Navigating a disability claim denial for anxiety disorders | Disability Law Show TV – S4 E17

Episode Summary

HOW TO SUCCESSFULLY NAVIGATE A DISABILITY CLAIM DENIAL FOR ANXIETY DISORDERS on Season 4 Episode 17 of the Disability Law Show with disability lawyer and Partner, James Fireman.

Watch above to discover the steps you need to take when the insurance company cuts off or denies your long-term disability claim in Ontario, British Columbia, or Alberta, on the only disability law show on TV and radio in Canada.

Episode Notes

Benefits are cut off as anxiety is deemed related to a specific issue

I’ve been on disability and was approved for LTD for a few months when my employer implemented a vaccine mandate. My anxiety as a result of this mandate worsened. My benefits were then cut off as my anxiety was deemed not a general issue. What can I do?

• Anxiety disorders and benefits: Insurance companies can argue that in some cases, a claimant’s mental health condition is not generalized but is in fact specific to a certain occupation and thus they can work in another setting. It is important to remember that the insurers, in this case, established the claimant was able to work before the mandate was put in place. Claimants that were working before the mandate was put in place would have more difficulty seeking out disability benefits. Adjusters might be given instructions regarding circumstances to deny benefits outright rather than investigating the claim further.
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Applying for CPP benefits while on LTD

I am currently on LTD and approaching the two-year mark. I was asked by my insurer to apply for CPPD benefits. I’ve been off of work due to a neurological issue, and I do not have a return to work date yet from my doctor. Is the insurer trying to forgo paying my benefits?

• Told to apply for CPPD: Claimants should apply for CPPD benefits as there is no reason not to apply. Claimants should note that the test in order to qualify and receive CPPD benefits is much more significant and severe than that of long-term disability. In most disability policies there are provisions that conclude that insurance adjusters can assume claimants have applied for CPPD and deduct payments based on the additional benefits. There is no disadvantage to applying for CPPD. An approval for CPPD will strengthen a claim for LTD.

How to successfully navigate a disability claim denial for anxiety disorders

• An anxiety disorder and qualifying for LTD: While everyone has a certain level of anxiety, those with anxiety disorders are not able to function and perform the essential duties of their job. Individuals struggling to work due to anxiety should speak to their doctors as soon as possible. Possible recommendations for treatment and specialists can and are typically offered through a claimant’s own doctor.
• Why are claims for anxiety disorders denied: There are some negative and more traditional views regarding mental illnesses at insurance companies, although there has been some progression. It is very important for claimants to seek treatment as in most disability policies, in order to receive benefits appropriate treatment is required. Claimants should not stop treatment without the approval of their doctor and medical team. Some insurance adjusters also view mental illnesses and disorders as situational and do not believe claimants cannot work at any other workplace.
• How can I strengthen my claim: It is important for claimants to have written support from their doctor and specific documentation. Medical reports should illuminate a claimant’s specific limitations and inabilities due to their anxiety disorder.  A timeline for re-assessment as well as the recommended treatments should also be noted.
• Can I hire a disability lawyer if my claim was denied: Claimants should contact a disability lawyer as soon as their claim has been denied in order to pursue their benefits. It is important not to waste time and try to appeal a denial as they are rarely effective.

Insurance adjuster following claimant while on LTD

I’ve been on long-term disability benefits now for about 3 years. In the last few months, I believe my insurer is having me followed for surveillance. My anxiety goes up every time I leave the house and my overall mental health has suffered as a result. Is there anything that I can do?

• Surveillance and effect on health: Claimants who believe they are being followed and are worried for their safety should contact the police and report the incidents in question. Surveillance is ultimately not a significant factor for claimants on long-term disability. Claimants should be as honest and forthright as possible with their doctor and insurance adjuster and follow recommended treatments. It is important for claimants to communicate to their doctors and treating medical team that they are being surveilled so that they can adjust treatment as well as a note in their file that their condition could have worsened.
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Previous Episode: Disability Law Show S4 E16 – 3 Things to ask your disability lawyer before you hire them