Invisible Disabilities and Mental Health: How to Qualify for Disability Benefits in Canada?
Mental health struggles aren’t always visible, but they are very real. Conditions like anxiety, depression, PTSD, and other invisible disabilities can seriously impact your ability to function at work, even though there’s no cast, crutch, or x-ray to prove it. If you’re experiencing a mental health issue that’s interfering with your job, you may be eligible for short-term or long-term disability benefits.
This guide explains what invisible disabilities are, how to apply for disability benefits for mental health, and what to do if your claim is denied. At Whitten & Lublin, we understand the challenges of proving a mental health claim, and we’re here to help you protect your rights, your income, and your peace of mind.
What Are Invisible Disabilities and Why Do They Matter?
“Invisible Disabilities”. What are they? Unlike a broken bone, an invisible disability is one that cannot be seen and refers to mental health conditions. There has been a wider focus on the importance of mental health over the previous decade. As the risk and awareness of burnout has taken the spotlight, society has realized the significant importance of maintaining a healthy and happy brain. Some may do this through exercise, others do it through therapy and some may require medical intervention.
Regardless of how you look after your mental health, there may come a time when it declines and negatively impacts your ability to work. If you suffer from anxiety, depression or any other mental health issue that is preventing you from working, you should apply for disability benefits.
What are Disability Benefits and How Do I Apply?
A disability insurance plan is insurance coverage you receive either through your employers group benefits policy or that you pay for individually. It is income replacement insurance in case you suffer from a medical illness or injury that prevents you from working. Disability insurance is meant to give you peace of mind if you ever find yourself medically unfit to work.
You can ask for the application package from your human resources representative or your insurance company to get the process started. You’ll need to submit the following forms to apply for disability coverage:
- Plan Member Statement- this form is filled in by you and provides some information about your condition and your job.
- Attending Physician Statement – you will need to get your doctor to fill in this form regarding your medical condition.
- Plan Sponsor Statement – your employer will submit this form to the insurer.
Once these forms are submitted, the insurance company will either approve or deny your claim.
Can You Get Disability Benefits for Mental Health Conditions?
If you’ve submitted a claim with a mental health diagnosis (i.e.: anxiety, depression, PTSD, etc.), your insurer may not understand why your mental health diagnosis is preventing you from working.
The challenges of proving mental illness
Let’s explore why it is so challenging to get approved for disability benefits when suffering from mental illnesses.
If you’re a professional basketball player and you break your leg, it is easy for an insurer to conclude that you will likely be unable to play basketball because your leg is broken.
Mental health claims have a larger grey area around the why. There isn’t an x-ray that we can take of the brain that is conclusive of anxiety or depression. Rather, doctors use diagnostic tests, questionnaires and treatment recommendations in helping improve your mental health.
Like a broken leg impacts your ability to walk, mental health issues impact your ability to cognitively function.
Insurance Case Managers Are Not Medical Experts
Given the grey area in understanding mental health claims, an LTD case manager, who is not a doctor, might not be able to appreciate or understand how your mental health condition is impacting your ability to function.
If your mental health is declining, it will be difficult to continue working in a job that requires high attention to detail or long periods of concentration. Getting out of bed can be difficult for some.
This disconnect means insurers commonly deny mental health claims. It’s difficult for them to put themselves in your shoes of how you are feeling.
How to Strengthen Your Mental Health Disability Claim?
- Provide detailed medical documentation: Obtaining clear medical documentation from your treatment practitioners is important. It is helpful if your doctor can clearly outline or explain your diagnoses along with your restrictions and limitations and provide the information to your insurer.
- Keep your insurer updated of your treatment: If your treatment plan has changed or you are awaiting a specialist referral or assessment, keep your insurer informed.
What to Do If Your Mental Health Disability Claim is Denied
If your insurance company has denied your disability claim, you have the option to appeal. If you choose to appeal, you will need to submit additional medical documentation in support of your claim.
Appealing a denied mental health claim
A few suggestions and not an exhaustive list for additional documentation can be:
- Further documents provided by your doctors
- A written response describing limitations in your functionality and why you cannot work
- Information about a new diagnosis or treatment plan
If you are considering an appeal, it’s best to consult an experienced disability lawyer who can outline the best way to present your appeal.
Why should you Contact a Disability Lawyer?
Working on your mental health while balancing the demands of your insurer, doctor appointments and your employer can exacerbate your mental illness. Having a disability lawyer working with you can help reduce your stress and help you focus on what really matters, your mental well-being.
At Whitten & Lublin, we offer free consultations for short-term and long-term disability claims. If your disability claim related to your mental health condition has been denied, contact us online or call us 416 640 2667.
Author – Aman Chaggar