Mental Illness and Long-Term Disability: Understanding Coverage for Depression and Anxiety

Most long-term disability policies cover conditions that prevent a person from working for an extended period but will eventually be resolved. The person will eventually return to work. A mental illness disability can also interfere with a person’s life, leading to functional impairments that can prevent them from working. The World Health Organization reports that depression is a leading cause of disability worldwide.

mental health and long term disability

Depression, anxiety, and other mental illnesses must be diagnosed and documented just like any other physical condition. In many cases, these illnesses also exhibit physical symptoms like fatigue, headaches, and other aches and pains that do not resolve. But since there isn’t a physical diagnostic like an X-ray or a blood test that shows mental illness, you’ll need to show proof that it’s as equally disabling as a physical injury.

What The Policy Says

If you’re planning to file for long-term disability for depression, the first thing you need to do is read your policy. You need to know if it allows for mental illness, and for how long.

Typically, LTD coverage for mental illness is 12 to 24 months. If that’s the case, you will only have one to two years of coverage, maximum. Benefits will end once the period ends, and the severity of your illness will no longer matter.

Some policies consider mental illness an “exclusion.” That is, the policy does not offer LTD benefits for any type of mental illness. You’ll need to know this before you begin your application.

Proving Disability

To have a successful LTD claim for depression, anxiety, or other mental illness, you’ll have to prove that it meets the definition of “disability” that’s described in your policy. This also requires you to demonstrate that your symptoms are severe enough to prevent you from performing the primary functions of your occupation. Some policies may go so far as to require proof that the symptoms prevent you from working in any occupation.

An insurer wants to see that you are undergoing treatment and doing what’s needed to improve your symptoms. Regular medical care is essential to show that there is a debilitating mental illness present and that you are actively working to resolve it. Without medical care, the insurer can deny your claim or terminate your benefits for non-compliance and lack of medical care.

You should also ensure that your medical records with your treating physician are accurate and complete. Document all appointments and treatments you receive, including medications and their side effects.

Your treating physician is a vital link in the process, and your insurer will require input from them. This includes doctor’s reports that include:

• The occurrence and intensity of your symptoms

• Any favorable findings in the mental status examination

• Their firsthand observations of you during office visits

• The precise restrictions and limitations hindering your ability to work

If your mental illness is due to objective cognitive problems, your benefits may be extended beyond the policy’s standard limits. Your physician may request a neuropsychological evaluation to measure your cognitive deficits. This testing can provide more substantial evidence of mental illness and the disability that it causes.

Your Houston LTD Disability Attorney

If you need help filing a long-term disability claim or are having trouble with the insurer paying your benefits, we’re here to help.

We’ve helped over 4,000 Houstonians receive the LTD benefits they need. The Herren Law Firm can help you with your application, appeals and help you through the process, and give you one less thing to worry about. Contact us today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation and no up-front fees. We will only collect a fee if we win your case.

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