• Beware of Mental Nervous Limitations in Long Term Disability Benefit Policies?

Disability Companies Are Wrongfully Using the 24 Month Mental Nervous Limitation

Every person that experiences pain also has a secondary dysfunction of their mental state. How could a person be in good spirits when he or she is suffering from a painful medical condition and unable to work? In this video, disability insurance lawyers Gregory Dell and Stephen Jessup discuss how disability insurance companies are manipulating the mental nervous limited pay period provision in order to deny long term disability benefit claims. We welcome your comments and feedback on this issue which we battle for claimants on a daily basis.

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There are 2 comments

  • Steve,

    First and foremost, contact your HR department to secure a copy of the long term disability policy. If your policy does contain a 2 year mental health limitation and your condition does not fall into any exception (if any), then it may in fact be limited to the 24 months. That being said, just because your claim has been approved it does not mean that it will continue to be approved for the full 24 months as disability is a month to month analysis. Your policy will require you to be under the appropriate care of a physician/treatment provider- if your doctor wants you to come every couple months it is arguable you will satisfy the appropriate care provision. However, with mental health claims Sedgwick will certainly expect that you have monthly if not bi-weekly visits if your condition is to be deemed severe enough to qualify for disability. Please feel free to contact our office should you have additional questions.

    Stephen JessupNov 14, 2014  #2

  • Hello Mr. Dell,

    I have been on disability for about 15 months. I was sent to an independent medical examiner and afterwords I received notification that my long-term disability was approved.

    Will my claim most likely be closed once the 24 month period hits because it is mental health? I noticed on my online claim information that it says RTW and then the date just happens to be at the 2 year mark.

    How can I obtain my employers group disability policy rules that Sedgwick follows?

    Since my long-term disability was approved does that mean I am approved at least up until it hits 24 months? Or will it be an ongoing approval type system like in the beginning of the claim process?

    Is there a certain limited amount of time that can pass in between doctor visits? A couple months or possibly longer?

    Any advice that you have is greatly appreciated.

    Thank you,

    SteveNov 13, 2014  #1

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