On behalf of Willeford & Toledano posted in ERISA Disability on Monday, February 6, 2017.
No one has to tell you how difficult it can be to do your job every day when dealing with the effects of a mental illness. Unfortunately, a stigma seems to persist by people who think they need to see physical signs of an illness or disability to believe that it is "serious."
Additionally, if you are eligible for short- or long-term disability benefits through a work-provided plan, the insurance companies may also see mental illness as not as serious as a physical ailment. Many people receiving private disability benefits are shocked to find their carrier limits benefits for mental illness to either 12 or 24 months.
What Conditions Are Subject To Limitations?
Many workers find it hard to perform their responsibilities when suffering from mental health conditions like depression, anxiety, schizophrenia, bipolar disorder or post-traumatic stress disorder. The conditions, or medications for the conditions, can lead to sleepless nights and cognitive difficulties, making it hard to concentrate at work.
Countless court challenges throughout the year have been mostly unsuccessful at removing the limitation on disability benefits for a mental health condition.
However, people receiving long-term disability benefits have been able to receive benefits for longer by proving that their condition is secondary to a physical condition. If you have a physical condition that prevents you from working - such as a serious back injury - but is also causing a mental health condition like depression, the insurance company should not limit your benefits. The use of painkillers - which could also hurt your cognitive function - for a physical disability could also qualify you for lengthier disability benefits.
The most important thing you can do if you are facing a claim denial or an attempt to limit your benefits is to talk to an attorney with a deep understanding of how workplace-provided disability plans are governed under ERISA. Your attorney can examine the reasons for the denial or limitation and help you determine the best way to proceed to seek the benefits you need.