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Qualifying Conditions

Getting Long-Term Disability (LTD) for Depression and Anxiety

The process of getting long-term disability (LTD) benefits for a mental health condition such as depression or anxiety is not always easy, and wrongful denials are often made by the insurance company.  Coping with a mental illness is challenging enough, without the added stress of having to fight the insurance company for the long-term disability benefits to which you are entitled.  Unfortunately, insurance companies are powerful entities and are all too often motivated by their own financial gain.

Thankfully, the attorneys and professionals at Chisholm Chisholm & Kilpatrick LTD know how to fight the insurance companies and help our clients get the long-term disability benefits they deserve.  Let us help ease your burden so that you can focus on your health and mental wellness. Contact us today at 401-331-6300 for a FREE consultation to see if we can fight for you.

Understanding Depression and Anxiety

Mental illness is a common and widespread problem in the United States that currently affects 1 in 4 adults at any given time.  While there are many different types of mental illness, two of the most common conditions are depression and anxiety.  Although these conditions often occur at the same time, they each have their own distinguishing set of symptoms and causes.  We will investigate each condition below.

Depression and Long-Term Disability

Throughout each of our lives, there will likely be times of distress, such as losing a loved one, going through a divorce, or losing your job, which can lead to us feeling sad, lonely, and scared.  While these feelings are normal reactions to difficult situations, if your low mood becomes severe and persists for longer than it should, you may be suffering from depression.

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The most common form of depression is Major Depressive Disorder (MDD).  MDD is typically diagnosed when you experience at least five of the diagnostic symptoms, including an overwhelming feeling of sadness or a loss of interest or pleasure in activities once enjoyed.  The other symptoms include:

  • Increase or decrease in appetite;
  • Insomnia or hypersomnia;
  • Constant fatigue;
  • Feelings of worthlessness;
  • Excessive or inappropriate guilt;
  • Thoughts of death and suicide; and
  • Cognitive issues such as a decreased ability to think, concentrate, and make decisions.

When these symptoms persist for two weeks or more and result in significant functional change, such as missing school or work, you should reach out to your doctor to discuss your treatment options.

Anxiety and Long-Term Disability

A lot of people who develop depression have a history of anxiety disorder.  While there is no evidence that one causes the other, many people suffer from both depression and anxiety at the same time. Most of us experience anxiety, fear, and worry throughout our lives from time to time.  For example, you may become anxious before a presentation or be worried about an important decision.  However, in people with chronic anxiety and anxiety disorders, the worry and fear become excessive and often lead to irrational thoughts that interfere with daily life.  The most common anxiety disorder in adults is Generalized Anxiety Disorder (GAD).

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People with Generalized Anxiety Disorder often experience symptoms that overlap with those indicative of Major Depressive Disorder.  These overlapping symptoms include fatigue; cognitive issues, including difficulties with concentration; and problems with sleep, including insomnia or hypersomnia.  However, Generalized Anxiety Disorder also presents with its own set of symptoms including:

  • Muscle tension;
  • Racing heart;
  • Jaw pain from teeth grinding;
  • Shortness of breath;
  • Restlessness;
  • Irritability; and
  • Excessive worry, fear, dread, and/or panic.

If you are experiencing these symptoms and they are interfering with or impacting your daily life, contact your doctor and ask about different treatment options available to you.

Treatment for Depression and Anxiety

While the causes and symptoms of depression and anxiety can vary, treatment is typically similar for both conditions.  First, your doctor may suggest a holistic approach to treatment including exercise, developing a good sleep routine, drinking more water, and starting a nutritious diet.

While some people see improvement with these lifestyle changes, others may need additional treatment to manage their symptoms.  Your doctor will likely refer you to therapy with a mental health clinician or licensed clinical social worker.  There are different techniques that your therapist may try, including cognitive behavioral therapy, interpersonal therapy, or problem-solving therapy, to see which, if any, work for you.

