Statistics from the Mental Health Commission of Canada show that mental illness accounts for 70 percent of disability costs in the work place. One in every five Canadians will experience mental disability at some point in their life and one third of both long term and short term disability claims are related to mental health problems. As a victim of mental disability, you are entitled to seek disability benefits. Unfortunately, it is not easy to get your claim approved because the process is complicated. Additionally, employers rarely understand mental disability, so you are likely to run into problems while trying to get the help you need. If you find yourself being a victim of mental disability, you should never try to pursue a claim on your own because you are likely to be frustrated in the process. Having a mental disability lawyer to help you navigate the process will make it less overwhelming and increase your chances of success significantly.
What is Mental Disability?
You have mental disability when you cannot perform the functions of your job due to a mental illness, also known as an “invisible illness”. It is invisible because it cannot be diagnosed in the same way as physical illnesses or injuries. A mental illness may be caused by different factors such as a traumatic event like an accident, death of a loved one, physical illness or work place stress. The most common conditions that lead to mental disability are depression and anxiety. Other conditions that lead to mental disability include:
– schizophrenia
– organic brain disorders
– affective disorders
– bipolar
– dementia
– autism, and
– personality disorders.
All the conditions are largely based on subjective evidence- how you experience the illness.
Symptoms of Disabling Depression and Anxiety
You know that you have depression if you suddenly lose pleasure or interest in activities that you used to enjoy, you have a feeling of sadness, suicidal ideation, you have difficulty concentrating, lack of motivation, changes to sleeping patterns, mood changes and an increase or decrease in appetite.
On the other hand, if you have anxiety, you will experience the following symptoms among others: nausea, sweating, shaking, a racing heart, agoraphobia, decreased appetite, anxiety attacks, difficulty sleeping, decreased appetite and difficulty in cognition. Symptoms of depression or anxiety can affect your ability to function in the work place.
How to Prove Mental Disability & Mental Disability Claims
Insurance companies usually assess the extent of your mental disability through a mental residual functional capacity assessment (RFC). This is a detailed report outlining how your mental disability affects the functions of your job. A RFC will evaluate the following activities among others:
- Can you follow simple directions?
- Can you work in a job setting without extra supervision?
- Are you disruptive to others at the work place?
- Can you make simple work-related decisions?
- Can you interact with the public well?
- How do you respond to criticism from your supervisors?
When making a mental disability claim, you should make sure that you have objective evidence that addresses these questions. If you support your claim with a general medical report that does not go to specifics, you are likely to get a denial.
Pre-existing Conditions: A Barrier to Receiving your Mental Disability Benefits
If you take out your own insurance, you are required to respond to a series of questions relating to your health history. If your employer takes a group cover for you, the insurer does not have the opportunity to ask these questions. Consequently, the insurer will have an exclusion for pre-existing conditions in the policy.
Disability for Mental Illness
The clause, bars you from making a claim based on a condition which you have suffered from before. This becomes problematic because if you have had mental issues in the past, it is probable that you will have the issues again, though it may not be disabling or prevent you from working. This, coupled with the difficulty in proving mental disability, explains the high rate of denial of mental disability claims.
Why a Mental Disability Lawyer?
Since mental disability claims are some of the most difficult to prove, you need the help of a person who has the requisite training and experience. An experienced mental disability lawyer knows the exact kind of medical reports to support your claim. The lawyer also knows when to go to the next doctor if your current one is not willing to give an objective report detailed enough to help you succeed in your application. If you receive a denial, your lawyer will be able to evaluate the reasons for denial and collect the right evidence to support an approval. The lawyer will also know when a denial is baseless and meant to delay your claim. If this is the case, there will be no need to appeal internally. The lawyer will immediately file a case in court to have the decision of the company overturned.
