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Does ‘burnout’ qualify as a long-term disability?

On Behalf of | Apr 12, 2023 | Long Term Disability Claim Denial

The World Health Organization recognizes “burnout” as a legitimate medical condition. But it is not included on the list of covered conditions on most long-term disability (LTD) insurance plans employers offer.

Still, the American Psychological Association says stress and burnout are at all-time highs, leading thousands of Americans to leave their jobs. Burnout is exceptionally high among healthcare workers who experienced challenging conditions during the pandemic.

Burnout may be a symptom of a covered condition

Just because burnout isn’t explicitly included in your employer’s LTD plan doesn’t mean you aren’t entitled to benefits. A claim may be warranted if the condition makes it impossible for you to carry out your job duties. Burnout is often a symptom of an underlying mental health disorder covered on most LTD plans. These include:

  • Depression
  • Anxiety
  • Post-traumatic stress disorder

The outcome of your claim depends on the employer’s LTD plan, the medical evidence supporting your condition and how you answer the insurer’s questions.

How do I prove my disability?

Don’t expect the insurance company to sign off on your claim automatically. Insurers rigorously scrutinize mental health claims for these so-called “hidden” disabilities. To be approved for long-term disability benefits, you must:

  • Correctly and comprehensively outline your job duties
  • Explain how your condition keeps you from being able to work
  • Provide the insurer with medical records of your condition

Crossing your “Ts” and dotting your “Is” is crucial when filing an LTD claim. A good strategy is to check the language in your employer’s long-term disability plan and receive a diagnosis from a qualified mental health professional.

Also, be prepared for an in-depth investigation by the insurance company, which many find more invasive and disruptive than expected. Insurers may even hire an investigator or, at the very least, monitor your social media channels to look for any discrepancies.

Insurance companies deny claims for any reason, but most denials result from paperwork errors and other avoidable mistakes.  If your claim is denied, that’s where getting help from an experienced long-term disability lawyer comes in handy. Attorneys specializing in these claims know what needs to be done and understand the tactics insurers use to deny benefits.