LTD & SSD

Just because you qualify for long term disability (“LTD”) benefits does not mean that you qualify for Social Security Disability (“SSD”) benefits, and vice versa. I have a 40 year old client from Wisconsin who was denied SSD benefits even though he had been receiving LTD benefits for years.

After reviewing the client’s LTD and SSD files I learned that the client was relying primarily on medical evidence from his chiropractor. The medical evidence previously submitted revealed that a cervical disc was deforming the claimant’s spinal cord. The claimant also submitted an attending physician statement from his chiropractor, which concluded the claimant was permanently disabled and had a less than sedentary residual functional capacity (“RFC”). While the contractual language of the LTD plan did not distinguish between a chiropractor and a physician, the Social Security Administration (the “SSA”) regulations do.

On appeal, I obtained two things from the claimant’s neurologist. First, an opinion that the claimant met a “listed impairment” of the spine. Second, an RFC assessment concluding that the claimant could not do sedentary work. Additionally, I obtained an RFC assessment from the claimant’s family doctor that also concluded the claimant lacked a sedentary RFC. I submitted the evidence in connection with a request for a fully favorable decision on the record (“OTR”).

Based on the new medical evidence the claimant’s OTR was granted. Therefore, not only was the claimant’s application approved, but he did not have to appear for a hearing, which probably would not have been scheduled for another year or two.