Did you know that about 20 percent of American adults—that’s 44 million persons—live with mental illnesses? Reports indicate that 10 million adults suffer from serious mental illnesses that interfere with their ability to perform the important duties of their occupations.
The most common mental illnesses are anxiety disorders such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder and irrational fears. Major depressive and mood disorders are also common causes of disability.
Sadly, reports indicate that less than half of all American adults suffering from a mental health condition get the help they need. Mental illnesses are estimated to cost patients almost $200 billion in lost earnings per year.
Don’t join their ranks. Though many individual and group long-term disability insurers exclude or limit mental health coverage, that’s not the end of the claim line. You’re not alone.
Contact the award-winning long-term individual disability attorneys and top-rated group ERISA lawyers at DarrasLaw if you’re one of the millions of Americans suffering from a mental health disorder and need to file a disability claim with your individual or group long-term disability insurance company. Even if your individual or group long-term disability policy excludes mental health conditions from coverage, people with mental health disorders often suffer from other disabling chronic health conditions that may be covered.
America’s nationally respected long-term individual disability lawyers and pre-eminent group ERISA attorneys at DarrasLaw can analyze your long-term disability policy and review the facts of your case for free. We’ll help determine whether your individual or group long-term disability company wrongfully delayed, denied, or terminated your benefits. Schedule your free disability policy analysis or free claim consultation today by calling 800-898-7299 or contacting us online.
“Self-Reported” Mental Health Conditions
You might suffer from situational depression after losing a loved one, or severe anxiety after a car accident. These conditions may resolve with time and treatment. On the other hand, clinical depression, manic-depressive disorder, schizophrenia, and related mental health conditions are not generally temporary. Instead, they’re legitimate medical disorders requiring extensive treatment. These disorders may worsen with time and can leave you unable to perform the important duties of your occupation with reasonable continuity and in the usual and customary way.
It’s crucial to immediately acknowledge when your mental health condition interferes with your ability to perform your occupation’s duties. You may not have any legal protection if you’re terminated for an inability to perform, even if a mental health disorder caused your problems. Instead, apply for individual or group long-term disability benefits with the help of the experienced long-term individual disability attorneys and seasoned group ERISA lawyers at DarrasLaw.
Many barriers can prevent the successful application for individual or group long-term disability benefits due to a mental health condition. Treating doctors and counselors can’t objectively confirm most mental health disorders. You can see a broken arm through an X-ray, test for a traumatic brain injury with a CT scan, and diagnose HIV with a blood test.
There is, however, no objective “test” for many mental health disorders. Instead, they’re diagnosed based on your “self-reported” or manifested symptoms. These can include, but are not limited to:
- Extreme mood changes
- Withdrawal from social settings
- Loss of motivation
- Fatigue
- Delusions, hallucinations, and paranoia
- High stress
- Inability to cope with people or situations
- Sadness and depression
- Confusion
- Inability to concentrate
- Excessive fear, worry, or guilt
- Increased anger
- Suicidal thoughts
- Significant changes in eating habits
The majority of these symptoms are “self-reported.” This means there’s no objective way to confirm your valid individual or group disability claim. Only you know if you’re experiencing hallucinations, feeling sad, or have lost motivation. While friends and family can testify to your change in mood or behavior, your treating doctors will have to provide the compelling medical evidence and proof necessary to claim individual or group long-term disability benefits.
You need the help of America’s top-rated long-term individual disability insurance attorneys and stellar group ERISA lawyers to fight a wrongful denial of individual or group mental health disability benefits. DarrasLaw understands these conditions. We can help you and your treating doctors to present the proper evidence to your individual or group long-term disability carrier, and help you fight a wrongful delay, denial, or termination of benefits.
Limitations on Individual or Group Long-Term Mental Health Benefits
Remember, insurance is a business, for-profit individual and group long-term disability insurers may limit self-reported and mental health disability coverage to 12, 18, or 24 months total. This means you may only claim a cumulative 12, 18, or 24 months of individual or group long-term disability benefits for self-reported conditions. Such self-reported conditions include:
- Fibromyalgia
- Chronic fatigue
- Substance/alcohol abuse
- Lupus
- Tinnitus (ringing in the ears)
- Chronic migraines
- Arthritis
- Vertigo
If you’ve claimed two years of individual or group fibromyalgia benefits but developed depression as the result of fibromyalgia, you can’t claim another two years of mental health benefits. Your individual or group long-term disability policy may also exclude mental health conditions from coverage altogether. The key to obtaining individual or group disability benefits is linking your mental health condition to a physical condition such as a traumatic brain injury, brain infection, or cancer, that your policy does cover.
Common Disabling Mental Health Conditions
Your mental health condition must prevent you from performing the material and substantial duties of your occupation to successfully claim individual or group long-term disability benefits. The severity of your condition isn’t always the determining factor.
For example, an individual or group long-term disability insurance company may determine that a writer with manic-depressive or bipolar disorder can take a break during a difficult emotional episode. His mental health disability, therefore, may not prevent him from performing the important duties of his occupation—at least in the eyes of his individual or group long-term disability insurance provider.
On the other hand, a police officer who develops the same condition may prove unable to perform the occupation’s important duties due to its stressful and dangerous nature. You’ll have to show through compelling medical evidence and proof, your treating physician’s chart notes and complete medical records and testing, pharmacy records, and treating therapist, Ph.D., or psychiatrist reports, how symptoms of your mental health disorder specifically impair your ability to perform the important duties of your occupation.
The most common disabling mental health disorders include, but are not limited to:
- Panic attacks – This common anxiety disorder differs from episodes of “legitimate” fear because the panic sets in for no reason. You could feel fine one moment, and without explanation, find yourself terrified with a pounding heart the next. This disorder is difficult to control. Some employers may make accommodations for you, such as allowing you to relax in a back room. However, if you are a teacher, doctor, or bus driver, these episodes may prevent you from safely performing the important duties of your occupation.
