Guide To Long Term Disability
Disclaimer: Every case is different, and the law is complex. The information provided here does not constitute legal advice, but is for informational purposes only. No solicitor-client relationship is established from the use of this information. We would be pleased to offer you a free initial consultation if you have any questions about a long-term disability or other insurance matter. Copyright, 2006. John D. Johnson and Rene A. Clonfero.
Q.What is long-term disability insurance?
A. Long-term disability insurance is designed to provide replacement income should you become disabled from work. Often, LTD coverage is bundled together with short-term disability coverage under a group insurance plan provided through your employer. If you have a private life or accident and sickness policy, you may have LTD coverage as well.
Q. What types of disability are covered?
A. Coverage varies from policy to policy, but generally speaking, LTD policies cover any type of injury or illness that prevents you from being able to work. Some policies exclude certain illnesses, while others exclude work-related injuries or illnesses. For the details of what is covered and not covered, you need to read the policy. If you don’t have the policy and are covered under a group insurance plan, the benefits booklet provided to you by your employer is a place to start.
Q. The insurance company is telling me that I have to apply for Canada Pension Plan Disability Benefits. Is this true?
Depression Disability Benefit Programs
Finding yourself in this situation may seem hopeless, but it isnt. There is the hope of solving the problem. The SSDI is a certified program created to support individuals going through the tough phase. The program doesnt cater to every person battling depression, not unless you fit the criterion used.
When you qualify to receive some benefits if your depression leads to disability, you and your family members receive benefits once you enroll in the program. Supplemental Security Income covers adults and children with less financial capabilities and resources.
Even though the two programs work separately, their main aim is to assist individuals with disabilities, and depression disability is included. If you plan to apply to the program, do your research and know what is required during application to smoothen the process.
The medical requirements for both programs are the same. For the non-medical criterion, you are entitled to monthly benefits if your medical condition lasts a year or longer and if the illness may lead to death.
The requirements for enrollment in disability programs include:
- Inability to work due to depression.
- Assets are lower than $2000 worth.
- Spouses also have insufficient support, and combining you and your spouses assets should be lower than $3000 in total.
- Your depression should be considered severe to be a disability.
- You cannot work based on your current condition, age, disability, and work history.
Social Security Disability Insurance
SSDI is the first program you may consider if depression has disrupted your ability to work. To qualify for the program, you must:
- prove you havent been able to work for at least 12 months
- have paid Social Security through paycheck deductions for the last 5 out of 10 years
The exact SSDI benefits you receive depend on your individual contributions to the Social Security system during your working years. On average, people on SSDI receive $1,165 per month as of 2014.
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Provide Evidence From Your Doctor
When determining whether your depression is disabling, your insurance company will likely also want the opinions of your treating doctor. Your doctors support is key. Your doctors reports should focus on:
- The frequency and severity of your symptoms
- Any positive mental status exam findings
- Their direct observations of you during office visits and
- The specific restrictions and limitations that prevent you from working.
How To Document An Ltd Claim For Depression Or Bipolar Disorder
It is essential to receive consistent treatment from a mental health professional, preferably a psychologist or psychiatrist, to have any chance of prevailing on a claim for depression or bipolar disorder. Make sure that your insurer carrier has requested and received all the medical records related to your condition, including those from your treating doctors and any hospitals or psychiatric facilities where you’ve received treatment. Don’t simply rely on your LTD carrier to solicit all the evidence it needs to make an informed decision in your case.
While your LTD carrier will likely contact your treating physician for an opinion about the functional limitations caused by your condition, the insurer’s paperwork may be less than thorough than you would want, or may be designed to elicit responses unfavorable to your claim. To help your case, you should make sure that detailed findings from your treating doctor about your vocational limitations get into your record. In particular, you should ask your doctor to submit information to the insurance company discussing any limitations you have in the following areas:
- avoiding tardiness or excessive absences from work
- staying on-task throughout the day
- maintaining focus and concentration throughout the day
- understanding, remembering, and carrying out simple and complex instructions
- responding appropriately to criticism from supervisors, and
- interacting appropriately with co-workers and the general public.
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Signs Of Hypomania In Bipolar 2 Disorder:
- Reckless and risky behavior
- Increased normal activity
Diagnosis is based on presenting signs and symptoms. Treatment is by use of mood stabilizers, anticonvulsants, and antidepressants.
