Legal Advocacy For Denied Long-Term Disability Claims Related To Mental Health Conditions
Life is hard when you live with a mental illness. It’s hard enough to perform essential tasks required to function, let alone expend the energy necessary to thrive. Many with mental disorders find it difficult to hold a job.
Long-term disability insurance is meant to provide financial assistance to those struggling. However, getting these benefits is often a complicated process. Denied claims are not uncommon.
The attorneys at ERISA Law Center help people in Fresno, California and beyond make sense of the legal requirements and take the necessary steps for a successful appeal.
Does Long-Term Disability Cover Mental Health?
Yes, long-term disability insurance covers mental health disorders. However, the Employee Retirement Income Security Act of 1974 (ERISA) – the federal law that, among other things, governs the requirements for long-term disability coverage – is nearly impossible to understand without legal help. For the best chances of a successful outcome of your long-term disability claim, you need to have an experienced long-term disability attorney assisting you with your case.
Types Of Mental Disorders Covered Under Long-Term Disability
At first glance, it might not seem like long-term disability and mental health belong in the same sentence. When people think of disabilities, they often think of outwardly visible conditions like cerebral palsy or amputations. However, an invisible illness like a mental health condition can be just as disabling. Examples of mental disorders that long-term disability could cover include:
If a mental health condition interferes with a person’s ability to work for an extended period, and they have long term disability insurance, they meet the basic requirements for long-term disability coverage. As you can see, LTD and mental health can go hand in hand.
What are the challenges?
If you are struggling with mental health disabilities, you will need to address some important issues in the benefits claim process:
- Coverage: Although it might seem obvious, if you ever expect to receive long-term disability benefits for mental health reasons, you need to make sure mental health is covered in your disability insurance plan.
- Medical analyses: Without proper medical care and documentation, no application for long term disability benefits will be approved. It is critical to have skilled doctors give clear analyses that establish your mental health disability.
- Accurate application for benefits: Errors on any type of disability benefits claim can be costly, but this is even more true in the context of mental health claims. Make sure that any information you provide is presented is complete and accurate.
These are just a few of the things you need to keep in mind when applying for long-term disability benefits for mental health conditions.
My Long-Term Disability Claim Was Denied. Should I Appeal?
Absolutely. You may have a wrongfully denied claim. Denied long-term disability for mental health is all too common. The insurance companies have a variety of reasons for denying or terminating a long term disability claim. When hearing of the denial or termination, or reading the denial letter itself, it may seem the reasons are legitimate and so going through the appeal process may seem like a waste of time and effort. This is the goal of the insurer- to discourage its claimants from appealing the denial and thus end any possibility that it must pay the claim.
Normally, a claimant will be notified verbally that their claim has been denied or terminated. There are times when the insurer will send out a denial of benefits letter. The denial letter is important because the document will detail the following:
- The insurance company’s decision to deny your coverage
- Their explanation for the denial
- Your right to obtain the insurance company’s file upon written request
- The timelines required in an ERISA appeal
- How to initiate an appeal of the decision
There are crucial deadlines in appealing the denial of benefits claims. If your long-term disability claim for mental health issues has been denied, talk to an attorney as soon as possible. Legal guidance helps make for a successful appeal.
What You Need To Appeal A Denied Claim
Before contacting a long-term disability lawyer, start seeing a therapist if you haven’t already. Keep records of your therapy appointments and retain documentation of anything else you’re doing to get help for your mental health condition. We’ll need this documentation to help you with your appeal.