnesses make one eligible for SSDI payments. Various medical conditions, from physical to mental illnesses, can make you eligible for SSDI benefits.

How Do You File for Long-Term Disability and SSDI?

Filing for SSDI benefits and long-term disability benefits is a somewhat similar process. While you will have to submit your application to different parties, you will have to provide the same kinds of information to apply for both SSDI and long-term disability benefits.

Whether you plan on filing for long-term disability benefits or SSDI benefits, you must be prepared to offer various documents proving your disability. Generally, the SSA requires applicants to provide information regarding their disability, treatments, income, and expenses. Be prepared to hand over all medical records relating to your disability and to answer some specific questions about your finances.

Expect to provide the same type of information to your long-term disability insurance carrier. Depending on your provider, they may be more stubborn when approving your claim. Because of that, it’s best to hire an experienced New Jersey disability lawyer. Your attorney can help you navigate difficult questions from an insurance company or the SSA and prepare the necessary information beforehand to lower the chance of unnecessary delays impacting your claim.

What Are Long-Term Disability Payments Compared to SSDI Payments?

Long-term disability and SSDI benefits can differ regarding maximum payment amounts. You may be eligible for substantial long-term disability payments depending on your previous earnings. For SSDI payment amounts, there is a strict threshold.

In 2022, the maximum monthly SSDI benefit amount is $3,345. In general, those who have worked decades and are near retirement age are the only individuals eligible to receive the maximum SSDI payment. The average monthly benefit is just over $1,000.

While each insurance carrier is likely to impose benefit maximums of their own, policyholders stand to receive high payments depending on their previous earning capacity. On average, those that file a long-term disability insurance claim can receive payments of up to 50% to 80% of their pre-disability earnings, provided that amount does not exceed the insurance carrier’s payment threshold. Depending on your previous income and policy, you may receive high long-term disability payments.

Of course, is only possible because of the premiums you pay towards your long-term disability insurance. To become eligible for SSDI benefits you don’t have to do much other than work, as your employer takes the necessary taxes out of your paychecks for you.

Understanding your potential monthly benefit amount, whether from SSDI or long-term disability insurance, can be difficult. To ensure you receive the payments you deserve and no less, consult a Lehigh County disability lawyer.

How Often Are Long-Term Disability and SSDI Recipients Evaluated?

Once you’re approved for either SSDI or long-term disability benefits, expect regular evaluations. The Social Security Administration revaluates cases depending on a doctor’s expectation of improvement, while each individual insurance carrier may request an evaluation at their own discretion.

While total disability is a prerequisite to receiving SSDI payments, conditions can improve. The SSA knows this, which is why it has a continuing disability review schedule based on a recipient’s chances of improvement.

If your medical records suggest that your condition will improve, the SSA may conduct a review within six to 18 months of its initial decision to grant you benefits. If improvement is possible but not likely, the SSA may review your eligibility every three years. If improvement is not expected at all, expect a review from the SSA once every seven years. That said, the SSA can request that you submit to an eligibility review at any time if it suspects your improvement.

Each long-term disability insurance carrier can set its own dates for reevaluation. Depending on your condition, your carrier may present you with a review schedule or may check in from time to time to ensure your continued eligibility.

How Long Can You Receive SSDI Benefits or Long-Term Disability Benefits?

After you’ve been approved for SSDI or long-term disability benefits, you can receive them for the rest of your life if you remain eligible. Because both benefits are designed to replace income for those unable to work, you can continue getting them if you cannot support yourself because of to your medical condition.

Both SSDI benefits and long-term disability benefits are for life, with conditions. When you’re approved for either benefit type, it’s often expected that you will require benefits or financial support for the rest of your life. However, you will only receive payments as long as you are eligible. If you were previously eligible for SSDI or long-term disability benefits but no longer qualify, your payments may be revoked.

