Bipolar Disorder Disability Insurance Benefits Claim
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Disability carriers often challenge a diagnosis of bipolar disorder. How can Disability Insurance Attorneys Dell & Schaefer assist you?
As disability insurance attorneys, Dell & Schaefer have represented numerous long term disability claimants that have been unable to work as a result of bipolar disorder. Disability Attorneys Dell & Schaefer have an expansive understanding of the significant restrictions and limitations that a person with bi-polar disorder must live with on a daily basis. We have worked closely with top physicians in order to sufficiently satisfy a disability carrier’s threshold of evidence necessary to prove that a client is disabled by bipolar disorder is.
Not everyone suffering with bipolar disorder qualifies for long-term disability benefits, therefore the medicals records of each client must be reviewed to determine the level of restrictions. We welcome the opportunity to discuss your long-term disability claim. You can contact us for a free initial consultation.
Attorneys Dell & Schaefer often battle with disability insurance carriers in determining whether bipolar disorder is a mental nervous condition or an organic brain disorder. In a long-term disability policy a mental nervous condition is usually limited to a maximum of 24 months of benefits; whereas a physical condition such as bipolar disorder would usually not be limited to 24 months if it is proven to be an organic brain disorder. Disability carriers will regularly challenge a diagnosis of bipolar as they are aware that it has been classified in the medical literature as an organic brain disorder. There are a variety of legal court decisions around the country that have classified bipolar disorder as an organic brain disorder. If a long-term disability policy does not include bipolar disorder within the mental nervous limitation clause, then a claimant should challenge any attempt to classify bipolar disorder as a non-physical illness. A skilled psychiatrist and psychologist are a critical component in appropriately documenting bipolar disorder.
What is bipolar disorder?
Bipolar disorder, also known as manic-depressive illness, is an organic brain disorder that causes remarkable shifts in mood, energy, activity levels, and can hinder the ability for a person to accomplish everyday tasks. People who suffer from bipolar disorder are often misdiagnosed as having schizophrenia, due to the appearance of psychotic symptoms. It should be noted that even individuals that display psychotic symptoms as a feature of their bipolar disorder, never meet the full diagnostic criteria for schizophrenia.
Bipolar disorder affects men and women equally. It usually appears between ages 15 – 25. The exact cause is unknown, but it occurs more often in relatives of people who have bipolar disorder. People with bipolar disorder seem to have imbalanced amounts of neurotransmitters called dopamine, serotonin and norepinephrine, which help control persons moods. Neurotransmitters are chemicals in the brain which send messages to different parts of our brain to control various functions.
How the symptoms can affect you
People who suffer with bipolar disorder experience unusually intense emotional states that are called “mood episodes.” An overly elated or overexcited state is called a “manic episode”, and an extremely sad or despondent state is called a “depressive episode”.
Sometimes, a mood episode includes symptoms of both mania and depression. This is called a “mixed state”. People with bipolar disorder may also be volatile and irritable during a mood episode.
Physical changes in a person that suffers from bipolar disorder can be equally incapacitating and can include talking faster, racing thoughts, insomnia and impulsive behavior.
Because bipolar disorder is a lifelong and recurrent illness, people with the disorder need long-term treatment, including psychotherapy and medication, to maintain control of their symptoms.
However, sometimes symptoms are so severe that the person cannot function normally. Bipolar symptoms can result in damaged personal and professional relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives.
Resources and information
There are many valuable sources of bipolar disorder information available. You can also access resources over the internet such as:
There are numerous charities dedicated to bipolar disorder research and treatment including:
Metlife has been reviewing my claim for bipolar (employer LTD) for close to a month.
Clara, under an employer provided policy MetLife would have an initial 45 days to render a decision on your benefit for LTD. Please note that MetLife’s LTD policies contain various limitations as they relate to mental health claims and based on the policy in your language your claim may be limited to 24 months. Please feel free to contact our office to discuss your claim and policy.
Hello,
I have been dealing with anxiety and panic attacks since 1999. I have struggled the whole time working hard to maintain a normal life and been able to continue a stable job history. I was prescribed anti depressants and Xanax to deal with the chronic anxiety/panic attacks. I have had ongoing panic attacks weekly since than. I have had meds switched and increased over the years but finally in the past 2 years it became very overwhelming as I have aged. I started to experience severe mood swings, severe depression, and finally began seeing a Physciatrist on the recommendation of my Primary care physician. I have since been diagnosed with Bi Polar Disorder, Panic Disorder, and PTSD. Considering that I would have the up and down days, weeks I continued to try to work and accommodate my employer the best I can. I was approved for a Intermittent FMLA from Unum with the hope that I could overcome this and regain my ability to just deal with it. At this time I struggle to make it 100% everyday, I have begun to experience thoughts of suicide and my therapists suggests I try to file for short term disability. Unum previously denied this when they approved the FMLA, because I assumed that if I was not 100% unable to work everyday I was not eligible for benefits which I have paid for the past 13 years.
Today I started to file a short term disability claim, but after research am unsure if I need to look at potentially seeking representation and pursuing a LTD claim. I am at the point where I feel I cannot function in my current position any longer.
I would welcome any advice on what path I should pursue.
GM, please feel free to contact our office to discuss how we may be able to assist you in filing for benefits. If you do not already have a copy of your policy(ies) I would recommend you secure same from your HR department at work.
Hi,
I am currently approved for long term disability through my employers ERISA plan based on bipolar disorder. This coverage is limited to 24 months per the disability contract. The disability contract does classify bipolar disorder as a mental nervous condition. Do I have any avenue forward where I can get coverage extended past the 24 months?
