A significant number of Canadians suffer mental health conditions that affect their ability to do their jobs. If they are unable to work for an extended period of time due to mental health concerns, they may qualify for long term disability Ontario mental health benefits. However, insurance companies impose some barriers that may make it difficult for some individuals to receive payment.

Long Term Disability for Mental Health Overview

The Canadian Mental Health Association estimates that one in five Canadians will experience mental illness during their lifetimes. In some cases, mental health issues can become so severe that they prevent a worker from being able to perform their job functions.

Mental health disability claims cost employers about $20 billion each year, according to the Mental Health Commission of Canada. One-third of all disability claims reportedly involve mental health, and account for about 70 percent of all disability payments in Canada.

People may suffer from mental health issues for a variety of reasons. Some people are born with certain mental health issues; others develop them following a life-altering event or other circumstances.

Mental illness can have a significant impact on many areas of a person’s life. Persistent mental health conditions can negatively affect a person’s employment, family life, social network, and their ability to cope with stress. When mental illness is severe, it may force a person to take a significant amount of time off of work while they get mental health treatment.

Unfortunately, individuals experiencing severe mental health issues may find that treatment can be expensive, especially if they are unable to work. Long term disability Ontario mental health benefits are designed to provide financial support to people who suffer from a mental illness that prevents them from working.

What Are the Barriers to Receiving Long Term Disability for Mental Health?

Insurance companies all too often seem to prioritize their bottom line over the health of people suffering from mental health issues. They seemingly seize on any opportunity to deny long term disability for mental health claims.

By its nature, mental health involves an “invisible” disability. Unlike a physical injury or trauma, there is no diagnostic imaging like an MRI or xray that can prove the existence of the disability. Often, the insurance company will thoroughly evaluate every mental health claim to find any reason to deny payment.

To maximize your chances of having your long term disability Ontario mental health claim approved, you should follow the directions provided by your insurance company. If you have concerns about these requirements, it is a good idea to reach out to a long term disability lawyer to learn more about your rights and obligations.

How to File a Claim

To file a long term disability mental health claim, you will need to follow the procedure set forth by your insurance company. Typically, you will need to provide documentation from your employer and a healthcare professional. Depending on the nature of your mental illness, you may also need to provide documentation from a psychiatrist and/or a psychologist and see them regularly for treatment.

If you have questions or concerns about putting together a compelling claim for your insurance company, you can contact a long term disability lawyer for assistance.

Why Was My Long Term Disability for Mental Health Claim Denied?

There are several reasons long term disability for mental health claims might be denied.

One reason is that, according to your insurance company, you are not getting “regular care” from a physician. For mental health cases, a patient typically must see a health care professional at least once a month to qualify for long term disability benefits. If you are taking medication to treat your mental health issue, you will likely need to be monitored carefully by your doctor to ensure the medication and dosage is helping.

If you fail to see your doctor on a regular basis, your insurance company will likely deny your claim, even if you have a legitimate mental health long term disability claim. Some doctors are booked out far in advance and it can be difficult to get an appointment. Ask your doctor to schedule your appointments on a regular basis to ensure you will have adequate monitoring and keep your insurer from denying your mental health claim.

NOTE: Your long term disability benefits provider may require you to see a psychiatrist in order to qualify. If you do not require ongoing treatment from a psychiatrist, you should still seek a consultation for your treatment. If you fail to see a psychiatrist, your insurance company may see that failure as a sign that your mental health issues are not severe enough to cause long term disability.

Your doctor may recommend that you see a psychologist as part of your mental health treatment. In this case, you absolutely need to attend the recommended appointments or your insurer may deny your disability claim.

Unfortunately, even if you are attending regular appointments with all of the professionals involved in your treatment, your claim could still be denied if your insurer decides they are not following best practices, or if they are not providing the proper documentation for your treatment. If you are concerned that your health care providers are providing inadequate care, it is a good idea to get a second opinion.

How Can I File an Appeal?

When an insurance company denies a long term disability claim, you should have the right to appeal the denial. The policy documents should explain how to file an appeal. You will likely be asked to submit additional documentation to support your claim.

To minimize the chances that your claim will be denied again, contact a long term disability lawyer to help you file your appeal.

How Can a Long Term Disability Lawyer Help?

A long term disability lawyer is knowledgeable about the tactics insurance companies use to deny claims. They can help you gather the evidence and supporting documentation you need to maximize your chances of having your long term disability for a mental health claim approved so you can get the payout you deserve.