Disability insurance companies don’t always make it easy for policyholders who have mental illness to get the disability benefits they deserve.
How Do Disability Carriers View Mental Illness Disability Claims?
Many claims are denied because the disability insurance company says:
(1) There is no objective basis of the diagnosis,
(2) There is no objective basis for the restrictions and limitations assigned by your physician, or
(3) There is no causal relationship between your mental illness and/or your restrictions and limitations, and your inability to do your own or any occupation.
Why The Definition of Mental or Nervous Conditions In Your Policy Is Key
If you are lucky, there is no mental nervous limitation in your policy. If you remain disabled, you will be eligible for benefits for the life of the policy.
How your policy defines “mental illness” or “nervous conditions” is key to how long you get disability benefits. Many policies limit benefits to 24 months.
There is NO uniform policy definition for these terms, and many were written poorly. Some disability insurance policies define mental illness as:
- “Any psychological, behavioral, or emotional disorder,”
- “Any disorder found in the current diagnostic standards manual of the American Psychiatric Association.”
Other policies list conditions they have decided are mental or nervous conditions and list others they have decided are not mental or nervous conditions.
Some policies also say that if any mental nervous condition contributes in any way to your overall disability, benefits are limited to 24 months. You might have undergone back surgery and become anxious. Your benefits might be limited to 24 months.
Nancy Cavey, who has 35 years experience handling disability cases, often battles disability carriers over these ambiguities. Courts have reached many different decisions on what mental nervous policy terms mean. It is crucial you know what the courts will do before you apply for benefits and that you fill out your application properly.
Ms. Cavey works closely with you, your family and your physician to overcome a claims denial or termination of benefits before or after the payment of 24 months of benefits.
Nancy Cavey offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.
What Mental Conditions Can Have Limited Pay Periods
There can be limited pay periods for:
Anxiety disorders, including:
- Generalized anxiety disorder;
- Various phobic disorders like simple phobia, social phobia and agoraphobia;
- Panic disorder;
- Obsessive compulsive disorder; and
- Post-traumatic stress disorder (PTSD).
Depressive disorders, including:
- Major depression;
- Dysthymic disorder;
- Psychotic depression;
- Postpartum depression;
- Seasonal affective disorder; and
- Bipolar disorder.
What Other Games Do Carriers Play with Mental Nervous Condition Clauses?
Disability carriers will try to characterize your physical problem as a mental problem. Carriers will approve benefits for a mental health condition and ignore your physical problems.
It is crucial that before you apply for benefits, you understand the games carriers play and how they manipulate the mental nervous limitations to their advantage. The carrier will do a file review months before the 24-month limitation runs; they will be looking in your medical records for continuing mental health problems so they can say, “Got you!”
Nancy Cavey will make sure that your physical disability is well developed in your medical records and that your doctors properly comment that you are NOT disabled as a result of any mental conditions.
It takes teamwork!
How Do I Get The Disability Insurance Benefits I Deserve?
Mental or nervous conditions can make it difficult, if not impossible, to do things around your home and work. Mental or nervous conditions can damage and even destroy professional relationships and result in poor work performance.
If you no longer can work or your doctor has told you to apply for disability benefits, you should take steps before you apply:
- Obtain a copy of your disability policy. See how it defines “disability,” “occupation” and “self-reported conditions.” You’ll need to understand what you have to prove to get your benefits because of mental or nervous conditions.
Your policy can include a mental/nervous limitation that classifies your problem as a mental disorder, or the policy can be silent on the issue. You’ll want to know what your policy says before you apply for benefits.
- Obtain a copy of your medical records. Review them to see if there is an objective basis for your diagnosis, what your records say about your report of symptoms and your restrictions and limitations.
- Obtain a copy of your personnel file to see if your mental or nervous problems have affected your work performance.
- Obtain a copy of your job description. Create your own description of your physical duties with an explanation of how your symptoms impact your ability to do your occupation.
- Provide your doctor with the occupational description. Ask your doctor to prepare a report that explains the objective basis for your diagnosis, the objective basis of your restrictions and limitations, and the objective reasons you can’t perform some or all of the material and substantial duties of your occupation.
- Prepare a diary that explains your symptoms and the side effects of medication. Be sure to give examples of how your symptoms interfere with your ability to do things on a daily basis.
- Hire Nancy Cavey to help you file your initial application. The application process is confusing and designed so you and your physician make mistakes that can result in a delay or even a denial of your benefits. Ms. Cavey knows how to prepare and file a winning shock and awe disability application that leaves the carrier little reason to question your claim.
- Hire Nancy Cavey to help you appeal a wrongful denial or termination of your disability benefits. Disability carriers are in the business of collecting premiums and not paying disability benefits for anxiety disorder. Carriers routinely cut off benefits at 24 months and misapply the mental nervous condition limitations. They’ll use any reason to deny your claim.
The odds of getting your benefits on appeal are greater when you are represented by an experienced ERISA/private ID policy disability attorney who can work with you, your family and your psychiatrist.
Contact Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live
Mental or nervous conditions can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Nancy Cavey can review your policy and your medical records, and explain to you what your policy says and how to get your disability benefits. Call today for a free consultation at 727-894-3188.