Cyclothymia is the mild form of bipolar disorder, meaning the mood swings are not as chronic. The difference between the two is dependent on the severity and duration of the mood swing. To be eligible for the SSDI, you have to meet the criteria used by the program. Some of the considerations are not functioning generally despite proper treatment or by listing any of the chronic forms of depression-like bipolar disorder.
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Medications And Side Effects
Serious medications make a serious medical condition more believable. So, you must try all the recommended medications even if you fear the side effects.
If youre not taking antidepressants,, then the insurance company will think your symptoms arent serious enough to qualify for disability benefits. Its common for doctors to have you try multiple medications and different dosages to find the right treatment. So, if you have a bad reaction to one medication, you cant refuse the troubleshooting that follows. You have to try all other medications or changing your dosage.
If you have bad reactions to your medications, your medical records must report that in detail. And, if your doctor recommended against a medication, you need to have it documented that the side effects were worse than the condition. Again, you run the risk of denial if you stray from standard treatments without a good reason.
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How Is Depression Diagnosed
Before filing for long term disability, the first step is receiving a diagnosis for your depression. The insurance company will require proof of diagnosis to approve your claim.
A doctor will be able to give you a correct diagnosis. First, a doctor may conduct a physical examination, blood labs, or other testing to rule out other health conditions causing your symptoms.
If your symptoms are not caused by other illnesses, your doctor may conduct a mental health evaluation. Your doctor may also provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating depressive disorders.
Your doctor or mental health professional will likely conduct a full diagnostic evaluation. By interviewing you on your moods and behaviors, and how long these symptoms have persisted, your doctor will determine whether you are suffering from clinical depression.
In addition, your doctor or mental health professional may question you on any family history of depression or other mental illnesses. Your doctor or mental health professional may also talk to your close relatives or spouse to see how they describe your symptoms and family medical history.
Do You Have Disability Claim Questions
If you have filed or are preparing to file an individual or group sponsored long-term disability claim, or believe your benefits were wrongfully denied, contact DarrasLaws top-rated, individual and long-term disability insurance attorneys for a free claim consultation.
Your disability insurance should protect you in the event that an illness or injury disables you, but sometimes insurance companies fail when you need them most. We can help!
At DarrasLaw, our experienced disability insurance lawyers, led by Americas top disability insurance lawyer, Frank N. Darras, have the experience and resources to assist and fight for the disability benefits you deserveand win. We can offer immediate help with disability claims. We understand that a disability can suddenly and unpredictably hurt your income we are here and able to assist. We evaluate cases throughout the United States.
If you havent experienced a wrongful disability claim denial yet but have questions about your policy and its limitations, contact DarrasLaw.
If you have individual or long-term disability insurance questions, the legal team at DarrasLaw is here to help. Call us today at or email us to schedule your free disability claim consultation or free policy analysis.
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Medical Vocational Allowance For Depression
The standard of proof for getting disability benefits for depression is high, and some people may not meet the standard but still are unable to work. If that happens you can still be eligible for disability benefits under the Medical Vocational Allowance. To qualify this way you need to download the Residual Functional Capacity evaluation form from the SSA website. Your doctor or psychologist needs to fill out this form and provide detailed information about your illness and the limitations you have as a result of that illness.
Then, the SSA will look at the RFC evaluation and your work history, the skills you have, and the limitations caused by your illness. They will try to find some type of work that you can do with the skills and limitations that you have. If they cant find any kind of work that you can do then you will be eligible to receive Social Security disability benefits.
Can You Claim Long
What if the driving force behind peoples refusal to get vaccinated is fear? Hesitancy is often driven by fear, as are anxiety, depression and many other recognized disabling psychological conditions, which are often debilitating for sufferers.
With an increasing number of workplaces in Canada mandating vaccinations, Ive spoken to some individuals who feel scared and angry at being compelled to be vaccinated. Rightly or wrongly, many of them are searching for ways to avoid being forced to vaccinate in order to keep their jobs.
The issues many employees are dealing with in relation to mandatory vaccines are not only rooted in employment law, but also in disability law. What if employees do not have a religious objection to the vaccine or a medical condition that would exempt them, but rather an intense fear that is debilitating and disabling? What will happen to them?
Based on my experience as a disability lawyer, if you suffer from a psychological condition such as severe anxiety or depression as it relates to workplace vaccine mandates, and it causes you to become disabled from working, you may be entitled to short-term or long-term disability.
How to apply for short-term and/or long-term disability
What should you do if you are denied disability by the insurance company?
