What Is Total and Permanent Disability?

What Is Total and Permanent Disability?

Total and permanent disability (TPD) is a classification that determines an individual’s qualification for government disability benefits or disability insurance benefits. The Social Security Administration (SSA) defines a disability as a physical or mental impairment that renders an adult unable to engage in any type of substantial gainful activity, such as employment. To qualify as a disability, the impairment must have lasted or be expected to last at least one year or that may lead to the individual’s death.

To meet the SSA disability requirements, a child under age 18 must have a mental or physical impairment that markedly or severely limits their ability to function. As with adults, the child’s impairment must have lasted or will last for at least 12 months or have enough severity to cause death.

Unlike a short-term disability, from which individuals can recover, TPDs are considered enduring or irreversible, from which a person can never fully recover. For example, Alzheimer's disease is an incurable disorder that causes progressive dementia, which can diminish a person’s ability to interact with others and complete daily tasks.

Understanding Total and Permanent Disability

According to the Centers for Disease Control and Prevention (CDC), 61 million U.S. adults live with disabilities. Two out of every five adults over the age of 65 have a disability, ranging from mobility problems to cognitive deficits to hearing, sight, and speech impairments.

Total and Permanent Disability Characteristics

The definition of total and permanent disability differs by organization. The SSA considers a qualifying disability one that renders a person unable to work or engage in sustainable activity and is expected to last at least one year or lead to death.

To qualify for a total and permanent disability discharge of your federal student loans, the requirements are more stringent. For that, a physician must certify a mental or physical impairment that is 100% disabling, is expected to lead to death, has caused continuous impairment for at least five years, or is expected to cause continuous impairment for at least 60 months.

The Department of Veteran Affairs classifies total disability as someone who has a 100% disability rating due to service-connected disabilities, or if their service-connected disabilities make them unemployable. For the total disability to be permanent, the law requires the disability be based upon an impairment reasonably certain to continue throughout the life of the disabled person.

Determining Total and Permanent Disability

To qualify for government benefits, a qualified health professional must determine and provide medical evidence that a mental or physical impairment is a disability. For example, the SSA accepts the determinations of a medical consultant, an individual’s doctor, a psychological consultant, the results of a consultative examination, and medical experts who testify before administrative law judges in the Administration’s Office of Hearing Operations.

Levels of Disability

According to the CDC a disability may affect an individual’s ability to:

• Hear
• Learn
• Move
• Remember
• See
• Socialize
• Talk
• Think

According to the World Health Organization’s International Classification of Functioning, Disability, and Health standards, disabilities can impact a person’s ability to manage daily tasks such as bathing and eating. Disabilities may also diminish an individual’s ability to engage in education, employment, interpersonal relationships, or social activities.

Some disabilities may slightly diminish a person’s abilities, while some TPDs can lead to total dependence on other people. To determine compensation rates, government agencies and insurance companies assign percentage levels to disabilities.

For example, the Department of Veterans Affairs (VA) pays disabled veterans the following monthly payments:

Social Security Administration Disability Benefits

The SSA provides disability compensation through the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs. SSDI provides benefits to disabled individuals who have contributed part of their earnings in Social Security taxes. SSI pays disability benefits to low-income people and children under age 18.

To qualify for SSDI, a person who is disabled must fall into one of the following categories:

• Younger than full retirement age
• Disabled since before age 22 and a dependent of a parent who has paid Social Security taxes or was a dependent of a deceased insured parent
• A disabled widow or widower aged 50 to 60, whose deceased spouse was insured under Social Security

Disability Insurance

Some employers include short- or long-term disability insurance in their benefits packages. Some life insurance policies offer disability insurance as an endorsement or rider.

Short-term disability insurance provides benefits immediately following the incident that caused the impairment. Short-term disability policies limit the amount of time they pay benefits, typically three to six months. Long-term coverage may pay benefits for several years or retirement, depending on your plan.

Disability Insurance Benefits

Typically, disability insurance pays a portion of the policyholder’s salary in direct monthly payments. The recipient can use the funds to pay living expenses such as car and mortgage payments, food, and utilities. Some disability insurance policies also cover certain rehabilitation costs.

Qualifying for Disability Insurance Benefits

The terms and conditions of disability insurance benefits vary by policy. Some policies pay benefits when the policyholder sustains an impairment that prevents them from performing their job. Others pay only if you are unable to perform any job that’s suitable for you based on your training, experience, and education. Some policies will not pay benefits if you're disabled and employed; others will pay a partial benefit if the policyholder remains employed but loses part of his or her income due to the disability.

Disability insurance benefits vary by carrier. Typically, policies have exclusions and limitations, so certain policies may not cover all types of disabilities.

The Bottom Line

Typically, TPDs are irreversible conditions that leave a person unable to work. Although the VA offers disability benefits for veterans with various levels of disability, the SSA only compensates individuals who are completely disabled.

Government programs are not the only type of disability compensation. Workers can often enroll in employee-sponsored disability insurance programs, and life insurance policyholders can sometimes add disability coverage to their policies. Disability policies vary, with some offering short-term benefits and others providing long-term aid for total and permanent disability.