If you’re unable to work because of a health condition, you may have heard about long-term disability insurance and Social Security Disability Insurance. You might ask yourself, what is the difference between LTD and Social Security Disability? The answer matters because choosing the right benefits—or applying for both—could have a big effect on your monthly income and long-term financial security.
Below, we cover how each program works, who qualifies, how benefits are paid, and what to do if a claim gets denied. We also cover how a disability attorney can help. If you need help with your LTD claim, reach out to a long-term disability lawyer near you for a free consultation.
What Are Long-Term Disability Benefits?
Long-term disability (LTD) insurance provides income if a health condition stops you from working for an extended time. It doesn’t come from the government—it’s a private insurance policy that you either get through your job or buy on your own.
Types of LTD Policies
- Employer-sponsored: Offered as part of a workplace benefits package. These usually follow federal rules under ERISA (Employee Retirement Income Security Act).
- Individual policies: Bought directly from an insurance company. They tend to be more flexible but also more expensive.
Coverage and Elimination Periods
LTD insurance doesn’t kick in right away. You have to wait through what’s called an elimination period—usually 90 to 180 days from when you became disabled. Once that period ends, you can start receiving monthly payments.
Benefit Amounts
Most LTD policies pay between 60% and 80% of your pre-disability income. For example, if you earned $5,000 a month before your disability, your LTD benefits might be $3,000–$4,000 a month.
Tax Considerations
Whether your LTD benefits are taxed depends on how the premiums were paid. If your employer paid the premiums, your benefits are probably taxable. If you paid with after-tax dollars, the benefits are usually tax-free.
How Do You Qualify for LTD Benefits?
To receive LTD benefits, you have to meet the definition of “disabled” in your insurance policy. Each policy defines that differently.
Policy-Specific Definitions
- Own Occupation: You can’t do your specific job anymore.
- Any Occupation: You can’t work in any job that fits your experience, education, and training.
Policies often switch from “own occupation” to “any occupation” after a set time—usually 24 months.
Medical Evidence Requirements
Insurance companies expect medical records, doctors’ notes, test results, and sometimes even video surveillance or independent exams. If the evidence doesn’t meet the policy’s standards, they’ll deny your claim.
Pre-existing Condition Limitations
Many LTD plans won’t cover conditions you had before the policy started, especially if you received treatment for the condition shortly before enrolling.
Ongoing Proof
You’ll need to keep proving your disability regularly. This could mean filling out monthly forms or undergoing exams.
What Is Social Security Disability Insurance?
Social Security Disability Insurance (SSDI) is a federal program. Unlike LTD, it’s not based on a private contract—it’s a benefit you earn by working and paying Social Security taxes.
Eligibility Requirements
To qualify, you need to have worked long enough and recently enough. The Social Security Administration (SSA) uses a system of “work credits” to determine this. Most people need 40 credits, 20 of which must have been earned in the last 10 years.
Application Process
You have to apply through the SSA, either online, by phone, or at a local office. The application asks for medical records, work history, and other personal information. Most people get denied at first and have to go through an appeal.
Benefit Calculation
SSDI benefits are based on your average lifetime earnings before you became disabled. The SSA uses a complex formula, but most people receive between $1,000 and $3,000 per month.
Medicare Eligibility
After 24 months of receiving SSDI benefits, you automatically qualify for Medicare—even if you’re under age 65.
How Do You Qualify for Social Security Disability?
The SSA uses a much tougher standard to decide if you qualify.
Strict Definition
The SSA only pays benefits if your condition is expected to last at least 12 months or result in death—and if you can’t do any kind of substantial work.
Substantial Gainful Activity (SGA)
If you earn more than a certain monthly amount ($1,550 in 2025 for non-blind applicants), the SSA assumes you’re not disabled.
Grid Rules
If your condition doesn’t meet a listed impairment, the SSA uses a set of rules called the “grids” to decide if you can adjust to another job based on your age, education, and work experience.
Five-Step Evaluation
- Are you working above the SGA level?
- Do you have a severe impairment?
- Does your condition meet a listed disability?
- Can you do your past work?
- Can you do any other work?
Compassionate Allowances
Some conditions, like ALS or certain cancers, qualify for faster approval through this program.
What Are the Key Differences in Coverage Between LTD and SSDI?
LTD (Long-Term Disability insurance) and SSDI (Social Security Disability Insurance) both offer monthly income when you can’t work due to a disability. However, they operate under different systems, follow different rules, and offer different kinds of support. Knowing how they compare helps you make the best decisions about applying for one—or both—programs.
Definition of Disability
- LTD: Most LTD policies start with an “own occupation” definition. You’re considered disabled if you can’t perform the main duties of the job you had when you became disabled. After a certain period—usually 24 months—the definition often changes to “any occupation.” That means you must prove you can’t work in any job that fits your background, training, or education.
- SSDI: SSDI uses a stricter standard from the start. You must show that you can’t perform any substantial gainful activity, not just your former job. The condition must also last (or be expected to last) at least one year or result in death.
Benefit Amounts
- LTD: The benefit amount is typically based on your salary before you became disabled. Most policies cover 60% to 80% of your regular income. If you earned $6,000 a month, your LTD benefit might be between $3,600 and $4,800.