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Types Of Disability Benefits For Depression
If you become unable to work because of depression, you have a few options. You might be eligible for disability benefits from the government, your employer, or your insurer.
This list covers the possible options for depression in Canada:
- Employment Insurance sickness benefits
- Short-term disability insurance
- Provincial disability benefits
- Disability tax credit
Lets go over each so you know whether you qualify, how to apply, and how to appeal if they deny your claim.
Depression Symptoms Under Part A
Depression symptoms under Part A are usually fairly easy to prove. But, only if you have the proper medical records. The best medical records are from your psychologist or psychiatrist. Not everyone can afford a psychiatrist, but a treating psychiatrist will typically prescribe your medications. Depression medications might be Prozac, Wellbutrin, Effexor, Lexapro, or Paxil. These are only some standard examples of what your psychiatrist may prescribe. You might also be taking other medications for insomnia, like Trazadone or Xanax. Medication, like therapy, may give you some relief from your symptoms.
Clinical depression is one of the most common mental health conditions. The symptoms in Part A can happen for a variety of reasons. But to win benefits under listing 12.04, your doctor should outline the following symptoms:
- persistent sadness
- memory problems
- suicidal thoughts and suicidal behaviors
Some people with Depression receive treatment from a psychologist or counselor. If you receive treatment from a psychologists, then you will probably have talk therapy. Likewise, a counselor gives weekly or biweekly talk therapy or counseling. Counseling is a useful therapy, because it can give you the tools and skills to deal with depression and symptoms of anxiety.
Medical Evidence Required For Disability Based On Depression
Your treating doctor should be able to submit a comprehensive psychiatric report and a well-documented psychiatric medical record showing the history of your depression to the SSA. Your psychiatric record should include all treatments attempted, including the types of medication and therapy, and the efficacy and side effects of each treatment. Your doctor should also include detailed examples of how your depression affects your daily activities and your ability to hold a job.
Write A Personal Narrative About Your Depression
Given the varying symptoms of depressive disorders, you should explain to your insurance company how your individual symptoms prevent you from performing your job duties. You can do this by preparing a detailed, written narrative for the insurance company. In many cases, it is helpful if the narrative addresses all your symptoms by listing them separately first. Because most symptoms of depressive disorder are subjective in nature, your narrative can also address the severity of your symptoms, as well as factors that trigger or exacerbate your symptoms.
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The Effects Of Depression On Your Life
Depression can have genetic roots it can be a piggyback disorder of a major chronic health condition or psychological damages may be related to a major accident like a serious car accident or a bad slip-and-fall incident.
Major depression can impact every aspect of your personal and professional life. It can affect not only your emotional and cognitive functioning, but also your social and physical functioning. Clinical depression can have the following negative effects.
- affects your ability to work.
- causes major disruption in your family.
- increases the likelihood of developing physical conditions.
- results in lost work days.
- requires extensive psychiatric treatment and counseling.
- leads to a huge economic burden for the victim.
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Can I Work With Depression
Depression, also known as Clinical Depression, is a medical and mental condition which can severely affect many areas of your life, including your ability to perform meaningful work. In severe cases, those who suffer from depression find themselves unable to perform daily tasks required of those in the work force, and may find it difficult or impossible to maintain gainful employment.
Depression is different than the sadness we feel when we have suffered a loss. Such sadness is generally short term, and lessens with time. Depression, on the other hand, is marked by a sense of profound sadness or melancholy that affects not only how you feel, but also what you do. Depression can disrupt your daily routine and cause you to lose interest for things you once enjoyed, marked by long periods of hopelessness.
In some cases, those suffering from clinical depression may qualify for Social Security Disability benefits. Whether or not you qualify for Social Security Disability benefits because of your depression is largely due to the actual symptoms and their severity. No two people react exactly the same way to depression different people suffering with depression may respond in very different ways. For example, one person with depression may sleep 17 hours per day while another finds herself unable to sleep.
Social Security Disability Claims Based On Depression & Anxiety
Unlike long term disability policies, the Social Security Administration does not limit claims based on depression and anxiety. This means even if your long term disability benefits end, you can continue to receive Social Security Disability benefits based solely on mental health issues. Please note the Social Security Administration has specific rules governing mental health claims.
Contact Hawks QuindelIf you have applied for disability benefits and your claim has been denied, contact Hawks Quindel immediately. Hawks Quindel represents individuals who have been denied long term disability benefits and Social Security disability benefits. Please call 608/257-0040 for a free consultation.
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