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Long-Term Disability and Mental Illness - Everything You Need to Know

There are many stigmas and misconceptions that come along with mental disabilities. In some cases, an individual may struggle with doing day-to-day tasks or holding down a job. Fortunately, long-term disability covers mental disorders, but the process can be complicated to navigate without understanding how Employee Retirement Income Security Act (ERISA) laws work. Your best chances of getting an approved LT disability claim is to have an experienced disability attorney assist you with your case. However, it's also essential to remain educated to help make the process go smoother. Here's what you should know.

What Types of Mental Disorders are Covered Under Long-Term Disability?

Mental health issues can have a debilitating impact on everyday life. Many people struggling with mental health disabilities often have trouble maintaining a job or may even have difficulty with daily tasks. Although depression is one of the most common mental conditions covered under long-term disability, the following are also typically covered:

  • Autism
  • Mental retardation
  • Personality disorders
  • Bipolar disorders
  • Alcohol/drug disorders
  • General anxiety disorder
  • PTSD
  • Traumatic brain injury

Depression and Long-Term Disability

Many people with depression are often misunderstood and may even be told to just, “get over it.” However, depression isn't something that an individual can quickly recover from. In many cases, depression can last for years, and most people don't realize that depression is a covered condition under most long-term disability policies. Some individuals may also fail to apply for long-term disability benefits because they have not been officially diagnosed, nor have they sought out proper treatment.

The Warning Signs of Depression

If you think you may have depression, it's imperative to seek a mental health professional as soon as possible to receive treatment. The following are some signs that a person may be suffering from depression:

  • Feeling anxious, sad, and hopeless
  • Loss of interest in hobbies or activities
  • Feeling irritable
  • Thoughts of death or suicide
  • Lack of energy
  • Trouble concentrating
  • Difficulty making decisions
  • Loss of appetite/weight loss

Depression and PTSD are typically co-existing conditions. Since PTSD is also a covered condition, having supporting documentation of both conditions is critical. When it comes to proving that your mental health disorder was not pre-existing, there is no claim without supporting documentation.

Pre-Existing Clauses in Long-Term Disability Claims

Nearly every long-term disability policy has an outlined pre-existing condition clause. Pre-existing condition clauses are often a problem for mental health claims. This is because insurance companies take a relaxed approach when determining if a mental health disorder is a pre-existing condition. Often this leads to wrongfully denied claims. Insurance companies review claims with scrutiny, so it's critical to have supporting documentation that proves your depression is not pre-existing.

How Does the Insurance Company Determine a Pre-Existing Condition?

The insurance company will examine the following factors in your case to decide whether or not your mental impairment is a pre-existing condition:

  • Medical care, treatment, and other healthcare services
  • Professional medical consultations related to your mental health condition
  • Prescription medications administered

How to Handle LT Disability Claim Denial

Besides paper errors and missing information, one of the top reasons why mental disorder disability claims get denied is through pre-existing condition clauses in policies. If your long-term disability claim has been denied for any reason, it's imperative to contact an ERISA attorney. Your attorney can advise you of your rights and help you get started on the appeals process. The sooner you begin the appeals process, the sooner you'll be able to receive the benefits you deserve.

Why It's Important to Keep Good Documentation for Mental Disorder LTD Claims

Insurance companies are well-known for denying long-term disability claims. Leaving out necessary supporting medical documentation only makes it much easier for them to deny you the benefits you deserve. Here are some tips for keeping good records.

Medical Documentation

Medical documentation is critical to the success of your claim. A note from your doctor will not suffice and support your mental disability claim. Keep all medical documentation about your disability organized for easy access.

Mental Health Professional Statements

In support of your medical records, statements about your mental health condition from your mental health professional is a vital piece of evidence in your claim. Cooperation from your doctors is vital to the success of your claim. It's also important for your treating doctor to understand how to file the paperwork correctly, meet critical deadlines, and how to deal with insurance companies in long-term disability claims.

The Independent Medical Exam (IME)

IMEs are summoned by the insurance company, and it's imperative to keep in mind that IME doctors are well-versed in long-term disability claims. They also tend to lean in favor of the insurance company. Even though you may think an IME will be the demise of your case, here are some things you can do to be proactive in getting the best possible outcome:

  • Bring a friend or family member to your appointment and have them take detailed notes about your exam. For example, how much time the doctor spent with you and the questions you were asked.
  • Ask for a copy of the IME report. Review the report for any discrepancies. If there is questionable information, it's in your best interest to consult an attorney who specializes in long-term disability claims.

How A Long-Term Disability Attorney Can Help With Your Claim

Your main concern is focusing on your mental health and well-being. Filing a long-term disability claim can be a stressful task to take on, especially when not knowing how ERISA laws work. If your long-term disability claim was denied for any reason, including a pre-existing condition, it's critical to enlist the assistance of a skilled disability attorney.

Whether you need help with a new claim or an appeal, contact Dabdoub Law Firm today at (800) 969-0488 to schedule a free consultation to learn more about receiving the benefits you deserve.