Thursday, July 18, 2024

Short Term Disability Denied Depression

How Can Our Short Term Disability Lawyers Help You:

Long-term Disability | Top 5 reasons why mental illness claims are denied

It all starts with a free review of your short term disability claim. Whether you want to speak for 15 minutes, or want to have a complete in-depth review of your full disability claim, call us today. We do not charge any fees for our case reviews.

Our Short Term Disability Lawyers can help with

  • Free Case Reviews
  • Free Short Term Disability Appeals
  • Or explaining your rights and the process involved, helping you make an informed decision as to what is right for your unique situation.

No matter what you decide, our short term disability lawyers will make sure you understand the options available to you, to help you arrive at the best decision for your specific case.

Workplace Issues

We also help you manage any workplace issues. Call us if your employer is:

  • demanding that you return to work
  • threatening to terminate your job
  • asking you to resign
  • claiming you have abandoned your job.

You are not alone, and dont be bullied into any action before knowing your options and what decision is best for you and your family.

Mental & Cognitive Conditions Qualifying For Long Term Disability

Many physical disorders have obvious symptoms that can be shown with objective medical evidence. Conditions like cancer, respiratory diseases and musculoskeletal conditions can be diagnosed with tests and tools like X-rays, blood tests and MRIs.

Mental and cognitive disorders are not as easy to diagnose, and proving that you have one is not always easy. Symptoms are frequently self-reported and may lack considerable documented evidence from your treating physician. This can result in your long-term disability claim being denied.

Our long-term disability attorney can help. We consult with those who are applying for LTD benefits, and we also can prepare an appeal and lawsuit if you were wrongfully denied long-term disability benefits. We will even review your denial letter for free. Call us today at 816-203-0143.

Metlifes Denial Of Short

After 18 years of work as a management assistant at Raytheon Company, Dorothy Whitehouse suffered a psychotic episode in the workplace triggered by an experience with her boss and co-workers. The severity of the attack prompted her to immediately schedule an emergency appointment with her therapist, a licensed social worker on August 23, 2007.

On August 28, Whitehouse filed a claim for short-term disability benefits with MetLife, the insurance company that provided Raytheons short-term disability basic benefit plan. The company plan provided income replacement at 75% of her weekly base pay for 10 weeks. She also participated in a short-term disability plus coverage plan that covered the remaining 25% of her weekly base pay.

Whitehouse went to see a psychiatrist who submitted session notes to MetLife on August 30. Whitehouses therapist also sent a short letter to MetLife on September 6. He described the incident precipitating her claim and stated that she reported a feeling of exhaustion, inability to focus and fear. He noted that she was seeing him and that he had also encouraged a transfer from her work environment.

The next day on September 26, Whitehouses therapist called to give an update on her condition. He said that she had not shown any further paranoia symptoms since the work incident, but she did continue to exhibit anxiety and depression.

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Depression Disability Claims For Social Security Disability Insurance

If Social Security has denied your disability claim for depression, the law allows you to have your claim reconsidered or appealed. As an attorney who is Board Certified in Social Security Disability law, I will help you throughout the entire process, all the way through a final appeal in federal court.

To win Social Security Disability for depression, you need to prove one thing that your depression is severe enough to stop you from working.

To determine a persons eligibility for benefits, the SSA adheres to their Listing of Impairments. The listing for depression disability is found under Mental Disorders, listing 12.04 Affective Disorders. If your condition is severe enough to satisfy these requirements, you will be considered disabled.

SSA will need medical evidence to support your exact limitations. This means they will want to see medical and psychiatric records from doctors, psychiatrists or psychologists, mental health clinics, and all other facilities where you have received treatment.

There is no charge for us to review your claim. If we take your case, fees for our legal services are set by the Social Security Administration , and you do not pay our fees unless we successfully resolve your claim.

Employment Rights On Short

Can you get on disability for depression?

Employers have the right to fire a person who is on sick leave. Most employers wont do this, however. There are practical and legal reasons. Firstly, you must get reasonable notice of termination to be fired legally. Otherwise, without notice, they have to pay you severance. This is the same for those on sick leave and those actively working.

As an employee on sick leave, you may be protected by human rights laws. Namely, laws that prevent discrimination for disability. However, protection under these laws isnt guaranteed. Not all sick leaves qualify as a disability especially if youre expected to recover shortly.

Being protected under these laws can mean a few things. Your employment is protected but maybe not your specific role. And, your employer has a duty to accommodate your disability. They might modify your job, allow you to work reduced hours, or move you to a different role.

If youre on sick leave that goes well beyond the short-term disability period, then your employer eventually has the right to stop your employment. Yes even without notice of termination or severance pay.

To learn more, check out our page on employment rights and disability benefits.

