When Does Professional Burnout Constitute Disability Under a Long Term Disability Policy?

The COVID-19 pandemic has stressed the nation’s health systems in many ways.  One notable casualty has been to the frontline critical care health providers who have fought day and night to help people suffering from the virus.  When they can no longer help the sick because their own health has been compromised by the demand for their services without a break, our heath saviors may need to turn the tables and ask for help.

Most health care providers working for health and hospital systems are insured under long term disability policies.  How would they fare if they made a claim for exhaustion or burnout under the policies’ terms?

Most, if not all, group long term disability policies require that a covered person suffer from a sickness or injury that prevents them from performing their occupational duties.  In addition, there is usually a waiting period or elimination period in the policy that prevents the insured from receiving benefits for a period of time.  These periods vary but are usually 90 or 180 days.  Physical exhaustion is often deemed by insurers a temporary condition and may not meet the 90 to 180 day waiting period.  On the other hand, in addition to physical exhaustion, many of our brave health care workers are suffering from mental health conditions brought about by the stress of no break from treating patients suffering from COVID and the day-in and day-out heartbreak of watching people pass away from the virus despite their best efforts.

All long term disability insurers require proof of disability which includes medical support for the disabling condition. Unfortunately, it is not enough to simply explain to the disability insurer how you have been feeling and that you cannot work anymore. Common symptoms that might indicate a health care worker should seek help from a mental health care provider are nervousness, avoidance, anxiety, feelings of helplessness, lack of motivation, overwhelming sadness, difficulty sleeping and trouble concentrating.  For those considering making a disability claim, these symptoms must be reported to a mental health care professional who can document them and begin treatment.  Treatment information from a mental health care provider can be used to support a long term disability claim.

If you have questions about navigating a long term disability claim, call Gisonni Law Firm.