How to get Long Term Disability Benefits for Rare Diseases

The general answer to the question above is as follows:

1. If you have purchased a long term disability program through an employer or other insurance provider source you would review your policy and begin to make a determination as to whether or not the rare diseases at issue with would be covered and/or whether or not the mental and/or physical impairments resulting from the rare diseases would be severe enough and long term enough to be considered disabilities under that particular insurance policy.
2. Social Security provides long-term disability benefits based on an adult applicant’s salary and the number of years he have worked and contributed to the Social Security system.  To be eligible for Social Security disability benefits, certain primary eligibility conditions must be met first regardless of the physical or mental etymology of an applicant’s disability.

Social Security Eligibility Requirements for a Child

A child, or an individual under age eighteen, is “disabled” if medically determinable evidence is submitted documenting a physical or mental impairment which has the following elements:

• The condition causes marked or severe functional limitations or
• Can be expected to result in death and
• Has lasted or is expected to last for twelve months or longer

Social Security Eligibility Requirements for an Adult

A person over age eighteen will be considered disabled if he can produce medical evidence and documentation supporting a “medically determinable physical or mental impairment” meeting the following criteria:

• The condition results in an inability to do any substantially gainful activity and
• Can be expected to result in death or
• Has lasted or is expected to last for a continuous period not less than twelve months

Proving a Rare Disease Impairment for Social Security and SSI

Applicants diagnosed with rare diseases must be able to document the existence of a medically determinable rare disease and document rare disease related impairments of the required duration by submitting medical evidence detailing symptoms, signs, and laboratory findings including psychological or developmental test findings.    

Getting Legal Help

If you or a member of your family has been diagnosed with a rare disease and that disease is resulting in moderate or severe disabling conditions adversely affecting daily function it would be helpful to discuss the disability circumstances with a disability lawyer.  An attorney can provide valuable assistance in reviewing long term disability insurance policies to understand available long term disabilty benefits and, if necessary, in submitting applications to Social Security or SSI.