Issues in Securing Disability Benefits for a Mental Health Condition

Oct 31, 2018 | Blog |

Whether you are suffering from a mental health condition that has rendered you incapable of performing the duties of your occupation (or, perhaps, that has even prevented you from securing gainful alternative employment in another occupation), or are suffering from a disabling physical condition that also has had a significant impact on your overall mental health, there’s a good chance that you’ll be faced with some conflict when engaging your disability insurance carrier.

Long-term disability insurers are often incentivized to redefine your disabling condition as a mental health problem so as to minimize their liabilities — some insurance policies include language that specifies a limited period of time for which disability payments must be paid out to the claimant.  By categorizing your disability as a mental health condition, the insurer may be able to avoid having to pay out significant lifetime benefits that they might otherwise owe.  As such, it’s important that you get in touch with a Chicago long term disability attorney for assistance.

The “Mental and Nervous” Limitation

Oftentimes, long-term disability policies include a “Mental and Nervous” clause that specifies a limited period of time for which such disabling conditions will be eligible for benefits.  Policies vary substantially, but as a general rule, most “Mental and Nervous” clauses impose a one- or two-year limitation.

For example, if you are suffering from depression that is so severe that it renders you incapable of working, then you may be eligible for benefits under your long-term disability plan, but the insurer will only do so for a period of — say — two years.  After the specified time period, the insurer is under no obligation to continue to payout benefits for your mental health disability.

It’s worth noting, however, that the “Mental and Nervous” limitation clause may involve certain exclusions that are designed to ensure that claimants with particularly severe and well-studied mental health conditions — such as bipolar disorder or dementia — can secure benefits for the full length of time guaranteed by the insurance contract for “standard” disabling conditions.

Ambiguity in Defining Mental Illness

Many disability policies include ambiguous definitions of mental health conditions that may be confusing to policyholder-claimants who are suffering from disabling conditions that involve both physical and mental effects — it is rare, in fact, for a serious, disabling condition to have no long-term psychological impact on the sufferer.

Fortunately, Illinois law ensures that all ambiguous provisions in an insurance contract are construed in favor of the policyholder.  As such, a more favorable interpretation of the ambiguous provision at-issue (defining mental illness or mental health conditions under the policy) will be read into the contract.

Contact an Experienced Chicago Long Term Disability Attorney for Help

Bryant Legal Group, P.C. is a boutique insurance litigation firm with a focus on representing policyholders-claimants in disputes against their insurance carriers.  We have extensive experience advocating on behalf of disability claimants, including those whose benefits claims have been wrongfully denied, delayed, undervalued, redefined, or otherwise mishandled by their insurer — and over the years, we have secured favorable verdicts and settlements for our clients.

Call (312) 634-6179 or submit a message through our website to connect to an experienced Chicago long term disability attorney at Bryant Legal Group, P.C. and schedule a consultation today.

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