Mental illnesses, including depression, anxiety, and bipolar disorder, have become increasingly common among Americans. While you might think of physical illnesses or injuries as the primary reason that you seek long-term disability benefits, mental conditions can be just as debilitating and prevent you from performing your job. As a result, many long-term disability insurance policies do provide coverage for disabilities due to mental conditions, as well.
However, many long-term disability insurance plans place significant restrictions on the receipt of benefits based on a disabling mental condition or “nervous” condition. Both employer-sponsored group disability plans and individual long-term disability plans often provide for a maximum of 24 months of benefits due to mental health. However, some policies do specifically exempt some kinds of mental conditions from these limitations, such as dementia, schizophrenia, and Alzheimer’s disease. Likewise, mental conditions that arise from a brain injury or stroke also likely are exceptions to the mental health limitation. In these cases, then, you should be able to draw benefits for longer than 24 months if your mental condition continues to prevent you from returning to work.
Another situation in which these limiting clauses may not apply is in the case of a mental condition that is the direct result of a physical ailment, or one that is secondary to the physical condition. For instance, if you are taking strong pain medication for a significant back injury, you may experience a lack of memory and concentration as a side effect of your primary medical condition. In this situation, you may be able to argue that the mental health limitation is inapplicable.
Mental health limitations also may lump substance abuse disorders with mental health conditions. As a result, substance abuse disorders that cause disability and an inability to work also are commonly subject to a 24-month limitation on the payment of benefits.
Bonnici Law Group has handled the claims of countless individuals who have encountered difficulties in procuring long-term disability benefits under their employers’ ERISA-governed insurance policies. We will protect your rights and advocate on your behalf throughout every stage of the claims process. Call our office at 858-261-5454 to set up an appointment to speak with us today.
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