Is a Mental Disability Considered a Disability?
Why Mental Health Disability Claims Are Denied
When a mental health condition like anxiety or depression leaves a person unable to work, the last thing they expect is to be denied Long Term Disability benefits. However, most insurers require more than a diagnosis of a mental health disorder to approve a claim.
Claimants must prove to their insurer that their disorder causes functional limitations and limits their ability to work, as described by their policy’s requirements.
Before you file a claim, keep in mind some of the reasons why mental health disability claims are denied:
- There is insufficient medical evidence to establish the existence of a mental health condition.
- Your medical records document a diagnosis, but don’t provide enough evidence to support functional limitations at work.
- Treatment records show that medication or therapy has helped control or improve your condition to the degree that you can reliably perform work duties.
- The insurer identifies gaps in your treatment or evidence that suggests the claimant is not following the recommended treatment plan.
- The insurer agrees that you have a legitimate condition, but disagrees that you are incapable of performing work duties based on policy language.
- Your policy applies an “any occupation” definition of disability, and the insurer determines that you can still perform another occupation under the policy terms.
- The insurer may use your social media activity or other surveillance to argue your activities are inconsistent with your reported limitations.
Filing a Mental Health Disability Claim
A strong mental health disability insurance claim should document the effect the disorder has on a person’s ability to consistently perform their work duties.
Fields Law’s mental health disability attorneys can help you gather the appropriate evidence.
We help our clients:
- Collect detailed medical documentation of your mental health disability
- Gather physician statements that document your symptoms
- Connect your symptoms to limitations in your work duties
Work with vocational experts to further demonstrate how the condition limits your ability to work
Carefully documenting the medical and functional effects of your mental health disability will strengthen your claim. Fields Law can help.
Social Security Disability and Mental Health Long Term Disability Benefits
Many people wonder if their anxiety or depression qualifies them for Long Term Disability benefits, do they automatically qualify for Social Security Disability Insurance (SSDI) benefits?
LTD benefits and SSDI are two different programs. LTD benefits are offered through private or employer-sponsored insurance plans, while Social Security is a government program.
Each program has a different application process, and the Social Security Administration (SSA) has different rules and evaluation criteria than private or employer-provided disability insurance. However, approval still largely depends on the severity of your specific condition and how it limits your ability to work.
If a person does qualify for SSDI, their LTD benefits may be offset by the amounts received from SSDI, which may affect the amount of LTD benefits they receive.
What Happens If Your Mental Disability Claim Is Denied?
When your mental health disability claim is denied, it can leave you feeling shocked and uncertain of what to do next.
Remember, a denial does not necessarily mean your claim is over. Many Long Term Disability insurance claims are denied initially, but claimants may have the option to appeal the insurer’s decision.
Many employer-sponsored Long Term Disability policies are governed by the Employee Retirement Income Security Act (ERISA). This federal law requires an ERISA-covered plan to provide a claimant with the opportunity for a full and fair review of their denial. However, not every private or employer-sponsored plan is subject to ERISA.
In most ERISA-covered plans, you have at least 180 days to appeal a claim denial.
With only a limited time to appeal, it’s important to seek legal help as soon as possible after receiving a denial letter.
Fields Law’s mental health disability lawyers can help you understand the reasons for your denial and begin your appeal. We can help you gather the evidence needed to create a strong appeal and help you file it within the appropriate deadline.
Our team of mental health disability attorneys can help you:
- Gather additional medical evidence
- Collect detailed statements from your treating physicians
- Obtain a written statement from your doctors that explains how your specific mental health disability symptoms restrict your work capacity
- Work with vocational experts to further document how your condition affects your work duties
- File an appeal within ERISA deadlines
For those already struggling with mental illness, the process of appealing an insurance denial can feel overwhelming. Fields Law can manage the appeal process on your behalf and advocate for the full extent of benefits available under your policy.
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Get Help With Your Mental Health Long Term Disability Claim Today
Whether you’re just beginning to file a claim or your mental health disability claim has already been denied, Fields Law can help you take the next step.
We provide nationwide advice and representation in disability claims involving mental health disabilities.
Contact Fields Law today for a free initial consultation. We represent clients on a contingency basis, through our Win-Win Guarantee®. There are no up front legal costs – we only get paid if you get paid.
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Nationwide Long Term Disability Insurance Claim Attorneys
Steve Fields
Founder | CEO | Attorney
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Principal | Attorney
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Principal | Attorney
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Attorney
Kendra Bredeson
Attorney
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Attorney
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Attorney
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