Are Disability Insurers More Aggressive with Mental Health Claims?

Having had the experience of reviewing loads of client’s disability claim files over the years, I have seen a disturbingly repetitive pattern. Disability insurers are extra unfair to people with mental health disabilities. Three common tactics employed by disability carriers give them an advantage in a claim setting.

  • Disability insurers demand confidential and protected psychotherapy notes.  

The communications between you and your mental health provider are federally and state-protected. Disability insurers that make you believe your claim simply cannot be processed because your attending psychiatrist has provided a summary of their treatment and not the actual communications of treatment are not dealing in good faith. Some insureds allow their psychiatrist to turn over this confidential information because of their concern that they will not be paid. What they don’t realize is that once the information is received by the insurance company, the claim representative and anyone else who has access to your electronic claim file can read those confidential communications. I have seen time and time again non-medical and medical employees twist and misconstrue sparsely-documented communications in psychotherapy notes leading to a denial of disability benefits.

  • Disability insurers’ employee-physicians treat mental health conditions as temporary.

As a rule, each mental health disability claim should be assessed on its specific facts and circumstances. Applying a blanket rule that a disorder should go away within 12 months as one would do when considering how long a broken bone takes to heal demonstrates ignorance and a real failure to consider the complicated field of mental health disorders. The problem with this approach is that once the unilateral time limit set by the insurer expires, it is a struggle to get the insurer to keep paying you.

  • If an insured can go on vacation, then he should not receive disability benefits.

Disability carriers like to contend that if an insured with a mental health disability boards a plane and goes on vacation with family members, then he must be fully capable of returning to his occupational duties. Yet there is no correlation between a clinically depressed individual going out of state for a week and being able to hold down full-time, continuous employment that requires executive functioning skills. I have yet to review a policy that has an exclusion for going on vacation.

When an insured is disabled because of a psychological disorder, one would expect that disability companies would not try to take advantage of his vulnerabilities. Unfortunately, those in that position need to be protected by their mental health providers and legal advocates more than ever. At Gisonni Law Firm, we have decades of experience helping clients who suffer from mental health disabilities. 

Gisonni Law Firm focuses its practice on disability claims and litigation for the disabled in New York, New Jersey and the tristate area. For an understanding of your legal rights from the perspective of a highly experienced disability attorney, call Gisonni Law Firm today.