- SSDI: SSDI benefits are based on your lifetime work history and Social Security taxes paid. The SSA uses a formula to calculate your benefit. In 2025, the average SSDI payment is about $1,500 to $1,800 per month, though some people get more.
Duration of Benefits
- LTD: Benefits can last until you recover, reach retirement age, or reach the policy’s maximum payout period (often age 65 or later). Some policies reduce benefits over time or require proof of ongoing disability through regular updates.
- SSDI: SSDI benefits continue as long as your disability meets Social Security’s standards. The SSA reviews your case periodically to check if you’ve improved. Once you reach full retirement age, SSDI converts to regular Social Security retirement benefits.
Partial Disability Considerations
- LTD: Many LTD policies pay partial benefits if you return to work part-time or in a reduced role. These benefits help fill the gap between your old income and your new, lower earnings.
- SSDI: SSDI does not offer partial disability payments. You either qualify for full benefits or none at all. If you earn above a certain monthly amount—called the Substantial Gainful Activity (SGA) threshold—you’re generally disqualified.
Medical Insurance Considerations
- LTD: LTD policies don’t offer health insurance. You may need to keep insurance through COBRA, a spouse’s plan, or another source while receiving LTD payments.
- SSDI: After receiving SSDI benefits for 24 months, you automatically qualify for Medicare. This includes Part A (hospital coverage) and the option to enroll in Part B (medical services) and Part D (prescription drugs).
In many cases, applying for both SSDI and LTD helps protect your financial stability over the long term, especially if one program provides support that the other doesn’t.
Can You Receive Both LTD and SSDI Benefits?
Yes, you can. In fact, many LTD insurance companies require you to apply for SSDI.
Offset Provisions
Most LTD policies reduce your monthly benefit by the amount you get from SSDI. For example, if your LTD benefit is $3,000 and SSDI pays $1,500, you’ll get $1,500 from LTD.
Coordination Process
Once you’re approved for SSDI, your LTD insurer recalculates your benefit. You’ll usually have to repay any LTD overpayments using your SSDI back pay.
Financial Advantages
Applying for both programs can help protect more of your income and extend your benefits over time.
Required by Policy
Many LTD contracts demand that you apply for SSDI within a certain time or risk losing LTD payments.
Why Is the SSDI Application Process So Challenging?
Most SSDI claims get denied at the start. You’ll need strong evidence and persistence to get approved.
High Denial Rates
Roughly 65%–70% of initial applications get denied. The SSA rejects many claims for lack of evidence or because they believe the applicant can still work.
Common Denial Reasons
- Not enough medical proof
- Incomplete application
- Earning too much money
- Condition expected to improve quickly
Appeals Process
You can appeal a denial by requesting:
- Reconsideration
- A hearing with an administrative law judge
- A review by the Appeals Council
- A federal court review
Processing Time
The entire process—especially if you go through appeals—can take many months, sometimes years.
Medical Documentation Matters
Well-organized medical records make a big difference. Missing or vague documentation causes many denials.
What Happens If Your Disability Claim Is Denied?
Whether you applied for LTD or SSDI, a denial doesn’t always mean the end.
LTD Appeals
Under ERISA, you have a limited time—often just 180 days—to appeal a denied LTD claim. You’ll need more medical evidence and strong arguments. If the insurance company refuses again, a lawsuit may follow.
SSDI Reconsideration and Hearing
For SSDI, the first appeal is reconsideration. If that fails, you can request a hearing before a judge. Many people win their cases at this stage with legal support.
Deadlines Matter
Both LTD and SSDI claims have strict appeal windows. Missing a deadline could force you to start over or give up the claim entirely.
Better Outcomes with Representation
People represented by lawyers win more disability appeals than those who go it alone.
How Can a Long-Term Care Attorney Help with Your Disability Claims?
Filing a disability claim isn’t just about filling out forms. Insurance companies and the SSA often look for reasons to deny claims. A disability attorney can help strengthen your case from the start.
- Application Help: An attorney prepares your application to avoid the mistakes that lead to rejections.
- Medical Evidence Development: Attorneys know what kind of proof insurance companies and the SSA expect—and how to get it.
- Communication with Insurance Companies: You won’t have to deal with insurance reps or claims adjusters on your own.
- Appeals Representation: If your claim gets denied, your attorney can write your appeal, gather new evidence, and represent you in hearings.
- Coordinating Benefits: When you qualify for both SSDI and LTD, an attorney makes sure both programs work together and you keep more of your money.
- Maximizing Benefits: Attorneys look for ways to increase the amount you receive by checking policy loopholes, deadlines, and mistakes by the insurer or SSA.
Contact Our Skilled LTD Attorneys Now
The disability system isn’t easy to deal with alone. If you’re struggling with a long-term disability claim, Sandstone Law Group is ready to step in.
We’ve helped many people recover the monthly benefits they’re owed—whether through employer LTD insurance, private policies, or SSDI. Our firm understands how these programs work and how they connect. We prepare strong claims, handle appeals, and deal with the paperwork so you don’t have to.
We offer free consultations and only collect attorney fees when we secure benefits for our clients. Contact us today to schedule your consultation. Deadlines can cut off your rights if you wait too long. Don’t risk missing out on the income you deserve.
