Helping the disabled from coast to coast Get Your Free Case Review

Disabled by Depression: Tips for Filing a Long-Term Disability Claim

Your source for the latest health, disability and insurance news and tips.

Disabled by Depression_ Tips for Filing a Long-Term Disability Claim.png

Not all disabilities involve visible injuries and conditions; Mental health conditions like depression can severely limit your ability to work and may make you eligible for long-term disability insurance benefits.

According to the World Health Organization, depression is a leading cause of disability worldwide and affects nearly 300 million people.

This mood disorder, which causes a persistent feeling of sadness and loss of interest, can emotionally and physically devastating and making it difficult to maintain your daily work routine.

Despite its prevalence, it can be challenging to file a successful long-term disability insurance claim for depression.

Here are tips to help you overcome common disability claim hurdles and strengthen your chances of receiving benefits.

Know how your policy defines a disability

Having depression does not automatically qualify you for disability insurance benefits, as the symptoms of this disorder can vary in severity and frequency and are not disabling for everyone.

In order to qualify for long-term disability benefits, you must prove your depression meets the criteria for disability as defined in your policy.

Generally, this means you must demonstrate the symptoms of your depression are so severe they prevent you from performing the material and substantial duties of your occupation (or even any occupation, depending on your policy).

Note common reasons for denial

Before you file your long-term disability insurance claim, it is important to note the denial strategies insurance companies often use for depression-related claims.

Not seeking proper medical care

Depression is a treatable condition, but a positive treatment outcome requires your be an active participant in the treatment your doctor prescribes.

While this one may seem obvious, it can be daunting for people with severe depression to seek medical treatment and take seemingly basic steps to take care of themselves.

However, it is imperative to seek regular medical treatment for your depression; if the insurance company does not see evidence of best practices of medical care and active participation on your part, your claim will be denied.

It is also important to keep your scheduled doctor's appointments, follow the recommended course of treatment, consistently take any medication prescribed to you and ensure your prescription medication is actively monitored by your doctor.

Surveillance evidence seems to contradict your condition

When you file a long-term disability claim, you can bet the insurance company will run surveillance on you and scour your social media for "evidence" that undermines your claim for benefits.

Many people with all kinds of disabling conditions have good and bad days; however, we often only present the good on social media and in public. This can help the insurance company create a false narrative about your state of disability.

Be mindful of how your online activity may be interpreted by claims investigators and do not partake in activities that should be limited or impossible because of your condition.

Ensure your medical records truly reflect your condition

There is no objective medical test to diagnose depression; instead, your doctor will likely look at the overall pattern and severity of your symptoms. Disability insurers often challenge depression claims because of this, making it imperative to document your condition as thoroughly as possible.

Work with your treating doctor to ensure your medical records are as complete and accurate as possible. Confirm that your form and frequency of treatment are thoroughly documented. The disability insurance company will rely heavily on these records when determining whether you qualify for benefits.

It is also essential to double-check that all the information in your medical records, as well as your claim forms, is entirely factual. Inclusion of false or misleading information could lead to a denial of benefits, a claim of fraud and even the rescission of your policy.

Keep a pain/symptom journal

Heart patients are often encouraged to keep a daily journal logging their pain and symptoms, as it can help supplement the often-limited objective evidence available to support their disability claim.

While insurance companies try to ignore symptoms that cannot be proven with objective testing, the combination of your doctor's records and your personal notes detailing the same symptoms can help your doctor support your disability claim.

Write down how you are feeling each day and note things like lack of interest in your normal activities, insomnia, lack of or overactive appetite and decreased energy. It is also helpful to log the frequency of your treatment and the intensity of your symptoms.

Note any physical impairments related to your depression

According to the World Health Organization, depression can arise from a complex interaction of social, psychological and biological factors: "There are interrelationships between depression and physical health. For example, cardiovascular disease can lead to depression and vice versa."

If you depression is caused by an underlying physical health condition, or if you have any other impairment that limits your ability to work, make note of it when you file your long-term disability insurance claim.

If you can prove the physical symptoms alone render you disabled through objective medical evidence, your chances of receiving benefits may increase significantly. This is because these symptoms put a "physical" aspect to an otherwise not-so-physical disability. As an added bonus, if you are able to prove you're disabled due to physical impairments, this will help you overcome the mental/nervous limitation on the duration of your benefits.

Note the mental/nervous limitation

The mental/nervous limitation is a common exclusion in a long-term disability insurance policy that only allows you to collect benefits for a specific amount of time.

If your disability is contributed to or caused by a mental/nervous condition classified in the most current edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, your payment of benefits will be limited to the period set forth by your policy.

Although some insurers do not put limits on claims caused by mental and nervous conditions, you can expect to see this provision in your policy.

The most common mental/nervous benefit period limitation is two years.

Do you have disability claim questions?

If you have filed or are preparing to file a long-term disability insurance claim, or believe your benefits have been wrongfully denied, contact our top-rated long-term disability insurance attorneys for a free consultation.

There is no risk involved in contacting DarrasLaw; if you have individual or long-term disability insurance questions, our legal team is here to help.

No Comments

Leave a comment
Comment Information