Mental Health Disability Insurance Claims
People who suffer from anxiety, depression, and other forms of mental illness often try to keep working while privately managing the challenges of their disability. Since nearly 1 in every 5 adults experience some form of mental illness, it is likely you know someone facing these difficulties. While they may not appear visibly affected, a decrease in performance or inability to concentrate enough to fulfill the material and substantial duties of their occupation may indicate it’s time to consider filing for disability coverage under a long-term disability insurance policy.
People with mental/nervous conditions often fear losing their job because their illness significantly impacts their ability to perform their duties. What happens to their disability insurance benefits if they lose their job? Learn more here.
For a disability claim to be approved—whether short-term or long-term—it must be well-prepared. This is especially true for claims involving anxiety, depression, or other mental/nervous conditions. A successful claim requires thoughtful responses to claim forms, strong medical support, and documentation of how the condition impairs one’s ability to work. Seeking guidance from an experienced long-term disability insurance attorney is critical to navigating the claim process and achieving success. Since the COVID-19 pandemic, these claims have increased significantly, prompting insurance companies to deny or delay many of them to control their financial exposure.
The Newfield Law Group has successfully represented many individuals with mental health claims, helping them navigate complex processes and counter insurance companies’ subjective denial tactics. Insurers often dismiss mental/nervous claims because these conditions, like pain, cannot be easily verified through objective diagnostic tests like X-rays or bloodwork. However, with a robust medical record and skilled advocacy, these claims can be successfully pursued.
Challenges of Mental/Nervous Disability Claims
In cases of sudden-onset mental illness resulting from traumatic events, it is essential to create a compelling narrative explaining the event’s significance. Sudden mental illness can be particularly challenging to substantiate due to a lack of medical history. Our firm works to ensure clients are under the regular care of an appropriate specialist, such as a psychiatrist or psychologist, to meet policy requirements.
Insurance companies often deny claims for mental health conditions if treatment has not been provided by a specialist. General practitioners prescribing antidepressants and noting symptoms in medical records do not meet the evidentiary standard required for disability claims. We assist clients in navigating this process to ensure their claims are supported by appropriate and comprehensive documentation.
Key Questions to Address in a Mental Health Disability Claim
- Does your condition prevent you from performing the specific tasks of your occupation?
- How impaired are you in performing your job and activities of daily living?
- What type of treatment have you received for your mental health disability, and how long have you been treated?
Why Work with a Disability Lawyer?
Mental health claims are inherently subjective, making them challenging to prove. A skilled disability lawyer can advocate on your behalf, ensuring that:
- Your functional impairments and deficits are clearly documented in medical records.
- Claims adjusters and insurance company tactics are countered effectively.
- Your policy’s provisions, such as limitations on mental health coverage, are understood and addressed.
In most Group LTD ERISA policies, benefits for mental/nervous conditions are limited to 24 months. However, if you have a concurrent physical disability, we can argue that the physical condition—not the mental health condition—is the primary driver of the disability claim, potentially extending coverage.
Common Tactics Used by Insurance Companies
Insurance companies often attempt to re-categorize claims with psychological components as purely mental health claims to limit benefits. This tactic is common but can be countered with strong evidence distinguishing between physical and mental conditions. For instance, we successfully overturned an insurance company’s attempt to reclassify a client’s Tourette Syndrome claim as a mental health condition, preserving the client’s benefits.
How We Help Mental Health Disability Claimants
Newfield Law Group has over two decades of experience representing clients with mental health disability claims. We provide:
- Thorough reviews of disability policies to identify limitations and ensure proper claim preparation.
- Robust advocacy to counter claim denials and navigate appeals or litigation if necessary.
- Comprehensive management of all communications and requests from the insurance company, allowing clients to focus on their health and recovery.
Call Us Today for a Free Consultation
If you are considering filing a mental health disability claim or have already been denied, call Newfield Law Group. We will review your situation, help you understand your rights, and guide you through the claim process. The call is free, with no obligation, and can provide clarity on what to expect from your disability insurance company.