“I was on LTD for 2 years, now my insurer has cut me off because of a “mental illness” provision. What if my disability is only partially based on a “mental illness?”

This is a great question for two reasons. First, because insurers use this trick frequently. They will often disregard all other disabling conditions and emphasize only your mental illness. Conveniently, this allows them to invoke their 2 year limitation, and stop paying you after 2 years. 

If you feel you are disabled for varying causes, only some of which are mental in nature, then you may have been frivolously denied. Here is the general rule: when you have multiple causes for a disability, each must be considered in isolation. An example is the best way to explain. Say you have a diagnosis of depression and anxiety, as well as fibromyalgia. Now assume you have been on claim for 2 years for those disabilities. After two years, your insurer should, pursuant to any “mental illness” provision, stop considering your depression and anxiety. But that doesn’t mean they can ignore your fibromyalgia. It must still be reviewed to see if it, alone, is disabling. Conveniently, insurers often leave out that step, and simply terminate you because of the 2 year limitation.

Second, because there is always that question of which came first, the chicken or the egg? 

Let me explain: people with chronic pain conditions and serious disabilities are often depressed, anxious, and have secondary mental illnesses. Your insurer will always try to say, as an example, “your depression makes your pain worse, therefore you have a mental illness subject to the 2 year limitation.” What they are trying to do is to say a mental illness causes your other condition, therefore they should all be lumped into the category of “mental illnesses,” conveniently subject to the contractual limitation. Again, you are entitled to separate review of separate disabilities. Furthermore, if your physical disability (or the like) is causing your mental illness, then logically it is the main disabling condition. It should be entitled to its own review.

As a final note, insurers are always looking to term your claim a mental illness claim. They always ask about your mental health and request psychological or therapy notes. They say it is to “help prove your disability,” but in reality, it to help give them a reason to terminate your benefits. If you have seen these types of requests, be warned: They are trying to find a reason to terminate your benefits early. Do not let them term your disability a “mental illness.”

For more information on long term disability cases, download my book Robbery Without a Gun FREE from my website. Or you can call BenGlassLaw at (703) 584-7277.