Now, if you have short-term disability insurance and not long-term disability insurance, that’s another story. Confusing the two can cause issues for applicants in need of financial support. To clarify which type of disability insurance you have and learn how long it will cover you, ask a Bensalem disability lawyer to review your case. Losing access to benefits when you need them can seriously impact you and your family.

What Can Threaten Your Access to SSDI and Long-Term Disability?

While SSDI and long-term disability benefit recipients can receive payments for the rest of their lives, certain things can threaten their access to benefits. The Social Security Administration outlines strict guidelines for recipients, while insurance carriers can dictate their own rules. Plainly put, violating any conditions can result in an elimination of either benefit type.

Earning Additional Income

The Social Security Administration closely monitors SSDI recipients that earn additional income. If you earn more than $1,350 monthly, or $2,260 monthly if you are blind, your SSDI payments can stop. In addition, earning over $970 automatically triggers a trial work period, which can cause your benefits to cease after nine months.

If you’re getting long-term disability benefits and are unsure whether or not you have income limits, ask your Allentown disability lawyer. Chances are your insurer does place a limit on additional income, whether it be a weekly, monthly, or annual threshold. Earning over the allowed amount for a specific period can give an insurance carrier a reason to eliminate your payments altogether.

Change in Medical Condition

One-half of the eligibility requirements for both SSDI and long-term disability benefits is having a qualifying medical condition. You may lose access to your benefits if your disability improves or is removed. Informing the SSA and your insurance carrier of any changes to your medical condition, whether improvements or alterations to its definition, is crucial. You have to do so, even if that means losing your monthly payments.

Failure to Continue Treatment

Depending on your individual long-term disability insurance policy, you may be required to seek continued medical treatment. Your insurance carrier may mandate you provide regular updates from your medical team to monitor your condition. If you fail to continue medical treatment after your long-term disability claim is approved, your insurer may cease benefits.

In terms of SSDI benefits, seeking continued medical treatment is also important. Suppose, during a continuing disability review from the SSA, you cannot provide updated medical information demonstrating that your condition has not improved. In that case, the SSA may question your eligibility for benefits.

Can Your Family Receive Long-Term Disability and SSDI?

One way in which Social Security Disability and long-term disability benefits differ is their extension to families. While there are family benefits through SSDI, the same can’t always be said for many long-term disability insurance policies.

Generally, children and spouses of SSDI recipients can also get family benefits through a primary beneficiary. While there may be specific eligibility requirements that family members must meet, family benefits can provide much-needed financial support for your loved ones who once relied on your income.

If you have long-term disability insurance through your employer, your spouse or children may be unable to benefit from it. Generally, these policies are exclusive to employees and not their families. If you choose to purchase a policy yourself and not through an employer, it is possible that your spouse can receive benefits as well. However, this can be challenging as insurance companies are notorious for denying claims whenever possible. If you are unsure whether or not your family can receive benefits through your long-term disability plan, speak to a West Chester disability lawyer for clarification.

Can You Get SSDI and Long-Term Disability at the Same Time?

While SSDI and long-term disability benefits differ, they can work in tandem with one another. Depending on your case, you may qualify for both Social Security Disability and long-term disability benefits.

Although you can get SSDI and long-term disability benefits simultaneously, SSDI will offset your long-term disability payments, meaning you’re not likely to receive greater payments in total. So, depending on your case, it may not benefit you to apply for both SSDI and long-term disability.

That said, because of the offset in payments, insurance carriers may require you to also apply for SSDI. Be sure to ask your disability lawyer whether or not this caveat is part of your policy. If it is and you fail to apply for Social Security Disability payments, your insurer may revoke your benefits.

Call Our Attorneys to Apply for SSDI or Long-Term Disability Today

If you need disability benefits to support your family, our attorneys are here to help. For a free case evaluation with the Upper Darby disability lawyers at Young, Marr, Mallis & Deane, call today at (215) 515-2954 or (609) 557-3081.