Long-term disability insurance (LTD) is intended to replace a percentage of an individual’s former income if he or she is forced to leave the workforce due to a disability. Submitting LTD claims for psychological conditions themselves is not unusual, but long-term disability and mental health issues can also appear together when a mid-career disability leads to depression or anxiety. People whose mental health conditions have complicated daily activities their whole lives must deal with mental health impact on LTD, even if their disability is unrelated to their mental health. Each of these situations can trigger its own set of interactions between long-term disability and mental health issues. This means they may demand slightly different approaches, but the basic elements will always be rooted in a combination of policy terms and individual circumstances.
Long-Term Disability and Mental Health Issues
The mental health impact on LTD claims in a given situation usually depends on whether a mental illness is the reason for filing the claim. People do sometimes submit LTD claims for psychological conditions that have become crippling, interfering with the person’s day-to-day activities to such an extent that they are no longer able to continue working and in many cases have withdrawn from friends and family as well. At the same time, many people who had no known mental health issues prior to becoming disabled find that the experience of disability leads to depression or triggers severe anxiety about every aspect of their lives, not just the pieces most obviously connected to their loss of health.
Still other people have lifelong mental health conditions that they have managed for decades. These disorders may be unrelated to the condition that has caused them to file for disability. The mental health impact on LTD claims in these situations may be that the person’s mental health struggles make it more difficult for them to collect and organize documentation, understand and follow the steps to submit a claim, and keep track of and respond to deadlines effectively.
When the Disorder Is the Disability: LTD Claims for Psychological Conditions
LTD claims for psychological conditions can be some of the most challenging to get approved. There are a number of reasons for this problem. Understanding some of the most common of these reasons can put you in a stronger position for preparing to navigate the challenges.
Mental Health Is Often an Invisible Illness
By their nature, mental health disorders are not visible in the same way as many kinds of physical tissue damage. Even musculoskeletal conditions that do not show outward signs of injury can, in many cases, still be verified by a scan. The results of these scans and imaging procedures can be copied and sent to insurance companies as part of the documentation submitted in support of a long-term disability claim.
Even though some psychiatric disorders are also associated with differences that can show up in certain types of clinical tests, such as MRIs (magnetic resonance imaging), in most cases mental illness is diagnosed primarily by a trained clinician interviewing the patient and sometimes engaging in observation of the individual’s behavior. Insurance adjusters, lacking this specialized training, can sometimes be skeptical of whether a condition diagnosed through conversation is legitimately disabling.
Stigma of Mental Health Conditions
Unfortunately, it is all too common for insurance adjusters and even patients themselves to take the attitude that if the problem is “all in your head,” then you should be able to “toughen up” and somehow overcome the disorder through sheer force of will. This perspective defies a certain logic: If “all in your head” means in the brain, and the brain controls not only our thoughts and feelings but all our actions, then it makes sense that a disorder affecting how the brain functions might be especially debilitating.
While many people struggling with their mental health are very much aware of the problem, it is not unusual for one mental health impact on LTD claims to center on this dismissiveness. Even people who readily acknowledge that physical weakness demands support and care are often inclined to treat perceived mental weakness as a character flaw, rather than a medical condition.
Mental Health Condition Exclusions
People who are used to the requirements for employer-sponsored health insurance under the Mental Health Parity and Addiction Equity Act (MHPAEA) may be accustomed to the idea of mental health “parity.” In the context of insurance coverage, mental health parity usually means covering mental health services at the same level as any other medical needs. Insurance companies in the United States are not necessarily required to offer mental health coverage, but plans that do are typically required to cover office visits, diagnostics, and prescriptions related to mental health at the same level used in calculating benefits for internal medicine.
What many people may not realize is that the MHPAEA only applies to health insurance, not to long-term disability. States may impose specific rules within their own borders, but in the absence of nationwide regulation the mental health impact on LTD claims can be substantial. The vast majority of long-term disability policies limit the duration of benefits for LTD claims for psychological conditions to no more than two years. Some plans offer even less.
When Disability Is Depressing: Charting the Connections Between Long-Term Disability and Mental Health Issues
Another potential mental health impact on LTD claims is not so much about LTD claims for psychological conditions as it is about how the impacts of disability on mental health can make the process of submitting a long-term disability claim more difficult. Many people who become disabled mid-career due to illness or injury find that the experience of disability itself has a negative impact on their mental health as they struggle to adjust to their “new normal.” They may grieve deeply for the healthy lives they used to live, and the strength and stamina they once took for granted. Individuals who placed much of their sense of self-worth in the work they did for a living can find it especially devastating to be forced to leave jobs in which they were previously thriving.
