Which Anxiety and Depression Issues Qualify for Disability?

Certain mental health disorders may impact and impair you enough that it prevents you from working. If that happens, you may qualify for disability benefits through your insurance policy.    

Anxiety disorder is wide ranging and may present as difficulty breathing and concentrating, heart palpitations, and/or panic attacks – which can make it difficult or even impossible to focus or perform work.  Anxiety disorders include obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), social anxiety disorder, panic disorder, and phobias.  

As an example, we represented an employee who was required to deliver presentations in connection with her work. These presentations were typically given to higher level (C Suite) executives. Her anxiety became so severe that she was unable to speak in front of that audience. We were able to advocate for her claim based upon these limitations.  Her specific limitations due to her condition prevented her from performing her occupational duties, and once they were properly conveyed, the claim was able to be accepted.

Depression goes far beyond simple feelings of sadness. Depression is marked by a lack of interest or ability to take pleasure in any activities. Those suffering from depression often experience low energy, fatigue, difficulty sleeping, focus and concentration issues, feelings of inadequacy, and may even harbor suicidal ideations. Many people cannot work as they are unable to make decisions or perform any of the regular tasks of their occupation.

Work manifestations due to mental health issues often involved interpersonal engagement and the inability to accept or receive criticism or work around others, or the ability to think clearly and make decisions.  Many of these challenges will support an insured’s disability claim once articulated by their treating provider.  

Types of depression include major depressive disorder, clinical depression, persistent depressive disorder or dysthymia, or bipolar disorder-related depression. It is not the name which matters for a claim as much as how and why it impacts somebody’s ability to work and the treatment they are pursuing. For some individuals, prescription medicines are used in combination with various types of talk therapy. More severe cases require hospitalization at a facility specializing in mental health issues.

Other mental health disorders include post-traumatic stress disorder (PTSD), neurocognitive disorders, personality disorders, learning disabilities, schizophrenia, and somatic symptom disorders. Often these conditions impact one’s ability to perform their job or to work at all.

Anyone seeking to pursue a mental health disability claim through a disability insurance policy must satisfy policy provisions, including to be under the care and treatment of a qualified psychiatrist or psychologist, for appropriate care and treatment to support a claim.  The claim support must importantly demonstrate that these mental health issues are significant and impairing, and document how and why the condition affects their ability to work and impacts functionality.

In most Group LTD ERISA policies, there is a specific limitation clause that limits mental and nervous claims to 24 months.  Insurance companies wrote these policies with limited benefit coverage specifically to contain costs, and the rules are strongly in their favor on these issues.  Courts have thus far refused to provide parity between physical and mental health claims.  Even if you remain disabled, where a mental health issue is your cause of disability, your payments will end at the end of that period unless you demonstrate that you have another condition causing your disability, even if your mental health condition continues.  We have succeeded in navigating these challenging claims, often showing how or why the other condition is the claim driving condition.

A frequent tactic of a disability insurance company is to try to change the characterization of a claim, for claimants who suffer from a physical disability with some psychological or cognitive overlay, into the mental and nervous category as a means of limiting benefit payments.   We had a client who suffered Tourette’s Syndrome, and had been paid for that condition, when the insurance company unilaterally altered its consideration of the claim to a mental health claim.  We were successful in getting the insurance company to appreciate our arguments and the support developed for his claim.

You and your doctor must clearly distinguish between physical and mental conditions and support how the physical issues are impairing your ability to work. Many people with serious injuries or chronic illnesses become depressed because their life has been permanently altered or they live with chronic pain. This would make almost anyone depressed or anxious.   This might be considered adjustment disorder or simply secondary depression.

However, if your doctor’s notes indicate depression or anxiety even if the note clearly states the mental/nervous condition is a direct result of your physical disability, the insurance company may well attempt to re-categorize your disability. This is a common tactic and one we have fought successfully.

If your depression, anxiety, or nervous condition is severe and you cannot perform your job tasks and/or you feel your job is in jeopardy due to performance issues resulting from your disability, you should speak with a disability insurance policy lawyer who has successfully represented claimants suffering from depression, anxiety, and mental and nervous disorders. If you have questions, call our experienced attorney directly at 1-877-LTD-CLAIM (583-2524) or send us an email.

Can You Get Long Term Disability For Anxiety and Depression?

Many people have anxiety over something in their life.  Others have pervasive anxiety which occupies much of their thoughts and frustrates the ability to make decisions, take actions, or engage in activities.  Have you struggled to keep working despite suffering from a mental health issue or disability and not known what to do about it?  Are you concerned that your job performance has been impacted by your condition, and your job might be at risk?  Statistically, about one in five people experience a mental health issue at some point every year – many of whom cannot continue to work as a direct result of their mental health. Over many years, we have seen these issues repeatedly, and we know that challenges faced by disabled employees can turn into long-term disability claims and that help along with the way is critical with these types of claims.   