Thank you
Michael, unless you have physical medical conditions preventing you from working then your claim may unfortunately be limited to the 24 month period.
Hi, There is an additional physical issue which I believe is listed as interverbral disc displacement and spinal stenosis in my medical record. It is identifiable on an MRI I have had. UNUM has focused on the bipolar diagnosis though, and my treatment for the lower back issues has been less extensive, therefore much less documentation, because there isn’t any improvement that I can expect. My doctor said it can only get worse not better. I have not had any surgeries for this.
Thanks
Michael, then you can certainly raise an argument as to that condition, but you will need your doctor to support disability on account of same, have medical evidence to support the restrictions and limitations. If you would like to discuss your claim further, please feel free to contact our office to discuss your claim further.
I suffer from spinal stenosis from an accident or two but the real issue is Bi Polar disorder. I can’t even leave the house most days, I’m going to ask for a psychological evaluation tomorrow from my treating doctor as well as possible psychology consult. The anxiety and shear terror of leaving the house to go to work requires a dose of clonazapam and xanax just to cope. My employer has coverage through Unum. What can I expect in support from them?
CL McCroan, one immediate factor would be a potential 24 month maximum benefit period under your policy for claims related to mental health conditions. If you have a copy of your policy please feel free to contact our office to discuss your options under same.
I was diagnosed with bipolar affective disorder when I was around 20. I tried to dismiss it, stopped taking Lithium and all meds. I’m now 42 and I feel my condition is as bad as ever. I’m milking my job as a newly graduated occupational therapist assistant because I need the money but don’t have the time or desire to become proficient as they need to be at it. I’m inevitably going to lose my job out of guilt or ineptitude. I also have a wife and daughter and stepdaughter which I never intended. I’m just out of control of my life and feel I have been for some time. I can’t see holding many jobs. I haven’t the skill set to do many that I could hang onto as a career. I’m seeing a psych tomorrow to see where that leads but how can I get started looking into disability?
Barry, does your employer provided short and/or long term disability coverage? If so, you may consider filing a claim under those documents though I would caution you that if you have been covered under any such policy for less than 12 months there could be a very real issue with a pre-existing condition. If you do not have private coverage your only option may be to file for SSDI if you have sufficient work credits.
My diagnosis from the psychiatrist has always been bipolar disorder (mainly depressive). Metlife deemed me to have other depressive/depression/anxiety. They swept me under the 24 month limitation. I was notified that my last payment is approaching soon.
My functional forms show bipolar and the office notes show the symptoms of depression and no concentration.
I have written them but no response.
Can I appeal?
Clara, with a formal denial of benefits, yes, you have rights to appeal. If you have a copy of your disability policy and any correspondence regarding the application of the 24 month limitation please feel free to contact our officer for a free consultation to discuss your claim in greater detail.
I was fired from my job of 30 years with several occurrences related to being Bipolar 1. I was diagnosed in 2012 and have suffered through depression more than once. I’m currently seeing two doctors and take the required meds to curb the swings. I’m finding it hard to find work with my former employer giving me a bad reference. Currently in no condition to work and need advice on what I can do to make it. I have no insurance at this time.
Andy,
If you have no disability insurance you may want to consider looking in to filing for social security disability if your doctors believe you are disabled.
Does approved for denied disability claim leave a record for background checks or future employers?
MetLife authorization to disclose info form asks for my permission for doctors to disclose medical records to MetLife, consumer reporting agencies (background check I’m worried about), investigative agencies, attorneys acting on behalf of MetLife. It also permits MetLife to disclose all my health info to my employer. This is too much info for too broad of an audience. Can I put restrictions by crossing out what I don’t feel comfy with? If this won’t be clear to them, can I submit a self-written note and mail them? Will such alternatives with restrictions be honored?
Just filing FMLA without disability claim still requires disclosure, and the standard FMLA form has a section on description of medical facts, symptoms, diagnosis. If the doctor is happy writing/disclosing nothing there, would it still be approved by MetLife/employer?
Samuel, you can attempt to line strike parts of the authorizations that you are not comfortable with and see if MetLife accepts it. If they don’t then your policy may require that you sign an authorization in order to comply with the proof of loss requirements of your disability policy.
I was diagnosed with Bi Polar 1 in 2009. I have had several manic periods since then as well as depressive periods. I currently am in a severe depressive state. I have private disability insurance and am currently recieving LTD payments. I am seeing a doctor who has been adjusting medications and dosages for about a year now with no real benifits. During my manic episodes I spent too much money and am now strugling with extreme debt which adds to my anxiety and depression. I have lost my company after 30 years due to this illness and am dependant on my disability benifits to survive.
I basically sit at home 24/7 and only leave the house to run errands and visit family. Do to my isolation, I have lost contact with friends and every time I think about the prospects of looking for a job my anxiety and depression only get worse. I have lost a considerable amount of weight and need to excersize, but I’m afraid that I may loose my benefits if I go to a gym. My doctor says that excercise can also help with my mental state.
Am I allowed to go to a gym to excercise or is that a red flag of some sort for my insurance carrier to deny further payments on my claim?
AW, I am sorry to hear of your troubles. While we have seen insurance companies use exercise as an excuse for denying a claim, your doctor has essentially prescribed such for you. Thus, if you exercise the insurance company should be praising you for attempting to better yourself so that you can get off claim. There is no way we can predict how your insurance carrier will treat it, but should they deny your claim for that or any reason we will gladly review your claim and hopefully be able to assist you in getting back on claim. Please feel free to contact us for a free consultation.