Can Short-Term Disability Be Denied for Mental Health?
Contact the short-term disability lawyers at Bryant Legal Group in Chicago for help appealing a disability denial for a mental health condition.
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Long-Term Disability Benefits
Long-term disability insurance is supposed to replace a portion of your income when illness or injury keeps you from working. In practice, claims are denied, delayed, and terminated every day — often for technical reasons that have nothing to do with whether you’re actually disabled. Our Chicago disability attorneys help clients across Illinois secure the benefits they’ve already paid for.
Our long-term disability attorneys help clients fight denied and delayed claims so they can focus on their health, not their insurance company. We take a practical, results-driven approach that focuses on your needs.
Hear From Our Clients
If you become disabled and are unable to work for an extended period, your long-term disability (LTD) insurance should replace a portion of your lost income and protect the standard of living you worked so hard to build. But in practice, that’s not always how it works.
Filing a long-term disability claim is often a complex and confusing process. Minor mistakes during filing can lead to an unfair denial of long-term disability benefits with only a limited time to appeal. And even if you did nothing wrong, the insurance company may unfairly deny your disability claim and leave you in the lurch.
If you need help applying for long-term disability benefits, appealing a denied claim, or negotiating a settlement or buyout of your existing benefits, contact the Chicago disability attorneys at Bryant Legal Group today. We have decades of experience helping workers and professionals across Illinois get the benefits they deserve.
Our Illinois long-term disability attorneys can assist their clients with every aspect of their claims:
Please note that long-term disability insurance is not the same as Social Security Disability Insurance. Bryant Legal Group does not handle standalone Social Security Disability claims.
Common Challenges Faced When Applying for Long-Term Disability Insurance
You or your employer have paid your premiums every month, so you expect your long-term disability insurance to be there for you need it. But far too often, policyholders encounter obstacles that prevent them from getting promptly approved for the benefits they need.
Satisfying the Definition of Disability
Your insurance documents will define what “disabled” means under the plan. There are two broad definitions:
- Own occupation: you are considered disabled if you can no longer perform the duties of the job you held when you became disabled.
- Any occupation: you are considered disabled if you are unable to work any job to which you are reasonably suited—even if that job is much lower-paying and less fulfilling than your previous work.
Policyholders often run into issues when they disagree with the insurance company about whether their illness or injury qualifies them as disabled under the policy definition. Claimants often need to provide a substantial amount of medical records, vocational evidence, functional test results, letters of support, and other documentation to prove their claim.
It’s also not unusual for long-term disability policies to start out using an own-occupation definition of disability, then change to any occupation coverage after a set number of months or years (often two years). This can result in a sudden loss of coverage even if you are still unable to return to your original job.
Long-term Disability Policy Exclusions
Long-term disability policies often include limitations and exclusions regarding covered conditions. For example:
- Coverage for pre-existing conditions may be excluded if those conditions were present before the policy’s effective date or during a specified look-back period.
- Coverage for disabilities related to mental health issues (e.g., depression, anxiety, post-traumatic stress disorder) or substance abuse may be limited to a shorter benefit period, such as 24 months.
- Conditions involving subjective or self-reported symptoms (e.g., fibromyalgia, degenerative disc disease, chronic fatigue syndrome) may have stricter requirements for objective medical evidence and/or be limited to a shorter benefit period.
- Disabilities that result from workplace injuries are typically covered under a workers’ compensation claim, with disputes typically handled by the Illinois Workers’ Compensation Commission. Your long-term disability coverage may not apply or only pay a partial benefit.
Related Article: Going from Short-term Disability to Long-Term Disability
Complex Procedures and Tight Deadlines
Filing claims and appeals is often complex and confusing, with each insurance company and plan having its own set of rules. It’s easy to make mistakes if you don’t have an experienced long-term disability attorney helping you.
Furthermore, group policies governed by ERISA require policyholders to go through the insurance company’s administrative appeals process before filing a lawsuit in federal court. At that point, the court can only consider evidence that was previously submitted as part of the administrative appeal. This means it’s critically important for claimants to put together an expansive, comprehensive claim file, often just a few months before a tight deadline.
The Chicago Disability Lawyers at Bryant Legal Group Can Help You
Bryant Legal Group has a long-established and ongoing record of going up against big insurance companies and helping clients receive the benefits they deserve. Our victories include:
- A successful appeal on behalf of a skilled dentist who had been found only Partially Disabled by Fidelity Life Insurance Company. We demonstrated that a Total Disability finding was warranted, and Fidelity reversed its decision without the need for litigation.
- A successful reversal of a UNUM termination of benefits to a sports medicine orthopedic surgeon, restoring our client’s long-term disability benefits. This appeal was led by Bryant Legal Group and supported by Meyers & Flowers.
