The COVID-19 pandemic has devastated public health and economic stability worldwide. The rapid changes in our society have also affected mental health.
A U.S. Census Bureau poll found that over 42% of people reported anxiety or depression in December 2020, which was up from 11% in 2019.
Your health should always be a top priority. If your mental health suffers, this can impact your ability to work. Short-term disability benefits can help you bridge the financial gap as you focus on recovering your health.
In this article, we’ll cover everything you need to know about claiming short-term disability for mental health and what to do if your claim is denied.
Table of Contents:
- When to seek short-term disability benefits
- Does mental health qualify for short-term disability?
- How to get short-term disability for mental health
- What if your claim is denied?
- How to streamline the claims process
When to seek short-term disability benefits
When you’re going through mental health issues, you might struggle to find motivation or to achieve sharp focus. Or you might have issues organizing your thoughts or managing your stress levels.
If you continue to work while you’re experiencing symptoms like these, it could make your condition worse. It could also lead to termination if you can’t perform essential job duties.
If your mental health has compromised your ability to work, it might be time to consider your short-term disability options. Every insurance policy is different, so you will need to check your plan documents from your employer to determine what benefits are available to you. We’ll come back to that in a minute.
Don’t be ashamed to seek help
If you’re struggling with a serious mental health issue, there is no shame in seeking help! We all struggle with life’s hurdles from time to time.
The past year has placed enormous amounts of stress on all of us. It is absolutely understandable if you, like so many others, are having a hard time coping.
That’s why the Family and Medical Leave Act was expanded in 2020. It now allows you to take leave if you are sick with COVID-19 or caring for ill family members. Some states, such as Washington, even offer paid leave to residents in these cases.
Does mental health qualify for short-term disability?
Yes, mental health can qualify for short-term disability, depending on your specific situation. To qualify, you must be able to show that your mental health condition is preventing you from working or performing the essential duties of your job.
Mental health conditions that might be covered, depending on your plan:
- Clinical depression
- Anxiety disorder
- Stress conditions like Post-Traumatic Stress Disorder (PTSD)
- Ongoing addiction problems
- Bipolar or panic disorders
If you’re struggling with carrying out everyday tasks due to a mental illness, it might be time to file a short-term disability claim. Let’s look at how to file a claim in more detail now.
How to get short-term disability for mental health
Determine your eligibility
Before you do anything else, you must contact your Human Resources department to make sure that your employer offers short-term disability coverage. It’s important to understand that not all employers provide short-term disability insurance as part of their benefits package.
To be eligible for short-term disability benefits, you must have a certain number of working hours and a qualifying condition covered by your policy. Mental health may or may not be covered in your plan, so you should check your plan documents to determine your eligibility.
Once you have verified that your employer does offer this benefit and that the policy covers mental health conditions, then you can move forward with the process of filing a claim.
Gather your supporting documentation
You must provide documentation to prove that your mental health condition is preventing you from performing the essential duties of your job. Your company’s HR department or your “claims administrator” for your insurance company should be able to point you in the right direction as to what documentation is required.
You will typically have to fill out three different forms. These include:
- An Employee Statement that you fill out
- An Employer Statement for your company
- An Attending Physician statement that your doctor completes
Note: If you see multiple doctors for your condition, you will need each one to fill out an Attending Physician statement. If you have multiple therapists or a therapist and a psychiatrist, they should all complete a form.
Submit your forms to your claims administrator
After you finish your forms, you will typically submit them to your claims administrator — but make sure to check any instructions on the forms themselves to be sure.
How long does it take to get short-term disability benefits?
The amount of time it takes to receive short-term disability benefits can vary depending on your condition and your claims administrator. Generally, once a claim is submitted, you can expect to begin receiving benefits anywhere within one to 14 days.
Generally, once a claim is submitted, you can expect to begin receiving benefits anywhere within one to fourteen days.
However, this timeline may be impacted by various factors, such as the nature of the medical condition, the complexity of the claim, and the specific policies of the claims administrator. It’s important to keep in touch with the claims administrator to get an accurate timeline for when you can expect to receive benefits.
What if your claim is denied?
Most insurance policies come with some limitations.
For example, some disability policies will not cover pre-existing conditions. If your mental health condition is ongoing, your provider might not cover this condition under disability insurance.
If your short-term disability claim is rejected, you will receive a denial letter in the mail. This letter will tell you why your claim has been denied and explain the specific reasoning behind it. It will also provide you with instructions on how to appeal the decision.
You have the right to appeal
If your short-term disability is denied, you have the right to file an appeal, but time is of the essence. After you receive the denial letter, you must file an appeal within 180 days.
When you submit your appeal, you should include plenty of information justifying your case. If you originally submitted incomplete medical records, make sure you send complete and updated medical evidence.
You could also include a personal statement detailing how your mental health issue impacts your ability to work. You might ask friends or family members to send in letters of support, too.
How to streamline the claims process
The process for filing a disability claim can be complicated. It can be especially difficult if you’re dealing with a serious mental health condition. That’s why we recommend hiring an experienced lawyer to assist you throughout this process.
Roy Law Group specializes in going up against disability insurance companies. Our highly trained and compassionate lawyers can help you through every step of the short-term disability claim process.
Having a disability lawyer on your side exponentially increases the chance your claim will be accepted. Roy Law Group will take the hassle out of this process so you can focus on what matters: your health and well-being.
Get legal support today
If you’re planning to claim short-term disability for mental health, Roy Law Group is ready to help. We have been helping people like you to secure their disability benefits in Portland, Seattle, and throughout the West Coast since 2009. Our experienced legal team can walk you through every step of this process.
Contact us today to learn more about why Roy Law Group is right for you!