In Canada, long-term disability (LTD) claims for mental disorders, such as depression and anxiety, make up the majority of claims filed each year.
While anxiety is recognized as a disorder that can significantly affect an employee’s ability to perform their job duties, it’s common for insurance companies to deny these kinds of legitimate claims.
There is no shortage of excuses that insurers will use to prevent claimants from accessing LTD benefits, which can have a profound impact on their mental and financial health.
READ MORE: 3 things that can help reduce stress when dealing with a long-term disability insurer
If you are planning on submitting a claim for anxiety, don’t lose hope. By understanding why insurance companies turn down these claims beforehand, you can increase the likelihood of your application being approved.
Here are three reasons commonly used by insurers to deny anxiety-based claims.
1. You didn’t provide “sufficient” medical evidence
When you apply for LTD benefits, your insurance company will require your doctor to submit a physician statement. This document should clearly outline why you can’t work due to your anxiety.
However, insurers often turn down anxiety-based claims – arguing that the treating doctor didn’t properly detail the disabling nature of the disorder.
Before submitting the physician statement, carefully review it. Make sure your doctor did explain why your anxiety is so severe that you aren’t able to perform the duties of your job.
READ MORE: ‘Get full support from your doctor’: Disability lawyer’s guide to making insurance claims
One of the firm’s clients, a bank teller struggling with social anxiety disorder, applied for disability benefits.
Roughly a week later, his insurance company informed him over the phone that his LTD claim had been denied because his treating doctor didn’t clearly outline why he couldn’t work due to his anxiety.
Before ending the call, the bank teller asked his insurer to provide him with the denial in writing. Once he received the denial letter, he immediately contacted Samfiru Tumarkin LLP.
When our lawyers reviewed the physician statement, it was clear that the individual’s doctor did explain why he couldn’t perform the duties of his job.
READ MORE: What to expect when hiring a lawyer to fight your disability claim denial
The report specifically noted that he suffered severe panic attacks when leaving his house and struggled to focus when faced with a variety of stressors.
After bringing our findings to the bank teller’s insurance company, we were able to secure proper compensation for the employee.
2. Your treatment plan isn’t appropriate
Once you claim your anxiety is so severe that you can’t work, expect your insurer to review your treatment plan.
Over the years, we have been told by many clients that they were denied disability benefits because their insurance company didn’t believe their treatment plan was appropriate or argued they weren’t following treatment recommendations.
READ MORE: Insurer’s medical consultant doesn’t think you’re disabled? 3 things to do
In addition to confirming that you are seeing your doctor on a regular basis, insurers often check the medications you have been prescribed for your anxiety and whether you are participating in counselling.
Counselling is viewed as a crucial part of the treatment process. It’s very important that you ask your doctor about the counselling options available to you.
If you don’t feel a specific treatment for your anxiety is working, tell your physician immediately. Depending on your situation, it might be necessary for you to be referred to a psychiatrist.
3. It’s a workplace issue, not a disability matter
When employees file a disability claim related to a toxic workplace, many insurance companies in Canada are quick to take the position that it’s an employment issue rather than a disability matter.
In this situation, insurers argue that claimants don’t need access to LTD benefits because they should be able to return to work once their workplace isn’t toxic. However, it’s not that simple.
If your anxiety was caused by bullying or harassment at work, make sure your doctor clearly outlines why you can’t perform the duties of your own occupation instead of just your job.
READ MORE: Invisible illnesses: Can I still get long-term disability even if I don’t look sick?
Every LTD claim involving anxiety is unique. Claimants will require varying degrees of treatment before they can return to work – regardless of what caused it.
Let us fight for you
If you are denied or cut off from disability benefits for any reason, contact an experienced disability lawyer at Samfiru Tumarkin LLP before appealing the insurance company’s decision
Our firm regularly resolves LTD, life insurance, critical illness and mortgage insurance claim denials across Canada.
READ MORE: Insurer being difficult? 3 reasons you should hire a long-term disability lawyer
We know the law and have helped numerous clients, including Sandra Bullock and Julie Austin, hold insurers accountable after their claims were denied or cut off prematurely.
Our lawyers provide free consultations and don’t get paid unless we secure the compensation from your insurer that you are legally entitled to.
Long-term disability claim denied? Asked if you want to appeal the insurance company’s decision?
Contact the firm or call 1-855-821-5900 for a free consultation with a disability lawyer. We can help individuals anywhere in Canada (except Quebec). Get the advice you need and the compensation you deserve.
Sivan Tumarkin and Martin Willemse are disability lawyers at Samfiru Tumarkin LLP, Canada’s most positively reviewed law firm specializing in employment law and long-term disability claims. The firm provides free advice on Canada’s only Disability Law Show on TV and radio.