Psychologist & Psychiatrist Disability Insurance Claim Tips
By Gregory Dell and Alex Palamara
Presenting a long-term disability insurance claim as a psychologist or psychiatrist begins with establishing clear evidence of why you are no longer able to do your job. While most insurance carriers simply assume a psychologist’s or a psychiatrist’s job is sedentary, often, it entails a lot more than merely sitting in a chair all day. The work of psychologists and psychiatrists is highly demanding in terms of cognitive tasks, and sometimes, it may also entail physical activity such as travel.
In addition, child psychologists, for example, may have to move around more – they may need to engage the child in play or outdoor activity which can be difficult if you are suffering from, say, chronic back pain.
Finally, the job of a psychologist or psychiatrist is extremely demanding and stressful when it comes to cognitive abilities. Diagnosing and treating patients can be intense, and psychologists and psychiatrists have a very unique set of skills and requirements for their occupation. The amount of focus and concentration throughout a day of seeing many patients is tremendous.
Unfortunately, insurance carriers often claim that it all boils down to the sedentary nature of the occupation: if the specialist can sit for more than six hours a day, then he or she is able to do their job. However, most psychologists and psychiatrists do not have the luxury of taking 50-minute breaks between sessions to rest, recover, or take their medication – instead, they need to be on their game throughout the entire day. This should be taken into account and detailed clearly when presenting your claim.
Importance of Medical Documentation
When the time comes for the psychologist or psychiatrist to file their claim for disability (or if they’ve been denied and need continuing medical support), it’s extremely important to have adequate medical support and high-quality documentation in order to get approved for benefits.
As a claimant, it’s your duty to prove your claim, and strong medical documentation of your condition is vital.
Keep in mind that doctors are not trained to prepare medical records for an insurance claim review, and that’s why it’s crucial to speak to your treating physician and ask them to document your medical condition and its progression in a detailed and clear manner. Most disability insurance claims are reviewed by lay people, so your treating doctor needs to be as clear and concise as possible when they’re documenting your condition, your complaints, and the way your condition is impacting your ability to perform your occupational duties. These medical records are objective evidence of your disability, and it’s important to have strong proof whether you’re on the claim or preparing an appeal if it’s been denied.
Definition of “Disability”
The demands of a psychologist or psychiatrist are extremely high: working with people who have eating disorders, substance abuse, sever depression, autism, and a myriad of other serious mental health issues is highly stressful. A mental health specialist must be focused and dialed in at all times, taking notes, and often dealing with a huge amount of responsibility as the patient might be in an extremely delicate state. Sometimes, it may even be a life-or-death situation. And while insurance carriers frequently try to play it down – “if you can sit in a chair for 45 minutes per session, it means you are able to do your job” – in reality, sustained high concentration and focus may be extremely difficult to achieve if you suffer from a condition like chronic pain.
An additional challenge may be the insurance company’s assumption that as a psychologist or psychiatrist, you are able to work from home. In the post-COVID world, remote work and being a “teledoc” is a possibility, and the insurance carriers might claim that this could be an option for you if you have difficulty traveling to your office. These are arguments are commonly made, and they are making disability insurance claims for psychiatric professionals even more challenging. However, as a claimant, it’s up to you to define your specific occupational duties and requirements and prove your claim.
Another important issue to note is the definition of disability. If you work for a practice as an employee, you likely have a group insurance policy governed by ERISA laws. Typically, that policy will define disability as “unable to perform the duties of your own occupation”. Sometimes, however, there might be a change in the definition of disability, so if you get benefits for a certain amount of time, after that period – whether it’s 24 months or 36 months – it might change to the definition of disability to your inability to perform “any occupation”. In other words, you have to be unable to perform the duties of any occupation for which you’re qualified based on your training, education, and experience.
If you have your own individual disability insurance policy, this will typically be governed by state law. Mostly, those definitions of disability are “own occupation” policies requiring you to prove to the insurance company that you can’t do your own occupation (your own specialty).
Either way, as a claimant, you have to clearly explain to the insurance company what it means to do your job. Often, insurance carriers look at the job description under the Dictionary of Occupational Titles where the government puts out what they believe are the general requirements of being a psychiatrist or psychologist or someone in this field. However, you have to go above and beyond that.
In our experience as disability attorneys, we often do our own vocational reviews or vocational studies to show the insurance company what the actual requirements of the job are and prove that it’s more than just sitting there and talking to people all day and that this is way more encompassing than just being a sedentary job. We focus on the cognitive demands of your job. This is a crucial step in preparing your long-term disability insurance benefits claim as a psychologist or psychiatrist.
When to Get a Disability Lawyer Involved
Seeking the assistance of an experienced disability attorney can greatly increase the chances of a successful claim or appeal outcome for psychologists and psychiatrists. Here at Dell Disability Lawyers, we have extensive knowledge and experience in working with mental health professionals to help get their disability insurance claims and appeals approved.
We recommend browsing this site for more information on your specific disabling condition, insurance carrier, or occupation and using our resources to educate yourself on how to best prepare your claim. We have summarized hundreds of lawsuits, client reviews, and specific questions you may have to help you arm yourself with the best tools possible.
Alternatively, don’t hesitate to reach out for an initial free phone consultation. One of our experienced disability insurance attorneys will evaluate your case and let you know what we think of your claim and how we can best help you maximize the benefits under your policy. We serve clients all over the country, and we will do our best to get your benefits paid.
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New York Life
New York Life is a joke!
This company sucks when it comes to disability claims. They are slow at processing stuff, then they always say they didn't recieve the doctors information. You spend your ... read more >
MetLife
They FULL OF ****
MetLife is what everyone on this review are saying. They don't contact you to let you know what's going on with your claim or to let know you need additional info. I had a... read more >
Sedgwick
Worst Company Ever
If something happens to you at work you better hope you die, my son is going through HELL because this company is handling his work comp. NO RETURN PHONE CALLS, TEXTS, EMA... read more >
MetLife
MetLife for disability? Avoid the surgery unless it's life-threatening
The worst company I ever dealt with, never received a call from my claim manager.
Reliance Standard
Short Term Disability Claim/Inconsistent to NO Communication
When I did call & reach a live person they were kind & helpful. The person assigned to my claim left one phone message & I have not spoken to her since. Information she re... read more >
Unum
Unum Closed My Case Today
Unum will keep you around, if they pay you 100 a month. But as soon as have to pay more than 2700 a month, they will drop you. We will be going to the attorneys office fir... read more >
Prudential
Denied but Not Denied but I am Denied
I went out in Aug. 2022 for neck pain. After seeing a neurologist I had to get an ACDF C5-7, it was also determined I had carpal tunnel in my right hand and bulging disk i... read more >
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