Clinical depression can often follow a newly disabled person for months or years. Anxiety is also very common, and can be made worse by the financial strain they experience as they move through the LTD claim process. In these cases, the same disabling condition that negatively impacts mental health can also cause a negative mental health impact on LTD claims that makes an already challenging experience even more frustrating.
When the Disorder Is Too Familiar: Understanding the Mental Health Impact on LTD Claims for People With Psychological Conditions
Sometimes a person who has a lifelong mental health condition needs to file for disability for an unrelated medical reason. Medical conditions that exist in the same patient, but are not necessarily related, are called “comorbid.” In many cases comorbidity can mean that the symptoms of one condition make it harder to manage the other condition, even though neither condition has caused the other to occur.
Mental health conditions can make it harder for someone to interpret claim submission requirements, keep track of the overlapping timelines for multiple documentation requests, advocate for themselves in an interview or examination, and otherwise meet the demands of successfully filing a long-term disability claim. That means people with mental health comorbidities are at increased risk of initial denials and face an increased likelihood of delayed benefits and other problems, compared to their neurotypical peers.
How To Approach Long-Term Disability and Mental Health Issues
As frustrating as it may be to deal with long-term disability and mental health issues at the same time, there are some strategies that can make the challenges easier to navigate. Think about your own situation and the terms of your LTD policy carefully, and adopt general principles as needed to fit your unique circumstances.
Filing LTD Claims for Psychological Conditions
If you need long-term disability because of a mental health condition that has become unmanageable, prepare for a strong submission by collecting thorough documentation. Request copies of all medical records related to your diagnosis and treatment, and review them to be sure that you see the same materials the insurance adjuster sees. Work with the professionals who have been treating you to ensure that you and they are on the same page regarding your current condition and long-term prognosis.
Consider speaking with a lawyer who handles disability cases to get a sense of what insurance companies may look for in attending physician statements so that you can discuss your concerns honestly and openly with the mental health professionals involved in your care, without attempting to influence the opinions they provide. Review the terms of your insurance policy regularly to be sure you are not overlooking any medical evidence that might be helpful to your case, and make it a point to consistently document your adherence to all recommended treatments, even if following a doctor’s orders is business as usual for you.
Adapting to the New Normal
If your disability is causing your mental health struggles, rather than your mental health condition causing your disability, you may need a different approach. Collecting medical evidence and communicating with your healthcare providers will still be important, but in this situation, you will usually not need to actively document your own mental health status. Reviewing your policy documents and submission requirements with an attorney may help you to reduce your mental health impact on LTD claims.
Long-term disability and mental health issues can easily go hand-in-hand, but it is normal to feel grief, confusion, and anxiety when you are losing the future you had imagined for yourself, just as your everyday activities grow harder or become impossible. Be gentle with yourself, follow the procedural steps to submit your claim, and focus on crossing off one task at a time.
Managing Mental Health Issues During LTD Claims
If you have one or more of the mental health conditions that can make tasks like attending medical appointments and filing forms even more difficult than they are for the general public, then you need a strategy for minimizing mental health impact on LTD claims that builds on your strengths and supports your weaknesses. Evaluate what you already know about your mental health diagnosis and the challenges it presents. These will likely be related less to your disabling condition, and more to the process of submitting your claim.
If you struggle with resolving ambiguity in written instructions, reviewing your policy documents with an attorney may help. If you find it challenging to express yourself in high-stakes interactions, consider seeking professional mental health support as you prepare for your independent medical examination (IME). If you struggle with tracking multiple simultaneous projects with overlapping timelines, consider whether an attorney or other appropriate professional may be able to take on that portion of the claims process on your behalf, so that you can focus on collecting documentation and attending required appointments.
Tips for Managing The Mental Health Impact on LTD Claims
Mental health impact on LTD claims can vary widely, depending on the mental health condition involved and how it is related to the claim. LTD claims for psychological conditions present a different set of challenges from managing the long-term disability claims process when you are experiencing depression triggered by your loss of health. Navigating long-term disability and mental health issues that have been complicating factors for your entire life can mean a different impact again. As always, the key considerations to keep in mind are the terms and claim submission requirements of your specific policy, and the unique set of variables that led you to apply for long-term disability benefits.
Most importantly, be patient with yourself as you move through each step of the process, and consider reaching out for professional assistance when you encounter challenges that threaten to derail your case.