For a disability claim to be approved, short term or long term, especially one for anxiety, depression or other mental/nervous conditions, the claim must be well presented, and thought must be provided as to the responses for the claim forms, development of medical support, and its impact upon one’s ability to work and perform their work responsibilities.   Seeking an experienced long term disability insurance attorney to guide the disability insurance claim process is the critical first step to succeeding on your disability claim for a mental health disability.   Following COVID, these claims have increased further in numbers.  Because these claims are increasing in number, insurance companies are trying to control their exposure by denying or delaying many claims. 

Depression, anxiety, and mental and nervous disorders make coping with everyday life a challenge. Mental health issues often make work difficult, if not impossible. At Newfield Law Group, our New York disability insurance lawyers have a track record of success representing claimants and policyholders nationwide who are struggling to manage their lives while coping with depression, anxiety, and mental and nervous challenges.

The insurance companies consider mental/nervous claims to be a subjective disability and have made proving the disability a key part of their denial process. Like other conditions not readily revealed by diagnostic medical tests like bloodwork or X-rays, mental health claimants suffering from depression or anxiety must develop a robust medical record supporting their claim. If a person has a sudden onset of mental disease, there may not be a medical record history and information will not be available to support the claim.  

An individual whose primary care physician prescribes an antidepressant medication and then adds a short note to the patient’s medical file will typically not be considered depressed by the disability insurance company and therefore won’t qualify for benefits.  More information, including treatment from a psychiatrist or a psychologist will be needed in the development of that claim and the support will be critical for the claim to have success.  

If your claim for disability insurance benefits has been denied or is being delayed or for a free consultation of your issues, call our office at 1-877-LTD-CLAIM (583-2524) to learn how we can help.

Under the provisions of the disability insurance policy, mental health issues will only satisfy the requirements of a disability if they disrupt your work performance and negatively influence your ability to undertake day-to-day activities.  How is that defined?  

Your application for disability insurance coverage will consider the degree and extent to which your function is impaired when determining your level of disability or if you have a disability that will be covered at all. To succeed in the claim process, it is important to have an experienced disability insurance attorney working with you to advocate for your claim, as these invisible injuries are often disputed and dismissed by disability  insurance companies looking to deny your claim and save money.

For more than two decades, we have represented clients with mental health claims, allowing them to focus on their health. With our vast experience in this area, we can help you with your depression, anxiety or mental health disability insurance claim.   Read more to find out how Newfield Law Group can help fight for the disability insurance benefits you need and are entitled to. If you have questions, call us at 877-LTD-CLAIM to speak with an attorney.

What to Do if Your Claim Benefit is Denied or Terminated?

Claim denials and terminations for disability insurance benefits are surprisingly common. This is business and most insurance companies are publicly traded, with scrutiny from shareholders, financial analysts, and stock markets.  

The good news is that just because your claim was denied or terminated, it is not the end of the road, and you still have options depending on your situation. 

You can appeal the denial, though the ERISA disability appeal process is complex, and you will need to provide extensive medical evidence that your disability impacts and impairs your ability to work. You will need records (forms and narratives) from a healthcare professional supporting your claim. Because of the complexities, it is important to have an experienced disability insurance lawyer on your team.

Most long-term disability insurance policies pay benefits for a limited period of time for qualifying mental health claims, so protecting the claim is especially important for the financial well-being of the claimant and their dependents. Unlike physical disabilities, injuries, or illnesses, mental health disabilities do not appear in X-rays, diagnostic images, or blood tests and do not always show physical impairments. Private policies typically do not have any limitations for mental health claims; these policies, often held by medical professionals, can be extremely valuable and navigating these claims with an experienced attorney can yield tremendous value.

Fighting an enormous company with endless resources, financially motivated and incentivized claims adjusters, and layers of delay and requests is aggravating for a healthy person. For any disabled person who is suffering from anxiety, depression, or other mental health conditions, it can be overwhelming, exhausting and stand in the way of any health improvements.

Engaging a lawyer and having the entire process managed by an experienced New York disability attorney provides tremendous relief to our clients and allows some ability to focus on improving their health. Our deep knowledge and experience of what is necessary to successfully navigate these mental health claims helps our clients secure these important benefits.

We work to ensure that our clients suffering from a mental or nervous disability are under the regular care of an appropriate specialist to satisfy the policy provisions. Having a general practitioner prescribing anti-anxiety medication is likely to draw the attention of a claims manager. A disability insurance attorney will often guide the claimant in finding the right doctor for treatment so their claim will be strongly supported.

Finally, there are often many side effects to mental health medications. They can make claimants feel drowsy or sleepy, or impact upon focus and concentration.  These impacts should be noted, or they will not be considered. Having an advocate to fight for your claim and educate the insurer about the functional issues and deficits of the client and how and why the claim is supportable, is critical and what we offer for our clients.

If you are suffering from a mental health disability and the insurance company denies or terminates your claim, you do not have to fight alone. We can help.  At Newfield Law Group, PC, we have represented and helped many people just like you.

Our office is located in Long Island, New York, and we have built a reputation of effectively and efficiently serving claimants nationwide. Call us toll-free at 877-583-2524 or use our online contact form to schedule your free consultation today.