DO INSURERS THINK OF DEPRESSION AS A DISABILITY?

Depression might be a handicap if there are specific symptoms that affect your work capacity, such as your depression symptoms.

Whilst most claims based on depression are accepted, some of them can be difficult to verify. This combined with the subjective nature of depression means that a lot of these claims are usually denied. Depression claims are subjective in nature because no diagnostic tests can prove a diagnosis of depression, and insurers see the disease as primarily reliant on the claimant’s self-reported symptoms. Insurance companies often refuse depression disability claims because there is no “clinical” or “objective” proof of impairment. . The definition of clinical and objective is:”clinical” – a condition or symptom that can be detected by, or diagnosed by, medical/psychiatric professionals; “objective” – capable of being measured with the use of instruments or devices. So in order to qualify for disability insurance due to depression, the individual would need to have it confirmed.

One of the factors that insurers consider when deciding whether to pay disability payments is your doctor’s diagnosis of you as depressed or not. The disability insurance company is trying to determine if your illness is severe enough to meet the appropriate disability insurance policy’s disability test.

Treatment Frequency and Duration

When reviewing disability claims based on depression, insurers evaluate the following factors:

  • The medical professionals you encounter
  • Your treatment’s frequency and duration
  • The amount of times you visit your psychiatrist and/or psychologist each week or month

Your prescription medicine

Whether the drug is increased or decreased, and

Hospitalizations, inpatient therapy, or participation in hospital group programs are all prohibited.

Calling a therapist is an important step in receiving adequate mental health care and, unfortunately, some insurers can try to say that you’re not getting enough therapy thereby ending your disability benefits. When looking into what therapies are appropriate, it’s crucial to understand that mental health therapy is provided by a multitude of practitioners.

Psychiatrists are medical professionals who have the authority to prescribe drugs, which they may do in combination with psychotherapy. Psychologists are given the title of doctor by virtue of their professional qualifications e.g. a Ph.D., not because they are medical doctors. Psychologists are not allowed to administer drugs and instead focus on psychotherapy strategies such as cognitive and behavioral therapies. Counseling and emotional support are also provided by social workers and psychotherapists in the treatment of depression. When determining the severity of your depression claim, insurers take into account the sort of therapy provider you are visiting.

– The number of in-person therapy sessions per week

– The number of telephone therapy sessions per week

– The number of therapy sessions you have had with your provider

– The length of time you have been seeing your provider

To be considered eligible for a depression claim, your depression must be moderate or severe. Serious mental disorders such as bipolar disorder, schizophrenia, and psychotic depression will not qualify for a depression claim.

Levels of Activity

In order to prove that you’re unable to work due to your illness, it is important for an insurer to look over your clinical notes and records. Some insurers may also base their analysis on a review of your symptoms and daily activity levels. They may also perform surveillance on you or check your social media profiles.

As a consequence, be sure to constantly tell your treatment providers about the difficulties you’re having as a result of your depression. Include when your symptoms are bothering you and how they have an impact on your life. If you’re honest, consistent and detailed, your doctor will know what to look for and a timeline of what’s going on.

Condition Fluctuations

A disability claim may end when an individual has made significant progress. However, progress is relative and may not mean you’re able to return to work just yet. If your physicians report that your health has improved, make sure they explain why you are still unable to work despite the apparent improvement. For example, someone who is hospitalized for suicidal thoughts may no longer be suicidal after they’ve been released, but they may still have difficulties such as poor mood, social avoidance, lack of motivation to do anything and difficulty with focus which make it difficult for them to work. All of these factors may have an influence on their capacity to work.

“IME” stands for Independent Medical Examinations.

The insurance company has the authority to send you to a doctor of their choice for an examination under most long-term disability insurance policies or plans. If you file a claim for disability benefits based on depression, your insurer may refer you to a psychiatrist or schedule a psychological or neuropsychological examination. If you report any cognitive or executive functioning difficulties like memory, attention or focus to your doctor, they’ll likely ask for a neuropsychological evaluation.

An Independent Medical Examination, or “IME,” is a test that your long-term disability insurance provider arranges for you.

The insurance company will consult with the IME doctor to gauge your condition, ongoing symptoms and restrictions. The final diagnosis from the IME doctor is not compulsory for the insurance company to provide coverage. The insurance company may also ask the IME specialist for an opinion on your degree of impairment, treatment suggestions, and diagnosis and prognosis.

As long as the neuropsychological assessor is using tests with validity indices built in, insurers often employ the use of neuropsychological exams to establish the validity of a claim.

If you’ve been summoned for an IME, you should consult with a lawyer to learn more about the procedure and what to anticipate moving forward with your disability claim.

If your long-term disability claim for depression has been refused for whatever reason[DC1], you should speak with an expert lawyer about your situation. Disability Lawyers Markham are a group of skilled lawyers that specialize in disability insurance lawsuits. We would be delighted to provide you a free consultation. Please contact us over the internet. You should not rely on the information here to provide you with legal advice. The purpose of this blog is to provide a broad overview of what the law is and general tips, but not intended as specific legal advice. By accessing this blog, you acknowledge that you and the blog publisher do not have a solicitor-client relationship. with each other. If you have a question or concern about your legal rights as a reader, please contact an attorney in your area.