- Persuading Mutual of Omaha to reinstate long-term disability benefits for an educator who suffered a debilitating stroke and continues to experience significant physical and cognitive impairments.
Related Article: How Much is My Long-Term Disability Claim Worth?
How a Chicago Disability Attorney Can Help You File a Long-Term Disability Benefits Claim
If you’re planning to file a disability claim under a long-term disability insurance policy, we strongly encourage you to retain legal counsel with an experienced Chicago disability attorney.
When we are retained to represent individuals at the early filing stage, we work with them to provide the best possible evidence in support of their claim. We can also recommend ways to avoid delays and problems in the claims process.
Our Chicago disability attorneys usually recommend requesting a copy of your current long-term disability insurance policy to start. This document will contain requirements and procedures such as how quickly you must submit your claim, what type of proof of loss the insurance company requires, and how disability is defined.
Most insurance companies that administer long-term disability claims require you to complete an initial set of forms. These forms usually include:
- An insured’s claim (claimant statement) form
- An employer’s claim form or statement
- An authorization form that lets medical providers, financial institutions, and government agencies disclose information to the insurer
- An attending physician statement
If you become sick or injured, the insurance company may make it difficult for you to collect the benefits you are due. Rather than help you navigate your claims, the adjuster may give you misleading information or delay payment.
The filing process can be fraught with pitfalls. Our Chicago disability attorneys understand insurance companies’ tactics and can help you overcome these obstacles.
Why You Need an Airtight Long-Term Disability Claims File
It is important to ensure that every piece of evidence is submitted during the claims filing process. If the insurance company denies coverage and the dispute ends up in court, you are generally precluded from adding any new information to your file.
The insurance adjuster will likely deny your long-term disability claim if you provide incomplete records and evidence. Insurers have no incentive to award disability benefits in “close” cases where it is likely that the claimant has a disability but the record is not sufficient to objectively support such qualification. They will deny reasonable claims without adequate documentary evidence.
Our Chicago disability attorneys know how to build a claims file that will give you the best chance of getting the long-term disability benefits you deserve. We draw upon decades of industry knowledge to collect and assemble the most persuasive evidence for your case, including MRIs, CT scans, and other medical tests and vocational evaluations.
While you might manage the process on your own, you run the risk of making a mistake that could cost you your benefits. If you’ve already filed a claim on your own and had it denied, time is running out on your chance to appeal, and you will likely only have one opportunity to add the evidence you need to support your case.
When you work with a Chicago long-term disability lawyer at Bryant Legal Group, we will make sure that everything is done right so you can maximize your chances of success.
Visit our Long-Term Disability Hub for more information on appealing to common insurance companies.
Protect Your Long-Term Disability Benefits with Bryant Legal Group
The attorneys at Bryant Legal Group have decades of collective experience helping clients get the disability benefits they need to help make up for a loss in income. Our lawyers concentrate their practices exclusively on representing policyholders—we never represent the insurance companies. This focus and commitment ensure that we will do everything in our power to achieve an optimal outcome for you.
Contact one of our Chicago disability attorneys today by calling (312) 561-3010 or completing our online form. We can discuss your case and help you take the right steps for your situation.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.
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Frequently Asked Questions
Our experienced team has helped professionals across Chicago and Illinois recover millions in unpaid benefits and compensation. Bryant Legal Group takes a practical approach, focusing on your needs.
Short-term disability insurance typically covers a portion of your income for a limited period (usually 3-6 months), while long-term disability insurance provides coverage for extended periods, potentially until retirement age.
You should consult with a disability lawyer as soon as you receive a denial or termination of benefits, or if you’re having difficulty with your insurance company during the claims process.
ERISA (Employee Retirement Income Security Act) governs most employer-sponsored disability insurance plans. ERISA claims follow specific federal procedures and timelines that differ significantly from individual disability insurance policies.
Many disability insurance policies include provisions for partial or residual disability benefits if you can work in a limited capacity but cannot perform all the duties of your occupation.
Sometimes, yes. LTD insurance companies may demand repayment if they believe you received an “overpayment” under the terms of your policy. This commonly happens when you begin receiving other benefits—such as Social Security Disability Insurance (SSDI), workers’ compensation, or certain personal injury settlements—that trigger an offset provision in your LTD policy. Overpayments can also occur if you return to work and continue receiving full LTD benefits without promptly notifying the insurer.
However, insurers can make mistakes when calculating offsets or repayment amounts. Before agreeing to repay anything, you should carefully review the demand and consult with an experienced disability insurance attorney.
If you received a repayment demand or have questions about your LTD policy, Bryant Legal Group can help you understand your rights and options.
Related Article: Do I Have to Pay Back Long-Term Disability Benefits?
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