A quick story about my client – let’s call her Debra (names changed for protection). Debra worked for a local hospital for a number of years until a series of unfortunate events happened in her life. Debra had always dealt with some depression since she was a child, but she was able to manage with some anti-depressants from her general practitioner and from the positive support in her life. Unfortunately, Debra’s life began to spiral out of control including an unexpected divorce due to a cheating spouse and a major illness to one of her children. Her depression reared its head and the medication no longer worked – even in higher doses. Some days Debra could not even get out of bed – she did not want to face the day. Debra’s depression progressed to the point where she had to file for long-term disability benefits. She was shocked and angry when the long-term disability company told her that they were denying her claim! Why?
When you suffer from depression and/or anxiety, filing a long-term disability insurance claim based on these illnesses is often complicated and frustrating. Your long-term disability insurer is likely to tell you that there is no "objective evidence" of depression and anxiety is your records. The long-term disability insurer often denies these claims due to a "lack of medical proof" that your condition is severe enough to prevent you from working. And, this adds to your depression and anxiety. Or, also common, your insurer approves your claim but then tells you that they are denying further payments after a period of time – or that depression is only covered for 12 months (or another short period of time). I understand that frustration and anger!
To be successful in these claims, you should work closely with your treating psychiatrist, psychologist, and/or therapist to make sure your records (or treatment summary if no records can be provided) reflect concrete examples and clinical information that confirm the diagnoses and the severity of your condition. The information should mirror the DSM V for your diagnosis. You should insist on psychological testing or neuropsychological testing to help provide some “objective evidence” of your condition and limitations. These test results need to be included. Your provider can also relate the testing result to specific limitations you have such as work absences, need for additional breaks, and slower production. You should try to get a detailed statement from each treatment provider as well as testimonial statements from friends, family, and co-workers to submit.
At Louisiana Disability Law, we have successfully applied and appealed for long-term disability benefits on behalf of clients with mental/nervous conditions such as depression, anxiety, panic disorder, post-traumatic stress disorder, bipolar disorder, schizophrenia, and numerous other psychological conditions. We work closely with our clients, their treatment providers and, where appropriate, family, friends, and employers to make sure there is appropriate evidence to confirm their diagnoses and document the severity of the condition. Because we are familiar with the numerous reasons and excuses provided by many insurance companies used to deny these claims we are well prepared to do what is necessary to get a claim approved. Whether you are applying or appealing, you need to determine what evidence is lacking and then work with your treatment providers to include this information.
Clearly describing your symptoms and limitations is important. Your treatment providers can focus on specifically how your limitations prevent a return to your work or any other work. You should also understand that under many disability policies, employer-provided especially, mental/nervous claims are only payable for only 24 months. As a result, if you have both a physical impairment and a mental component, or if your depression or anxiety is a reaction to a physical illness or injury, your providers should clearly distinguish the related limitations so that benefits are payable for as long as the insured is disabled or to the end of the maximum benefit period.
Have questions or concerns about your long-term disability claim? Give Louisiana Disability Law a call right now at 985-240-9773. The call is free and we can help you determine quickly if we can help with your claim.