Perhaps. The thing to remember about long-term disability (LTD) plans is that they are designed to pay a portion of your income if you are injured or suffering from a chronic or acute medical ailment that is anticipated to last a long time – usually 12 months or longer. These plans often have limitations that will pay you for up to a certain number of years (or for life under generous plans). Because they are contractual agreements, the terms of the contract must be strictly followed. However, federal law also protects employees and determines what the insurance company can and can not put in the agreement, at least to some extent.
If you are facing a denial or need help preparing an application, give the lawyers at Burke Harvey, LLC a call today. We may be able to help you avoid costly mistakes, and if you are indeed denied, we may be able to assist with your appeal. When it comes to mental health conditions, LTD policies are notorious for issuing blanket denials, meaning they often ignore evidence and just deny. The following is what you should understand before you apply.
What is a Disability?
For the purposes of a long-term disability plan, a disability is generally defined as a chronic or acute medical condition that is expected to last at least a year. Of course, policies can vary widely on this. As a general rule, however, the idea is that LTD benefits should be paid in situations where, as a result of your condition, you can not work.
Typical Mental Health Diagnoses
Some of the more common diagnoses that people claim when applying for LTD benefits include:
- Clinical depression: It is important to distinguish between acute depression and a long-term and chronic condition. Many people suffer from transient depression due to life events. For instance, if you lose a loved one or deal with seasonal depression, these are limited types of conditions that may be severe for a short amount of time, but they often will not last the rest of your life. They are also treatable. Therefore, depression is one of the most common ailments that receive denials. There are, of course, situations in which depression is not transient and is so severe that it requires long-term psychological treatment, medication, and even hospitalization. In these cases, LTD benefits may be warranted. The key is proper psychiatric treatment evidence.
- Anxiety disorders: There is a big difference between a true anxiety disorder and having occasional anxiety or stress. Again, the key for the LTD benefits carrier will be to show exactly how the anxiety objectively affects your ability to work.
- Post-traumatic stress disorder: Whether you developed PTSD in military service and it has become worse with time, or you survived a traumatic event and have not been able to return to full-time work, an LTD policy may be available to help. Do not expect it to be easy to obtain your benefits, however. PTSD can improve with time and is generally quite responsive to treatment. Therefore, you will need solid medical evidence that shows the likelihood of the condition continuing for a long time.
- Bipolar disorder: Bipolar disorder plagues about 2.6% of the population, according to WebMD. Just having a diagnosis is not enough to qualify you for LTD benefits, however. You must clearly show that the condition prevents you from being able to work. This is a heavy burden to meet.
- Acute cognitive deficits: Conditions like dementia and early onset Alzheimer’s disease can also lead to the use of LTD benefits.
Be Prepared to Appeal Quickly
You will only get about 60 days to appeal a denial. So, you should try to contact an experienced LTD benefits lawyer early in the process. You want to make sure you have someone available to immediately review your denial and get the appeal filed with the insurance company. Failure to meet the requisite deadlines can eliminate your right to benefits entirely.
At Burke Harvey, LLC, we can evaluate your claim free of charge and help you determine whether you have a strong chance of success on appeal. If so, you can rest assured that our experienced team will handle all aspects of your LTD case in order to recover the benefits you and your family need. If we can not successfully get the benefits for you, then you owe us nothing. To schedule a free consultation to discuss your case today, call Burke Harvey, LLC. Just remember, time is limited so do not delay.