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.

psychologist disability insurance denial

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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Disability Company Reviews
(641)
Showing 8 of 641 Reviews
New York Life

Keeps claiming they will not approve claim for pre existing conditions but my illness is not preexisting

Reviewed by M.T. on February 15th 2024   Verified Policyholder | May 2023 date of disability
I have been appealing a claim for LTD for 8 months! New York Life keeps claiming they will not approve claim for pre existing conditions but my illness is not preexisting ... read more >
Reliance Standard

Staff Lie

Reviewed by Tanya on February 12th 2024   Verified Policyholder | August 2021 date of disability
I had my disability cut off the day I was scheduled to find out whether I should have surgery. The claims examiner was aware that I had an appointment on that date and sai... read more >
Reply
Sent on February 12th 2024 by Attorney Gregory Dell

I am sorry to hear about your experience. It’s crazy that Reliance Standard would deny your disability benefits when you are suffering so badly that you need surgery.... read more >

Hartford

Former Hartford employee has had life insurance and accidental death policy's revoked for one late premium payment

Reviewed by Becky H. THOMAS on February 12th 2024   Verified Policyholder | February 2024 date of disability
Dislike how they are constantly interrupting the lives of their disabled EE's whom are entitled to benefit which they paid into out of there pay check every pay period onl... read more >
Reply
Sent on February 12th 2024 by Attorney Gregory Dell

Thank you for your review of Hartford and we appreciate you sharing.  It’s sad they don’t take care of their own employees.

Lincoln Financial

Never received benefits my entire leave - or help with them

Reviewed by Anna on December 19th 2023   Verified Policyholder | November 2023 date of disability
I used my short term disability insurance for maternity leave and started the process beforehand knowing when I would be out (scheduled induction.) It took a little over a... read more >
Sun Life

Unscrupulous Tactics

Reviewed by Misseekayy on December 19th 2023   Verified Policyholder | May 2023 date of disability
Sunlife uses unscrupulous tactics in order to prevent payment of claims. They wait until it is close to the 30 day mark and then they ask for another form of information o... read more >
Sedgwick

Lame

Reviewed by Dennis T. on December 11th 2023   Verified Policyholder | March 2022 date of disability
My experience with Sedgwick and personell is as follows: Unhelpful, unprofessional and an overall unpleasant experience.
Unum

Low payments

Reviewed by Dorothy on November 30th 2023   Verified Policyholder | November 2023 date of disability
I was injured at work. I did house keeping in a hospital. I tore just about everything imaginable in my knee. I was let go from my job, because I was no longer able to do ... read more >
Lincoln Financial

Well Documented correspondence

Reviewed by Joshua on November 23rd 2023   Verified Policyholder | May 2023 date of disability
I read other situations and it’s all very similar to my case. I have received STD from May 2023 and when my FMLA run out LF would not respond or answer my calls. My last... read more >
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Our client came to us after he was denied continued Long Term Disability (LTD) benefits by The Lincoln National Life Insurance Company. Previ... Read More >

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Unum Wrongfully Terminated Disabled Lawyer’s Disability Claim of Depression and Anxiety Despite Improvement in His Condition

This Unum lawsuit and appeal in federal court is a great victory for all Unum disability claimants. This ca... Read More >

Federal Court Overturns Aetna Denial Of Disability Benefits

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Companion Life tried to play games and deny long term disability benefits, but thankfully a New Mexico Federal Judge made them pay disability ... Read More >

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In Darren Mickell v. Bert Bell/Pete Rozelle NFL Players Retirement Plan (Plan), Mickell spent nine years in the NFL as a defensive e... Read More >

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