Read Also: Why Do I Always Get Depressed

Claiming Depression Disability On A Ltd Insurance Policy

Whether you have long term disability insurance privately or through your employer, it is the insurance carrier who will process your claim. It has become routine practice for many insurance companies to deny legitimate claims for depression, or devalue the claim. If you have been unfairly denied benefits for a depression disorder, we can help you take legal action.

Insurance claims for depression disability present their own unique set of challenges. Our experience with LTD claims for depression and other mental impairments has given us a powerful arsenal for defense against the insurance companies frequent denial tactics.

One such argument from insurers regarding depressive disorders is that the condition is not severe enough to qualify for disability. Symptoms of depression are emotional and abstract, sometimes with highs and lows, and difficult to measure. This opens doors for the insurer to claim that you do not meet their definition of disabled.

When the insurance company uses these and other arguments to deny your claim, an experienced attorney will know how to fight the denial.

This is one reason why credibility of the claimant is very important. We are adept at establishing the credibility of our clients, with great care made to show consistency between the insureds complaints, medical history, and the accounts of a spouse or other third party who can attest to the difficulties faced by the claimant.

Physician Burnout: A Growing Epidemic

In the 2021 Medscape National Physician Burnout & Suicide Report, one physician surveyed commented, I often feel despair, I have severe anxiety and PTSD. I have severe self-doubt, and I have lost the strong sense of self and values I once had.

If this sounds like you, you are not alone.

Physician burnout has been an issue for years, but the COVID-19 pandemic accelerated the trend. About 42% of doctors experience burnoutand 47% of that population report severe symptoms that strongly affect their lives. It is resulting in doctors reducing their hours, changing their work settings, and even putting their practices up for sale.

Also Check: How To Support A Friend With Depression

If You Are Fighting Depression And Disability Benefits Have Been Denied Were Here To Help

We welcome anyone who has been denied disability benefits for depression to call our firm for direct answers and decisive legal help. We are here to fight for your rights for long-term disability coverage, Social Security Disability Income and Veterans Disability benefits.

Is depression an actual disability? Yes, a very real one. Please call our attorneys toll free at or ask a lawyer a question about your depression disability claim now. We represent the disabled nationwide.

About Marc Whitehead

Warning: Ltd Policies And Mental Illness Limitations

Depression & Anxiety Disability Insurance Claim Help & Tips

One thing to keep in mind when filing for long term disability is whether your long term disability insurance policy includes a Mental Illness Limitation.

Policies that contain a Mental Illness Limitation typically limit your benefits to two years if you are disabled due to a psychiatric condition such as depression or anxiety. Of course, each policy is different, so the prescribed maximum period may be shorter or longer depending on the terms of your particular policy.

Some policies with Mental Illness Limitations contain exemptions for certain mental conditions occasionally, bipolar disorder is exempt, though most other depressive disorders are not.

If you are solely disabled due to depression and your policy contains a Mental Illness Limitation that does not exempt it, your benefits will most likely stop when the maximum allowable period expires. Unfortunately, the severity of your mental illness will become irrelevant after the maximum allowable period expires.

However, if you can demonstrate that you are disabled due to objective cognitive problems, your benefits may extend beyond limitation period. A neuropsychological evaluation, as discussed earlier, can provide this evidence.

Read Also: Symptoms Of Major Depressive Disorder Dsm

Why Would My Claim Be Denied

As depression is an “invisible illness”, insurance companies often deny claims for short-term and long-term disability benefits because you do not meet their definition of totally disabled for reasons such as:

  • There is not enough medical evidence to support you have been disabled for the entire waiting period and beyond
  • Lack of objective medical evidence to substantiate your absence from work
  • No medically supported restrictions and/or limitations
  • Your insurer believes you can perform modified duties or can participate in a gradual return to work program
  • Your insurer believes you can perform your own occupation while attending treatment
  • Your insurer believes you can perform an alternate occupation

If your claim has been denied for any reason, you should not hesitate to call our law firm for a free initial consultation. Our lawyers have helped many clients who are unable to work due to mental health reasons. We are offering virtual consultations and consultations by phone and can arrange for document signing through DocuSign for your convenience.

Is Your Job Protected While You Take Short

Unlike a leave of absence you might take under the Family and Medical Leave Act , short-term disability doesnt offer any direct job protection. Many people are surprised to hear that you can legally be fired from your job while on leave, and you also arent entitled to the exact same position when you return.

However, the Americans With Disabilities Act protects people who meet the ADAs definition of disability, and makes it far more challenging for companies who are covered by ADA to fire an employee due to their disability.

Before terminating an employee, the company must first determine whether or not there are any accommodations they could make that would allow the employee to adequately do their job.

The company must work with the employee to try several variations of accommodations in an effort to find something that works. If theres no reasonable way to enable that person to fulfill the essential responsibilities of their position, only then can the employer explore termination of the employee.

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Does This Mean A Person With Mental Health Concerns Cant Ever Look To Short

Not necessarily. Experts indicate that short-term disability coverage may be helpful in situations involving psychotropic drugs. Many drugs have potentially serious side effects that could impair a persons ability to work.

