Question

Is there any case law in which a state government employee LTD plan decided to drop the 24 month mental health limitation? Has there been any success against a state government and Standard using ADA Title I (employee) and 3 (insurance company) from a discrimination basis?

Asked on May 9th 2018 by Marie K.
Your website is very helpful in providing information about litigation re: long term disability insurance. Two questions and then my specific situation. 1). Is there any case law in which a state government employee LTD plan was compelled (or decided to) drop the 24 month mental health limitation because of it’s implementation of the mental health act? 2). Has there been any success against a state government and Standard using ADA Title I (employee) and 3 (insurance company) from a discrimination basis. I retired from state government on a service disability a year ago and am receiving LTD benefits from Standard for mental disability. At the time I retired, I was advised that my mental conditions (resulting primarily from workplace issues but also organic causes) were deemed severe enough for the State Retirement Board for a finding of total disability and Standard was helpful in accepting and utilizing this finding in approving my claim. I was told that I needn’t include documentation of my physical conditions. I was notified a month ago that my disability benefits will cease at the 24 month mark due to a limitation for mental conditions in my group policy. Standard has said that if I can go back and document all of my physical conditions they will look at a reclassification. I find that approach really difficult because there is no way to eliminate the mental and come up with a purely physical dx. I know that the 24 month limitation for mental health is common but are we at some kind of a tipping point in litigation where at least state governments, who cannot legally discriminate against the public for mental health conditions, can be made to stop discrimination against their own employees? Specifically, has Standard ever lost a case involving a state long term disability plan?

Answer

Answered on May 10th 2018 by Attorney Alex Palamara

Marie, thank you for your compliments on our website. We strive very hard to get as much information out there as possible. With regards to your initial questions, I know of no case law that has compelled a state government employee LTD plan to drop the MH limiting language. Also, I know of no success using the ADA Title 1 and 3 to change the policies. Regarding your specific claim, often times MH limiting language can have exceptions for MH claims resulting from an organic cause. We will need to review your actual policy to see if there is a possible exception for your claim. Please feel free to contact us so that we can review your policy for you.