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Disability Insurance

Denied Disability for Mental Illness: Navigating Next Steps

It’s estimated that one in five British Columbians—nearly 900,000—will be affected by mental illness. Conditions like depression, anxiety disorders, bipolar disorder, schizophrenia, and PTSD are just some of the mental illnesses that can impact a person’s day-to-day life. In some cases, these conditions may even limit a person’s ability to work. Severe mental illness supports a valid long-term disability claim. Unfortunately, those who suffer from mental illnesses often struggle to get their claims accepted by insurance companies.

If you have been denied long-term disability (LTD) due to mental illness, you might feel like there is nothing you can do to get the benefits you deserve. However, there are steps you can take to build your case and, with legal support, secure your benefits.

Why Is Mental Health Considered An “Invisible Illness?”

Mental health conditions are generally viewed as “invisible illnesses” because the symptoms and challenges they cause aren’t typically visible to others. Physical illnesses and disabilities, on the other hand, are often highly visible and easily quantifiable by doctors. Mental health conditions are different because the intensity may vary over time and manifest differently from person to person. Those who have mental health struggles also tend to mask or conceal their symptoms in an attempt to hide their internal difficulties before they turn into outward issues.

Can I Get Disability Benefits for a Mental Illness?

If your mental illness is so severe that it keeps you from being able to work or hold a job, you are well within your rights to file an LTD claim. However, mental health disability claims are often denied by insurance companies, usually citing a lack of medical evidence. Insurance companies want definitive, quantifiable proof for LTD claims which is difficult to collect for mental health conditions. Even in cases where claimants have an accepted diagnosis, insurance providers may still state that a person’s mental illness isn’t severe enough to prevent them from working.

What Happens If I Am Denied Disability For Mental Illness?

If you have been denied LTD benefits, ask for a formal denial letter from the insurance company. Some companies may call you to deliver the news. Having the denial in writing will detail exactly why your claim wasn’t accepted, as well as instructions on how to appeal the decision and the timeframe you have to do so.

If you are planning to appeal, there are some steps you can take to help support your case.

Visit A Doctor

If you don’t already have a formal diagnosis from a medical professional, that needs to be your first step. The type of doctor who delivers your diagnosis is also important. Ideally, you should visit a psychiatrist or psychologist since these professionals specialize in mental health conditions. A primary care provider is a good start, but working with a psychiatrist or psychologist gives stronger support for your claim.

Follow Treatment Plans

Attend all appointments and follow all recommended treatments provided by your doctor. Having a documented history of working with a doctor and taking medications is key medical evidence. Missing appointments or treatments may indicate to insurance companies that your diagnosis isn’t severe, so you must strictly adhere to all health plans.

Contact a Lawyer

Following a denial, you should contact a lawyer. Though you don’t necessarily need legal counsel for your appeal, lawyers like those at Stephens & Holman have years of experience representing other clients who have gone through similar hurdles and can help guide you through the process.