- Memory loss – You may qualify for individual or group long-term disability benefits if you suffer from short or long-term memory loss. A traumatic brain injury or aging may cause memory loss. Memory loss can make the work environment especially difficult. Forgetting deadlines, phone calls, or office meetings can drastically hurt your ability to perform the important duties of your occupation.
- Somatoform disorders – This rare type of mental health disorder causes you to feel pain or discomfort in certain areas of your body without explanation—for example, if you had a limb amputated and still experience phantom pain in that area. Body dimorphic disorder, conversion disorder, and hypochondriasis are also examples of somatoform disorders. Physical symptoms “without medical explanation” characterize these disorders, and it’s difficult to get a diagnosis. Your treating doctor will have to rule out all other potential causes of the pain before diagnosing you with a somatoform disorder.
- Post-traumatic stress disorder (PTSD) – While many people associate this anxiety-based condition with combat veterans, it can manifest in anyone who has experienced severe trauma. A car accident, physical assault, or traumatic event can induce PTSD. It’s normal to experience nightmares, heart palpitations, and situational anxiety after a trauma, but you may have PTSD if these symptoms last more than a month. Veterans must take care when claiming individual or group long-term disability benefits for PTSD. Some long-term disability insurers will not cover combat-related injuries because veterans’ benefits should cover them.
- Bipolar (or manic-depressive) disorder – This mental health condition is characterized by often frightening, severe mood swings. During episodes of mania, the patient may experience days of euphoria, sleeplessness, psychosis, delusions of grandeur, paranoia, rage, and hallucinations. During depressive episodes, the depression may feel so severe that no treatment is effective. Untreated depression can result in suicidal thoughts, feelings of extreme helplessness, and lack of motivation.
- Borderline personality disorder – Healthcare professionals characterize borderline personality disorder as a pattern of varying moods and behaviors. Patients may also suffer from a high or low self-image, and many people with borderline personality disorder also suffer from bipolar disorder. People with borderline personality disorder may have episodes of intense anger, anxiety, and depression, but these may only last a few hours. These patients may take impulsive actions, change their minds quickly, and engage in self-harm. Borderline personality disorder differs from bipolar disorder in that these behaviors can occur at any time, not just during manic episodes.
- Schizophrenia – This is one of the most serious mental health conditions a person can experience. People with schizophrenia experience distorted thoughts, delusions, hallucinations, catatonic states, paranoia, and bizarre behavior. Patients are often unpredictable, exhibiting irrational behavior. Most patients with schizophrenia begin experiencing symptoms between the ages of 16 and 30, and it rarely does it initially strike people after the age of 45.
- Depression – One of the most common mental health disorders, depression, involves constant sadness, lack of motivation and fatigue. You may lose interest in activities you once enjoyed and have thoughts of suicide and feelings of hopelessness. While everyone experiences sadness or periods of depression, if it lasts more than a few months, you may suffer from clinical or organic depression.
The mind is incredibly complex. Unlike traumatic brain injuries, scientists can’t pinpoint the cause of most mental health disorders. Much treatment consists of trial and error, usually with intense medication side effects. Your medicine alone may cause you to miss work.
Furthermore, many patients suffer from multiple disorders. For example, borderline personality disorder and bipolar disorder often exist concurrently, as do depression and various anxiety disorders. Any combination of these conditions can leave you disabled, meaning you can’t consistently perform the important duties of your occupation or find the motivation to do so.
Medical Conditions Linked to Mental Health Disorders
Individual and group long-term disability insurance plans that limit mental health coverage may still offer benefits for organic mental health conditions and related illnesses. Physical issues with the brain such as infections or traumatic brain injuries often cause organic mental health disorders. This means that, but for the underlying illness, you would suffer from no mental health disorder.
Even if you cannot claim individual or group long-term disability insurance benefits for a mental health disorder, you may claim benefits for an underlying illness or injury. For example, amnesia may result from a traumatic brain injury while delirium can be a symptom of a brain tumor or parasitic infection. You would apply for individual or group long-term disability benefits based on the underlying condition—the brain tumor—as opposed to the symptoms of that condition—confusion and memory loss. Because your treating doctors can clinically confirm a brain tumor, your mental health condition won’t trigger a benefits exclusion or limitation.
Patients with severe mental health conditions suffer from an increased risk of physical ailments, including:
- Bacterial infections
- Pneumonia
- Sexually transmitted diseases
- Heart diseases
- Tuberculosis
- HIV/AIDS
- Hepatitis
- Cancer
- Pregnancy complications
- Osteoporosis
- Diabetes
If you can’t claim individual or group long-term disability benefits for the underlying mental health condition, you might claim disability benefits for a related physical condition. The top-rated long-term individual disability lawyers and experienced group ERISA attorneys at DarrasLaw know how to frame your medical issues so your case is as strong as possible. We can work with you and your treating doctors to fight wrongful delays, denials and terminations of individual or group long-term mental health disability benefits based on the proper medical evidence.
Contact America’s Top-Rated Long-Term Individual Disability Lawyers and Nationally Renowned Group ERISA Attorneys for a Free Consultation
The nation’s premier long-term disability lawyer, Frank N. Darras, and his firms have recovered nearly $1 billion in wrongfully delayed, denied, and terminated insurance benefits. Call our pre-eminent long-term individual disability attorneys and nationally respected group ERISA lawyers at DarrasLaw today to schedule your free disability policy analysis and free claim consultation. We’re here for you whether we need to litigate a complicated ERISA case, file an individual bad-faith disability claim, or negotiate a lump sum settlement. Contact us at 800-898-7299 or online without delay!
