What if your job is quite literally killing you by causing unmanageable stress? Can you stop working and receive short-term disability benefits for job stress? The short answer is yes, but only in specific situations.
Generally, conditions such as stress, anxiety, and depression are only considered disabilities if you can prove that they affect your job performance and would make you unable to perform your required job duties for any employer. Usually, you need to show evidence that your mental health conditions are affecting your ability to perform everyday activities as well, even outside of work. If you are overwhelmed at work but fine everywhere else, your policy probably will not cover you. If you feel you could still do your job if only your workplace was not so toxic, you almost certainly are not covered by your disability policy. How can this be?
My Job Is Killing Me – Why Aren’t I Covered by My Disability Policy?
Most policies have language that says, in effect, “we’re going to look at your job as it is practiced in the national economy and see if your condition prevents you from doing that job.” So, the fact that your boss, supervisors, or co-workers are making you uncomfortable or causing stress does not necessarily qualify you for benefits. Job-related stress is a difficult claim to pursue because if there are other jobs just like yours with different employers that would not cause you disabling stress, your policy does not have to pay.
So where does this leave you? You may need to hear someone say it, so: don’t continue to work in a job environment that is so toxic you feel it is killing you. If you can get a little breathing room, we can help you sort out whether you have an employment-related claim, need to job hunt for a new and better job, or have a short-term disability claim.
An employment-related claim is based on your job with your employer. There are certain things an employer is prohibited from doing in the workplace, but the law also protects employers in many cases. If you feel your stress, depression, and anxiety are largely caused by your workplace, you should seek out an employment lawyer to discuss whether you have a case. Often, armed with some basic information, you can work through your Human Resources department to shift your job conditions to give you some needed relief. If not, the employment lawyer would advise you about next steps. (If you’re in the greater Washington DC area, call us – we know a good one.)
If your job is just one part of a larger problem, though, you may have a short-term disability claim. This may or may not turn into a long-term disability claim, but you need to take that a step at a time. In most cases, you first need to build your short-term disability case.
Support for Your Short-Term Disability Claim
We say it over and over again: “you can’t make a claim without doctor support.” The insurance company doesn’t know you, and they usually aren’t going to take the time to examine you. When you make a claim, they are going to have their doctor examine your medical records from your doctor. If those records don’t exist, there is nothing to evaluate. No matter how much you plead, no matter how nice the insurance company representative seems on the phone, your claim will be denied because you did not provide the required “proof of disability.”
To initiate a claim, you will need records from someone who saw you for your disabling condition. This can be your primary care physician, the emergency department (if you are having a crisis), your employer’s Employee Assistance Program (if one exists), and of course a licensed mental health provider.
You need records from right around the time you stopped working – either you saw the provider first and they advised you to stop working so you could focus on treatment (first choice), or you saw the provider right after you stopped working and they examined you and confirmed that you were unable to return to work.
In the records, your provider must describe 1) your symptoms and 2) how they interfere with your ability to do your job and other “activities of daily living.” For example, a teacher might be having panic attacks multiple times per day that make them unsafe to supervise a classroom. A sales representative might be emotionally labile and unable to represent the company to clients due to poor emotional control (give examples). The notes must include your diagnosis, treatment plan, and return-to-work prognosis.
If approved, as your claim goes on, the insurance company will want to see continued proof that you are seeing your doctor(s) and that your care is escalating if treatment is not working. Keeping a daily journal can also help support your claim, as you describe your symptoms and limitations.
How Can We Help You?
If your short-term disability claim has been denied, we will review your denial letter for free and give you our honest assessment of your claim. If you have not yet applied and are wondering whether you have a claim at all, we offer a flat-fee consultation to review your disability policy and your medical records and discuss with you what proof you will need to provide of your disability. (If your claim is denied, and we do the appeal, we will apply your consultation fee to the appeal fee).
Questions We Will Ask
Our goal when you call is to have you leaving the call in a better position than when you started, even if just because you know something about the claims process that you didn’t know before. We will listen to you and give you suggestions for what to do next, whether we are the right ones to help you with your claim or not. On the initial call, we may ask you:
- Do you have a denial letter?
- Can we see a copy of your policy?
- Have you been seeing someone for your mental health?
- If so, how long have you been seeing them?
- Do you have records of your visits?
- When did your mental health condition start affecting your job performance?
- What are some specific things you need to do for your job that you are unable to do?
Job stress claims are hard to prove. Your policy probably only covers you if your disability prevents you from being able to do your job for any employer. If the problem is your employer’s toxic work environment, you might be better off turning to an employment attorney or Human Resources.
If it’s more than that, and your mental health condition would prevent you from doing your job even if you had a better work environment, you may well have a short-term disability claim. The key will be proving it. You must have support from a treating provider in-office visit notes, and they need to talk about why your symptoms interfere with your ability to do your job. You must show the insurance company that you have a treatment plan and a return-to-work prognosis. Keeping a daily log of your symptoms and how they affect your ability to function (both at work and outside work) can be useful support for your claim.
If you have any questions, please give us a call at (703) 584-7277. We will give you our honest assessment and can schedule a flat-fee consultation if you’d like us to review your policy and existing records and give you guidance on what could help strengthen your claim. And denial letter reviews are always free.