Intense workplace stress has been on the rise in the United States for years. According to a 2023 Gallup report, one quarter of workers express experiencing frequent work-related burnout. According to the CDC, the estimated rates of burnout are even higher among doctors, nurses, and other medical workers, with nearly half reporting frequent burnout.
Burnout can be the primary contributing factor to mental and physical health problems, many of which can significantly affect your job performance or even keep you from working for a period of time. Successfully claiming short-term disability benefits for burnout (or other mental health struggles) can often be challenging, though, and if you do not take the appropriate steps beforehand, your disability claim is likely to be denied.
Here’s how burnout can interfere with work and the steps you should take if you wish to qualify for short-term disability benefits.
What Is Burnout?
Everybody experiences stress at work from time to time. However, when work-related stress becomes chronic and employees feel like they never get a chance to take a mental break, significant symptoms can develop. The extreme exhaustion resulting from prolonged, unmanaged stress is often referred to as burnout.
Common signs of burnout include:
- Mental and physical exhaustion
- Inability to concentrate
- Irritability
- Anxiety
- Disruptions in sleep habits
- Chronic headaches
- Unexplained stomach or bowel problems
- Depression
Burnout can often lead to self-destructive coping mechanisms, such as disordered eating and substance abuse or addiction.
Burnout may arise in workers who are forced to work long hours and meet impossible demands, feel uncertain about their responsibilities, are isolated from their coworkers, or must put up with toxic work environments.
At the core of it all, though, is usually a feeling of helplessness and loss of control. Burned out workers often not only feel overwhelmed but think there is nothing they can do to make the situation better.
Physician Burnout: A Growing Epidemic
The 2023 Medscape National Physician Burnout & Depression Report revealed a pattern on physicians feeling stress that goes beyond expected workplace stress, affecting their entire outlook in a negative way, with lasting psychological ramifications.
If this sounds like you, you are not alone.
Physician burnout has been an issue for years, but the COVID-19 pandemic accelerated the trend. In the wake of the pandemic, medical professionals have made strides to implement more boundaries for themselves and seek out healthy coping mechanisms. However, there is still a long way to go before many physicians have a healthy work-life balance. Until that happens, we will continue to see workplace burnout.
What Is Short-Term Disability?
Short-term disability insurance pays disabled individuals a monthly benefit while they recover from a physical or mental health condition. Many people have short-term disability coverage through their employer. Or, you might have purchased a private or individual short-term disability policy yourself.
Like the name implies, you cannot receive short-term disability benefits forever. Most policies will cover your disability claim for a year or less. After that, you might be eligible for long-term disability benefits.
Can I Get Short-Term Disability for Burnout?
While it is possible to receive short-term disability benefits for burnout, successfully filing a claim can be tricky. The term “burnout” was coined in the 1970s, and the phenomenon has been the subject of studies for decades. However, burnout is still not recognized as a medical diagnosis. Simply feeling burnt out, while valid, is not enough to receive short-term disability.
You also will need to show that you have a documented, disabling medical condition that might be caused by burnout. What you might describe as burnout may be manifesting as an official, diagnosable condition such as:
- Anxiety
- Depression
- Post-traumatic stress disorder
- Chronic fatigue syndrome
You will need to convince the insurance company that your documented mental health conditions (along with any physical health conditions you have) make you eligible for short-term disability benefits.
Short-term disability benefits typically pay you a monthly benefit when you meet your policy’s definition of disability. Common definitions of disability include:
- Own occupation: you cannot perform the primary functions of your current job, due to health conditions
- Own specialty: you cannot practice your exact medical specialty, due to psychological or physical limitations
- Any occupation: you cannot perform any type of work, including the lightest jobs
If you need help interpreting your policy or a plan’s requirements, it is a good idea to consult with a disability insurance lawyer. They can review your summary plan description or policy and offer personalized advice based on your unique situation.
Challenges of Short-Term Disability Insurance Claims for Burnout
Once you have assessed your eligibility for benefits, it is time to file a disability insurance claim. However, if you are experiencing disabling burnout, be prepared for a fight. Insurance adjusters are often skeptical of mental health claims and self-reported symptoms.
Physical maladies are easier to verify than mental ones. You can objectively prove that someone has coronary artery disease or ulnar neuropathy. It is not as easy to show that you have disabling depression, anxiety, or other burnout-related conditions. Mental health conditions do not appear in imaging studies or lab work.
Insurance adjusters are always looking for reasons to question your credibility, and many of them will argue that your mental health conditions are not as severe as you allege—especially if you inconsistently seek care. Many mental health claims involving depression, anxiety, bipolar disorder, and post-traumatic stress disorder are initially denied, even when the conditions are otherwise qualifying.
How Treatment Can Support Your Short-Term Disability Claim for Burnout
Getting mental health treatment can be a big hurdle, especially in the case of burnout. It may feel as though one more task on your schedule will tip you over the edge, even self-care or a therapy appointment. However, getting medical care is vital not only to your overall health, but to your short-term disability claim.
