LTD Claim Denied for Anxiety or Depression?
In any given year, 1 in 5 Canadians will experience issues with mental illness.* Sometimes referred to as “invisible disabilities”, mental health issues can make it difficult to concentrate, sleep and function in day-to-day life. People who suffer from anxiety and depression may be unable to work because they need time to rest and recover. Symptoms relating to anxiety and depression are different for everyone. If you are suffering from anxiety and depression, you may qualify for long-term disability benefits.
What is Long Term Disability?
Long-term disability benefits are a monthly income benefit that is available through your employer’s group benefits policy. If an injury or illness prevents you from working, you may qualify for LTD benefits.
What is the definition of Total Disability?
For the first 24 months of your claim, your insurance company will determine whether your condition prevents you from working in your own occupation. After the 24-month period, the definition changes and becomes broader to whether your condition stops you from working in any occupation.
I’m having issues with anxiety and depression and I’m struggling to work, can I make a claim?
If you are struggling with anxiety and/or depression, you may qualify for LTD benefits. Policies cannot legally discriminate a medical condition based on whether it is physically visible or not. Anxiety and depression claims are encompassed by virtue of your policy language.
If you’re struggling with anxiety and depression that is impacting your ability to work, it’s time to think about making a claim for LTD benefits.
Are there time limits to when I should make a claim?
Yes, as a general rule the earlier the better. There are time limits within your policy for when a claim should be made. Although a late filed application can be challenged, it’s best to avoid this (if possible) and get your application process started as soon as you feel you are no longer able to work.
If you have short term disability benefits, you will need to make a claim for short-term disability before your LTD benefits begin.
What is the process for submitting a disability claim?
In submitting an application for LTD benefits, you’ll need three forms:
- Plan Member Statement (PMS), a form filled out by you;
- Plan Sponsor Statement (PSS), a form filled out by your employer; and
- Attending Physician Statement (APS), a form filled out by your doctor.
You can ask your human resources representative or reach out to your insurer to get the application process started. You’ll need to complete the PMS and have your doctor complete the APS. Your insurer will send your employer the PSS.
My LTD claim was denied for anxiety and depression
If your LTD claim was denied for anxiety and depression, it may be time to speak to a disability lawyer. A case manager at the insurance company may not understand your anxiety and depression related symptoms and unfairly deny your claim.
Having a lawyer involved can help you in a few ways:
- You can focus on your health and recovery while the lawyer focuses on your case,
- The lawyer can alleviate the stress of communicating with your insurer if you are awaiting a referral or assessment, and
- A disability lawyer can advocate on your behalf to get you the benefits you deserve.
It is difficult to deal with an insurance company while trying to better your mental health. If your LTD claim was denied for anxiety and depression, the disability team at Whitten & Lublin can help you take back control of your rights. We offer free consultations for short and long-term disability claims. Contact us online or call 416 640 2667.
* Mental Illness and Addiction: Facts and Statistics | CAMH
- “In any given year, 1 in 5 Canadians experiences a mental illness.1
- By the time Canadians reach 40 years of age, 1 in 2 have – or have had – a mental illness
** Mental disorders in Canada, 2022
Author – Aman Chaggar