Consider how some psychotropic medications cause weight gain, which can lead to the onset of diabetes or hypertension. These medication side effects are physical conditions that short-term disability might cover.

Its important to note that the size of a policy may have to be smaller. The reason is that the more coverage sought, the more complete the underwriting process and the higher the premiums.

What Are Your Options If Your Short

How Social Security Handles Mental Illness Claims ...

The first thing to do is to carefully read the correspondence thats saying its not being approved, advises Bartolic. That will tell the person a lot, and will tell them what to do if they disagree with the decision.

Most disability plans in America are covered under the Employee Retirement Income Security Act , which means claims are reviewed through the lens of this federal law.

If your plan is covered by ERISA, the law requires that the denied individual be presented with a right to appeal that decision. Its a mandatory feature of it, explains McDonald. That period of appeal is 180 days. During that time, you have perhaps your single best opportunity to give evidence to the insurer or plan administrator about why theyre wrong and why youre entitled to those benefits.

If you go through the appeal process and still are unable to convince them of your disability, then unfortunately youll have to initiate a lawsuit.

Also Check: Taking Antidepressants But Still Depressed

How To Apply For Short

Applying is the same for most short-term disability plans.

In some plans, you need to use all the paid time off you have through your job first. This includes paid sick leave and vacation days.

Then, youll need to get the right forms to apply. These are the three most common ones:

  • the Notice of Claim
  • the Employers Report
  • the Attending Doctors Report

These forms are almost the same for all short-term disability plans. But, you have to use the right form one from the company youre dealing with. Otherwise, they can reject your claim.

You fill out the Notice of Claim form. Then, you ask your work and doctor to fill out the others. Usually, you will submit these to an outside company. You should also submit any other documents they need. Its your job to make sure that they all get to the right place.

Finally, wait for a decision. Once all the forms are in, the insurer will start to judge your claim. It will either get denied or approved.

Is Depression A Disability In Ontario

Depression is a type of mood disorder that does qualify for short term disability and long term disability benefits, since it can significantly affect ones ability to work. According to a survey conducted by Ipsos, 17% of Canadians reported that they had to take time off work to deal with a personal mental health issue. Many people experience episodes of depression after traumatic events, such as the death of a loved one, though these episodes tend to be situational and temporary. However, if an episode lasts more than two months it may be considered major depression, which can have serious effects on everyday functioning. Approximately 11% of men and 16% of women will experience major depression at some point in their lives, which can limit quality of life, strain relationships, exacerbate chronic health conditions and lead to lost time from work.

The symptoms of depression can affect the way an individuals thought process and behaviour, while also having physical effects. According to the Government of Canada, some of the symptoms of depression are Feelings of hopelessness and despair Detachment from life and those around you Always feeling tired and having no energy Crying for no apparent reason Difficulties with concentration and decision making Thoughts of suicide Loss of appetite or a change in sleeping patterns Frequent headaches or stomach aches


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Keeping Your Benefits Can Be A Lot Of Work

Often, being approved for disability leave is just half the battle. Making sure patients keep their benefits for as long as they need also requires a considerable amount of effort and paperwork, according to Song.

For patients who are expected to make a recovery and return to work, insurance carriers often require physicians to submit updates every month, Song said.

But, he said, if Im not seeing them that regularly, it becomes difficult.

Patient volumes dont always allow for monthly check-ins, he said. And monthly visits just arent necessary because a patient isnt going to progress that fast, he added.

READ MORE: Depression and romantic relationships how to support someone you love

What Is Generalized Anxiety Disorder

Short-Term Disability: Common reasons for denial

According to the American Psychiatric Association, generalized anxiety disorder is excessive anxiety and worry that interferes with daily activities. It occurs on more days than not, for at least six months. The anxiety must be accompanied by at least three of the following six symptoms: restlessness, quickly becoming fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance. Often, the worries are related to everyday matters, including job or family responsibilities. Another disorder must not explain the anxiety. It should not be confused with panic disorder, which is characterized by panic attacks .

Read Also: How Do Doctors Test You For Depression

Frequency Of Mental Issues

According to the National Institutes of Health, about 25 percent of Americans will suffer from a serious mental illness during their lives. The Center for Reintegration reports that half of the reasons for disability are related to mental illness. It is prevalent in the workplace. As a recognized disability, it means that workers who suffer from mental illness are protected under the Americans with Disabilities Act.

What Are The Symptoms

According to the Mayo Clinic, seasonal affective disorder is a subtype of major depression.

Symptoms of major depression can be a part of seasonal affective disorder and include:

  • Low energy
  • Appetite changes
  • Weight gain

With seasonal affective disorder, the signs and symptoms tend to appear and disappear at the same time each year.

Also Check: How To Get Past Depression On Your Own

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