If burnout at work is causing you significant mental or physical distress, you should always seek medical attention. If necessary, step away and focus on your wellness and self-care. Long-term unaddressed burnout can lead to serious, chronic problems, including heart disease, high blood pressure, and increased susceptibility to illness.
When you consult with your doctor, ask them to help you determine whether you are suffering from a diagnosable mental illness. Even though burnout is not a medical diagnosis in and of itself, it may overlap with one or more mental illnesses such as anxiety disorder or clinical depression.
But a medical diagnosis is just the beginning. Not everyone with depression or anxiety qualifies for short-term disability benefits. You must convince the insurance adjuster (or a judge) that your burnout makes it impossible to work and that you are receiving a level of medical treatment that corresponds to your severity of symptoms and resulting limitations.
This is where consistent mental health treatment comes into play. Work with your doctor to develop a comprehensive treatment plan and follow it faithfully. In addition to helping you recover from burnout, you will be simultaneously building evidence that demonstrates the severity of your condition and that you and your doctor are taking the appropriate steps to treat it.
RELATED: Depression, Anxiety, and Disability Insurance: A Claimant’s Guide
How to Strengthen Evidence for Your Short-Term Disability Claim
Medical treatment, as discussed above, is the foundation of a strong burnout-related disability claim but not the whole picture. Insurance adjusters reviewing mental health claims will scrutinize every aspect of your file, and the strength of your supporting evidence can be the difference between an approval and a denial.
Here are a few considerations for strengthening a disability claim surrounding burnout:
Know what your policy requires. The evidence you need to gather will depend on whether your plan applies an “own occupation,” “own specialty,” or “any occupation” standard. Each threshold demands a different level of proof. If you are unsure how to interpret your policy’s language, a disability insurance attorney can help you identify exactly what the insurer will be looking for.
Make sure your records reflect functional limitations. A diagnosis alone is not enough. Your medical records need to connect your condition to your inability to perform your job. Ask your treating physician or mental health provider to document specific functional limitations such as difficulty concentrating, inability to manage complex decisions, or problems maintaining a reliable schedule. Include anything that directly corresponds to your policy’s definition of disability.
Gather evidence from multiple sources. A well-rounded file goes beyond office visit notes. Useful supporting documentation may include psychological evaluations or standardized mental health assessments, therapy notes, progress notes, written statements from your treating providers explaining why you cannot work, and employment records that reflect a measurable decline in performance prior to your leave (if applicable).
How to Appeal a Short-Term Disability Denial for Burnout
Receiving a denial letter is discouraging but not uncommon—particularly for mental health claims. Many legitimate burnout-related disability claims are denied on the first submission. If your claim has been denied, you have the right to appeal, and a carefully prepared appeal can significantly improve your chances of a favorable outcome.
Your insurer is required to provide a written explanation of why your claim was denied. Read this letter carefully. The specific grounds for denial should drive every decision you make in your appeal.
After reviewing the explanation:
Do not miss your deadline. Appeals are subject to strict timeframes. If your disability coverage is employer-sponsored and governed by ERISA, you typically have 180 days from receipt of the denial letter to file an administrative appeal. Missing this window can eliminate your right to challenge the decision in court. For private, non-ERISA policies, deadlines vary. Review your policy immediately or consult an attorney to confirm how much time you have.
Use the appeal period to strengthen your evidentiary record. Resubmitting the same documentation that accompanied your original claim is rarely sufficient. If the insurer cited a lack of medical evidence, work with your treating providers to obtain updated records, a detailed physician statement directly addressing the insurer’s concerns, or an independent psychological evaluation that corroborates both your diagnosis and your functional limitations.
Understand the stakes if your plan is ERISA-governed. Under ERISA, the administrative appeal record is typically the only evidence a federal court can consider if your case proceeds to litigation. In practical terms, this means the appeal stage may be your only opportunity to introduce critical evidence on your behalf. Getting this right the first time matters enormously.
Consider involving a disability insurance attorney. The appeals process is legally complex, and procedural missteps can have lasting consequences. An experienced disability insurance lawyer can help you identify the weaknesses in your original claim, build a stronger evidentiary record, and ensure your appeal is positioned as effectively as possible before it reaches a final decision.
RELATED: Doctor Disability Insurance: How to Appeal a Claim Denial
Need Help with Your Short-Term Disability Claim? Contact Bryant Legal Group Today
Our attorneys excel at protecting the legal rights of disabled workers and professionals, including doctors and nurses. We only represent individuals—never insurance companies—and will work hard to get you the short-term disability benefits you deserve under your plan.
Making sure you have solid medical evidence of your disability is crucial in any short-term disability claim, but especially mental health claims. We can help you understand your policy benefits and limitations, determine if you have a case, and guide you through the steps you need to take to have the best chance at getting the compensation you deserve.
To speak to an experienced Chicago short-term disability insurance lawyer at Bryant Legal Group, contact us by calling 312-667-2536 or completing our online form.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.