Post Traumatic Stress Disorder (“PTSD”) is a mental health condition caused by experiencing or witnessing trauma. The resulting symptoms of PTSD can significantly impact your ability to work and function in daily life. For individuals who are struggling with PTSD, short or long term disability insurance can provide financial support when you become unable to work due to your condition.
In this article, we will discuss whether you can receive short term or long term disability insurance benefits for PTSD, how PTSD causes disability, how insurance companies evaluate PTSD claims, and how The Maddox Firm can prove your PTSD short or long term disability claim.
Can You Receive Short or Long Term Disability for PTSD?
Yes, you can receive short and/or long term disability insurance benefits for PTSD, as long as you meet the terms of your disability insurance policy. In most cases, your insurance company will define disability as being unable to perform the substantial and material duties of your occupation. This means that if your PTSD causes symptoms severe and frequent enough to interfere with your ability to work, you may qualify for short or long term disability.
It is important to note that not all disability insurance policies cover mental health conditions such as PTSD. Many disability insurance policies also contain what is called a “mental illness limitation.” A mental illness limitation refers to a provision that limits or excludes coverage for disabilities caused by mental health conditions, which can include PTSD. This means that if your disability insurance policy does cover a PTSD disability claim, it may limit paying out benefits to a certain time period (usually two years).
How Does PTSD Cause Disability?
PTSD can cause disability in various ways. PTSD typically occurs after experiencing or witnessing a traumatic event, such as military combat, sexual assault, natural disasters, abuse, or serious accidents.
Some people suffer from “medical PTSD” resulting from a traumatic medical diagnosis, traumatic medical symptoms, or traumatic medical interventions or treatment. Medical PTSD is a common reason for filing a short term or long term disability claim.
The resulting psychological and cognitive symptoms can cause significant impairment in your ability to perform your job functions.
Some of the ways PTSD symptoms can cause disability include:
Intrusive Thoughts and Memories: PTSD can cause intrusive thoughts and memories related to the traumatic event. These can be distressing and can interfere with your ability to concentrate and carry out daily activities.
Flashbacks: Those with PTSD may experience flashbacks, which are vivid and intense memories of the traumatic event. Flashbacks can be triggered by specific stimuli and cause you to relive the traumatic experience, therefore inducing intense anxiety.
Depression and Anxiety: PTSD can cause depression and anxiety, which can interfere with your ability to work and carry out daily activities.
Avoidance Behaviors: People with PTSD may develop avoidance behaviors, such as avoiding places or situations that remind them of a traumatic event. Avoidance behaviors can limit your ability to engage in work or social activities and can impact your ability to form relationships.
Hypervigilance: PTSD can cause hypervigilance, which is a state of heightened alertness and anxiety. Hypervigilance can cause you to be easily startled, have difficulty sleeping, and experience mood swings. These symptoms can impact your ability to function in your personal and professional life.
Emotional Numbing: People with PTSD may experience emotional numbing, which is a sense of detachment from their emotions and the people around them. Emotional numbing can impact your ability to communicate effectively with others.
Substance Abuse: Some people with PTSD may turn to drugs or alcohol as a way to cope with their symptoms. Substance abuse can lead to addiction and can further impact your ability to function at work and in your personal life.
How Do Insurance Companies Evaluate PTSD Insurance Claims?
When evaluating PTSD insurance claims, insurance companies will demand proof that your diagnosis and symptoms are backed by medical evidence, as well as proof that you cannot work due to these symptoms. It is important to note that your insurance company may deny your PTSD short or long term disability claim if they believe that your symptoms do not meet the definition of disability under the policy, if you are not complying with treatment recommendations from your providers, or if they do not believe your PTSD interferes with your ability to work in your own occupation.
Proving a PTSD disability claim can be especially challenging due to the subjective nature of mental health conditions, the stigma surrounding mental health, and the complexity of PTSD symptoms.
Unlike physical conditions, there is no objective diagnostic test for PTSD. Medical evidence to support a PTSD claim may rely on your self-reported symptoms and the opinions of your treating physicians and mental health professionals. It can be difficult to quantify and qualify the extent to which PTSD symptoms impact your ability to work.
Unfortunately, there is still a stigma surrounding mental health conditions, which can lead to skepticism and discrimination from insurance companies. Some insurance adjusters and claims examiners may not fully understand PTSD symptoms or how they can impact your ability to perform your occupation.
It is important to work with a mental health professional and an experienced disability attorney to build a strong case and overcome these challenges.
What Evidence Can I Use To Support A PTSD Disability Claim?
To support your PTSD disability claim, your insurance company will look for both medical evidence establishing your diagnosis and symptoms and vocational evidence that demonstrates the nature of your occupation and why you cannot perform your job duties due to your condition.
Medical Evidence for PTSD Disability
Objective medical evidence is one of the most important kinds of documentation insurance companies take into consideration. While PTSD symptoms tend to be subjective in nature, there are many kinds of medical evidence you can submit in support of your short or long term disability claim.
