Can I Claim Disability If I Have Been Diagnosed with a Debilitating Mental Illness?

Mental illness is an invisible stigma that affects millions around the world, and as the recent suicides of Kate Spade and Anthony Bourdain reveal, these disorders do not discriminate. Mental illness is unfortunately underappreciated and misunderstood by most people, but these disorders, which include a large range of psychological conditions, are debilitating disabilities for some individuals, and prevent them from being able to work. Disability insurance is designed to replace a portion of lost income when a disabling condition stops a covered individual from working, and a mental illness disability is an issue that needs more attention. Because mental illnesses cannot be seen, and many do not truly understand how they manifest or why they occur, including disability insurance examiners, securing benefits for these conditions is extremely difficult, and would definitely benefit from the attention and efforts of an experienced disability lawyer.

Mental Illness Disability Claims Generally

Anxiety, depression, and other forms of mental illness in the workplace are quite prevalent in today’s world, but are poorly understood, and often assumed to be the result of a lack of will to improve. Because these conditions are becoming more commonly reported and more disability claims filed on these grounds, examiners are immediately skeptical of mental illness claims and scrutinize them more closely. Some policies even exclude disability coverage for mental illness entirely or establish separate evaluation tracts for mental illness disability claims that are designed to make approval as difficult as possible. Further, even when approved, benefits often terminate after two years based upon not meeting the definition of total disability or being terminated by one’s employer. Mental illness can usually be managed with behavioral therapy and medication, but depending upon severity, functioning in a work environment may not be feasible. Consequently, doing everything possible to increase one’s chances for approval is essential, as the insurance industry will do everything possible to find a reason to reject a mental illness disability claim.

Improving Chances of Approval

One of the more frustrating aspects of mental illness disability claims is the ongoing uncertainty about receiving and keeping benefits. Short-term disability is often available for mental illness because the benefits are payable for just a few months, six being the maximum for most policies. Long-term disability, which involves providing benefits for potentially many years, pushes providers to demand more and more medical documentation for an impairment. This brings up the first most common basis for denial – the lack of sufficient medical documentation. Overcoming this objection often requires asking treating physicians to write a narrative report outlining treatment, the claimant’s response, and how treatment was changed based upon the response.

Some additional reasons disability insurance providers commonly deny mental illness disability claims include:

• Not receiving regular care from a doctor. Remedied by scheduling bi-monthly or monthly appointments and making sure not to miss any.
• No treatment from a psychiatrist, the doctor insurance companies expect to see in the case of mental illness.
• Not receiving the recommended psychological treatment. This can be overcome by consistently seeing a psychologist and fully participating in the therapy program.
• Medical providers not following best practices in their care. If there is a question about a doctor’s approach or treatment plan, a second opinion should be obtained, both to show the insurance company one is serious about getting help and to increase the likelihood proper treatment is received.

Get Help

Having a mental illness should not be a barrier to getting disability benefits, and if you need help determining the best way to get financially supportive benefits, a disability lawyer is the source of information you need to make an informed decision. People with mental illnesses need help, and working is in direct contradiction with what many need to manage their condition. Knowing your legal options regarding disability benefits will help you to plan your financial future and place your focus where it is most needed – on your health.