If symptoms of depression and anxiety persist despite routine therapy appointments, your doctor may prescribe a medication, or refer you to a psychiatrist for a medication evaluation, in order to treat your conditions.  There are several different types of medications and, since the two conditions are similar, one medication may be enough to manage both.  Your doctors will likely prescribe an antidepressant, an antianxiety medication, a mood stabilizer, or a combination of the three.

While individuals may benefit from just one of these treatment options, many people require all three in order to manage their symptoms and allow them more freedom in their day-to-day life.

How Depression and Anxiety Can Impact Your Ability to Work

Depression and anxiety, both individually and together, can cause significant functional impairments that impact your ability to work.  For example, both conditions can cause increased fatigue, usually the result of insomnia or hypersomnia, which could impact your ability to focus, concentrate, or even get through an 8-hour workday without taking a nap.  You may also experience a loss of appetite and have reduced energy and stamina as a result of a lack of nutrition.  Additionally, if you have intrusive thoughts, like worthlessness or guilt commonly found in people with depression, or constant worry or fear commonly found in people with anxiety, your ability to focus on even simple tasks, pay attention to detail, and process and remember information or instruction may be impaired.

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Further, those who suffer from depression and anxiety are often irritable and easily agitated.  These symptoms would likely affect your ability to form and maintain relationships with your bosses and co-workers and could lead to negative consequences at work.  Lastly, there are also physical symptoms that are associated with depression and anxiety that could impact your ability to be physically able to work through an 8-hour workday.  For example, it is not uncommon for individuals with anxiety to have increased muscle tension, jaw pain, shortness of breath, or racing heart.  These symptoms are not only distracting, but could require you to lie down, rest, or take more breaks than are allowed during the day.

CCK Understands Mental Illness Disability Claims

Your insurance company may not understand how depression and anxiety disorders impact your ability to work.  We do.  We understand that the symptoms associated with depression and anxiety can be debilitating and can prevent you from working reliably and consistently, especially while you focus on your treatment and mental wellness.  At CCK, our attorneys and professionals have experience dealing with long-term disability claims for depression and anxiety at every stage of the claims process.  We can help level the playing field against the insurance company by using our knowledge and experience with ERISA, the U.S. Department of Labor Regulations, and various insurance policies to help you get the benefits to which you are entitled.

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When considering filing a long-term disability claim or pursuing an appeal for depression and anxiety disorders, it is important to have an open line of communication with your doctors and make sure things are documented appropriately in your medical records.  We typically talk with our clients about how to communicate effectively with their doctors about their conditions.  For example, it is crucial that you ask your doctor to document exam findings, medication changes, reported side effects, your symptoms, and your reports on how those symptoms impact your ability to function.  This is especially important in depression and anxiety claims where there is very little objective testing and evidence available to the claimant.

Most doctors want to help, but they are often busy with the demands of their medical practice and focused on treating their patients.  We can work with your doctors to make sure your symptoms are well documented in your medical records and, if necessary, get additional reports or statements from them.

In addition to working with your doctors, we will also work to get the file from the insurance company and review it for any errors or oversights made during the handling of your claim.  After we review and develop an appeal strategy, we gather your medical records, any test results that you have, reports from your treating doctors, witness statements, and, if necessary, expert opinions.  The most common expert testimony that we would likely recommend using in a mental illness claim is that which you receive from a neuropsychological examination.  This exam can help evaluate the severity of your anxiety and depression, as well as objectively test your cognitive abilities and determine if your cognitive function is impaired such that you are unable to return to work.

After we gather all the appropriate evidence, we write the appeal.  We make sure we have developed a strong and complete record and have based our arguments on the evidence.  This is particularly important in ERISA-governed long-term disability claims because the administrative appeal is often the claimant’s last opportunity to get evidence into the record before heading to court.

Call Chisholm Chisholm & Kilpatrick Today

Let the experienced team at Chisholm Chisholm & Kilpatrick help you. Contact us now at 401-331-6300 for a FREE initial consultation and see if we can fight for you.

Long-Term Disability claims and appeals process flowchart