Medical evidence for PTSD disability claims may include:
Medical Records: Your medical records should document your PTSD diagnosis and any treatment you have received for PTSD. This can include medication, therapy, and other forms of treatment. Oftentimes mental health professionals have policies against releasing session notes. Alternatively, you can request your providers to proffer a summary of treatment. The summary of treatment would list your diagnosis and dates that you have treated with the provider. This summary can also be helpful in demonstrating the extent of your treatment.
Supportive Letter from Mental Health Provider(s): A supplemental letter from your mental health provider(s) can provide valuable evidence to support your disability claim. The letter should describe your PTSD symptoms, the impact of those symptoms on your ability to function, and your provider’s opinion on your ability to work.
Neuropsychological Evaluation: A neuropsychological evaluation can provide objective evidence of the impact of your PTSD on your cognitive functioning. This evaluation can assess your memory, attention, processing speed, and other cognitive abilities, and can provide evidence of any cognitive deficits related to your PTSD.
Statements from Family and Friends: Statements from family and friends can provide important information about how your PTSD is impacting your ability to function in your daily life. They can also provide insights into how your symptoms have changed over time.
Providing comprehensive medical evidence is critical to ensure that your PTSD disability claim is evaluated fairly and accurately. Medical records, supportive letters from mental health providers, neuropsychological evaluation reports, and statements from family and friends can all be used to support a PTSD disability claim.
Vocational Evidence for PTSD Disability
When filing a PTSD disability claim, it’s essential that your insurance company understand the nature of your occupation and all of your responsibilities and functions. Vocational evidence can be used to demonstrate the extent of your occupational duties and the impact of your symptoms on your ability to work.
Vocational evidence that can be used to support a PTSD disability claim may include:
Resume: Your resume can provide evidence of your work history, skills, and education. This can be helpful in demonstrating your prior work experience and the types of jobs you are qualified to perform.
Official Job Description: Your official job description from your employer can provide insight into the specific duties and requirements of your job.
Vocational Assessment: A vocational assessment conducted by a vocational expert can provide an objective evaluation of your ability to work. This assessment can analyze your education, work experience, and transferable skills, as well as any limitations related to your PTSD. The vocational expert will analyze your occupation and the labor market, review your medical records, and interview you to get the complete picture on what your job role entails on a day-to-day basis, and how your PTSD prevents you from being able to perform your duties.
Statement from Employer or Co-workers: A statement from your employer or co-workers can provide evidence of the impact of your PTSD on your ability to work. This can include their firsthand experiences witnessing any difficulties you have had performing your job duties due to the onset of your condition.
Don’t forget to include vocational evidence to support your PTSD disability claim. It’s important to demonstrate the extent of your occupational duties and how your PTSD symptoms limit you from performing your role. Your resume, official job description, vocational assessment, and statements from your employer or co-workers can all be used to provide evidence of your disability.
How Can The Maddox Firm Prove My PTSD Disability Claim?
Due to the subjective nature of its symptoms, PTSD disability can be particularly challenging to prove to your insurance company. An experienced ERISA attorney can help you navigate the claims process and maximize your chances of benefit approval. The Maddox Firm can help you handle your PTSD short or long term disability claim the right way.
Here are some of the ways The Maddox Firm can prove your PTSD disability claim:
We Examine Your Long Term Disability Policy: Your disability insurance policy is key to your PTSD claim strategy. The Maddox Firm will examine your disability insurance policy terms to determine if your PTSD is a covered condition, whether there are any benefit limitations, and what your insurance company requires to approve your claim.
We Gather Evidence of Your PTSD Symptoms: The experienced team at The Maddox Firm will work with your healthcare providers to obtain your medical records and supplemental statements to make certain the full scope of your PTSD symptoms are included in the evidence. We also will refer you for a neuropsychological evaluation that provides the insurance company a detailed and objective assessment of your cognitive deficits. If needed, we can also refer you for a vocational assessment by a trusted professional to provide your insurance company comprehensive information regarding your occupational duties. At The Maddox Firm, our goal is to make your PTSD short or long term disability claim as bulletproof as possible.
We Handle All Communications with Your Insurance Company: Your insurance company will likely use a variety of tactics to justify denying your claim. The whole process can be exhausting and overwhelming to handle on your own. The Maddox Firm will immediately take charge of all communications with your insurance company and make sure they evaluate your disability claim fairly. We ensure your insurance company receives the information they are entitled to while protecting your rights as a claimant.
You should always speak with an experienced attorney before filing your PTSD short or long term disability claim. If you have already received a denial, you should consult with an experienced attorney before filing an appeal. The team at The Maddox Firm will examine your insurance policy, correspondence from your insurance company, medical records, and any other relevant documentation in order to give you personalized guidance on how we can help you win your long term disability claim.
Contact us to help you file your claim, appeal, or litigation the right way.