How Long Term Disability Carriers Use the Mental Nervous Limitation Provisions Against Policy Holders To Limit Benefits
Many disability policies limit the payment of disability insurance benefits if the policy holder has a psychiatric condition. The key to understanding the Mental Nervous exclusion turns to the language in the policy. Unfortunately, there is no uniform policy language. For example, policies can provide for a:
(1) mental illness exclusion based on “caused by or contributed to” language,
(2) mental illness exclusion based on a disability based solely on a mental illness.
These are completely two different types of mental illness exclusion provisions. The more problematic one is the mental exclusion that uses the “caused by or contributed to” language.
Why Is That?
For example, in the case of George v. Reliance Standard Life Insurance Company, 205 W.L 216729 (5th Circuit. 2005) policy holder George was a helicopter pilot who had flown for over twenty years after having an amputation at the knee.
However, as time progressed, he could no longer wear the prosthesis and operate the foot controls of the helicopter. He had severe pain at the amputation site and ultimately was diagnosed with depression and post-traumatic stress disorder.
George filed a long term disability claim. His Reliance Standard Life policy had a mental/nervous limitation that including anxiety disorders and mental illness. It was so broad that it limited the coverage to two years for those disability “caused by or contributed to” by a mental nervous disorder.
Reliance found that George’s depression and post-traumatic stress disorder contributed to his impairment and, as a result, denied his claim. The Fifth Circuit Court considered whether George’s physical disabilities alone were sufficient to render him totally disabled. The Court reversed noting that George’s physical disability was, in and of itself, sufficient to render him totally disabled.
The question becomes whether the physical disabilities alone are totally disabling.
What Should I Do If I Have A Combination of Conditions That Cause Me To Be Disabled?
It’s crucial that you understand the terms of your disability policy before you stop working.
It’s time for you to contact Mental Nervous limitation attorney Nancy Cavey who can help you get the disability benefits you deserve regardless of where you live in the United States. Call today for your complimentary consultation at 727-894-3188.