Can You Get Long-Term and Social Security Disability?

Individuals in the United States often face circumstances preventing them from working due to illness or injury. Questions frequently arise about financial support, specifically regarding long-term disability (LTD) insurance and Social Security Disability Insurance (SSDI). It is generally possible to collect benefits from both programs simultaneously, but understanding their distinct nature and interaction is important for navigating disability benefits.

Understanding Long-Term Disability and Social Security Disability

Long-Term Disability (LTD) insurance is a private policy, either purchased by an individual or provided through an employer. Its purpose is to replace a portion of an individual’s income when they are unable to work due to a non-work-related illness or injury. Private insurance companies administer these policies, and their specific terms, including the definition of disability, waiting periods, benefit percentages, and duration limits, are outlined in the policy contract. Many LTD policies begin with an “own occupation” definition of disability, meaning benefits are paid if an individual cannot perform their specific job. After this initial period, the definition often shifts to “any occupation,” requiring the individual to be unable to perform any job for which they are reasonably qualified by education, training, or experience.

Social Security Disability Insurance (SSDI) is a federal social insurance program administered by the Social Security Administration (SSA). This program provides benefits to individuals unable to engage in substantial gainful activity (SGA) due to a severe medical condition. The condition must be expected to last at least 12 months or result in death. Eligibility for SSDI is based on an individual’s work history and contributions to Social Security taxes, measured in “work credits.” A five-month waiting period applies before SSDI benefits can begin.

Coordination of Benefits

While it is possible to receive both Long-Term Disability and Social Security Disability Insurance benefits concurrently, their interaction is important. Long-Term Disability policies almost universally include provisions to reduce, or “offset,” their payments by the amount of SSDI benefits an individual receives. This means the combined total received may be capped at the LTD policy’s original benefit amount.

Many LTD policies explicitly require claimants to apply for SSDI benefits as a condition of continuing to receive their private disability payments. Insurers may even offer assistance with the SSDI application process, providing legal or administrative support, as it directly benefits them through the offset.

The Social Security Administration does not reduce SSDI benefits based on private LTD payments. Therefore, while the LTD payment is adjusted downwards by the SSDI amount, the SSDI payment itself remains unaffected by private LTD benefits.

Applying for Both Benefits

The process of applying for Long-Term Disability and Social Security Disability Insurance involves distinct procedures, though they often require similar documentation. For both applications, gathering comprehensive medical records, detailing work history, and providing personal information is necessary. Medical evidence, such as physician statements, diagnostic test results, and treatment plans, forms the foundation of any disability claim.

To apply for Long-Term Disability, individuals begin by notifying their private insurer or employer’s human resources department. This initiates the claim process, which involves submitting specific claim forms provided by the insurer. The insurer will review the submitted medical documentation and may require additional information or independent medical examinations.

For Social Security Disability Insurance, applications can be submitted online, by phone, or in person at a Social Security office. The SSA requires detailed medical evidence to support the claim and may schedule consultative examinations with their own doctors to assess the disability. The SSDI application process can be lengthy. Due to this longer processing time and the common requirement by LTD policies to apply for SSDI, it is advisable to apply for SSDI as soon as possible after becoming disabled.

Maintaining Benefits

After an individual is approved for both Long-Term Disability and Social Security Disability Insurance, certain ongoing responsibilities are necessary to maintain benefit eligibility. Both the private LTD insurer and the Social Security Administration require beneficiaries to report changes that could affect their benefits. This includes improvements in medical condition, any return to work, or changes in income. Failure to report these changes can lead to overpayments and potential penalties.

The Social Security Administration conducts periodic reviews, known as Continuing Disability Reviews (CDRs), to determine if an individual still meets the SSA’s definition of disability. The frequency of these reviews varies based on the likelihood of medical improvement. For instance, if medical improvement is expected, a review might occur every 6 to 18 months. If improvement is possible, reviews are typically every three years, and if improvement is not expected, reviews occur every five to seven years.

Long-Term Disability insurers also conduct their own reviews to ensure ongoing eligibility. These reviews often require updated medical information, physician statements, and sometimes functional capacity evaluations. The frequency and depth of LTD reviews depend on the specific policy and the nature of the disability. Any change in one benefit, such as an SSDI approval after initial LTD payments, will trigger adjustments to the LTD benefit due to the offset provisions. Conversely, if SSDI benefits cease, the LTD payment may increase back to its un-offset amount, assuming the individual continues to meet the LTD policy’s eligibility criteria.