Claiming long-term disability for depression? 5 things to know

Long-term disability (LTD) claims for mental disorders, such as depression, make up the lion’s share of claims in Canada.

Despite depression being recognized as a disorder that can affect an employee’s ability to perform their job duties, many insurance companies still deny legitimate depression-based claims.

A common excuse used by insurers to turn down these LTD claims is that depression is subjective and based on the self-reporting of the claimant.

READ MORE: 4 reasons why long-term disability claims are rejected

If you plan on filing a claim for depression, don’t lose hope. Here are five things you need to know as you apply for disability benefits.

1. LTD policies require you to be under the regular care of a physician

Insurance companies will review your physician’s clinical records to check how often you are seeing them for your depression, and to assess what symptoms, restrictions and limitations you have reported.

By seeing your physician on a regular basis and providing honest updates on the severity of your symptoms, it becomes more difficult for your insurer to turn down your LTD claim.

READ MORE: Most common mistakes people make when they are denied long-term disability

2. Make sure the treating doctor details your restrictions and limitations

Many depression-based claims are denied by insurance companies because the treating doctor didn’t detail the disabling nature of the depression.

There are several restrictions and limitations that can be caused by depression, including fatigue, low stress tolerance and the inability to multitask.

When applying for LTD benefits, your insurer will require your treating doctor to submit a physician statement.

Before handing it in, double-check that your doctor clearly explained why your depression is so severe that you are unable to perform important duties of your job.

READ MORE: ‘Get full support from your doctor’: Disability lawyer’s guide to making insurance claims

The more supporting medical information you are able to provide, the higher the likelihood your LTD claim will be approved.

3. Have an appropriate treatment plan in place and follow recommendations

If you claim your depression is so severe that you can’t work, your insurance company will check that you have an appropriate treatment plan in place.

Several of my clients have told me they were denied disability benefits because the insurer didn’t believe their treatment plan was appropriate or argued they weren’t following treatment recommendations.

READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment

If you don’t feel a specific treatment for your depression is working, inform your doctor immediately and ask them to recommend an alternative.

4. Get a referral to a psychiatrist

When reviewing depression-based claims, insurance companies often look to see if claimants have been referred to a psychiatrist.

If you don’t have a referral, and your condition isn’t improving following treatment with your family physician, some insurers will use this as an excuse to turn down your LTD claim.

READ MORE: Invisible illnesses: Can I still get long-term disability even if I don’t look sick?

Although wait lists for psychiatrists can be long, getting a referral and putting your name on a list is crucial if your depression isn’t improving.

5. Counselling can support your LTD claim

To treat your depression, your doctor might recommend medication, such as antidepressants.

If the medication isn’t effective or is causing side effects, your insurance company will want to know what other steps you are taking to improve your condition.

Participating in regular counselling, such as cognitive behavioural therapy, helps support your claim for disability benefits.

How a disability lawyer can help if your depression-based claim is denied

In my experience, insurers are hoping you will throw in the towel after they turn down your LTD claim. Unfortunately, many people do give up because they don’t know how to fight back.

If you are denied or cut off from disability benefits, it’s a good idea to talk to an experienced disability lawyer, like the ones at Samfiru Tumarkin LLP, before appealing the decision.

READ MORE: Insurer being difficult? 3 reasons you should hire a long-term disability lawyer

Our firm regularly resolves LTD, life insurance and mortgage insurance claim denials across Canada.

We know the law and have helped numerous clients, including Sandra Bullock and Julie Austin, hold insurance companies accountable after their claims were denied or cut off prematurely.

We 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.

Martin Willemse is a disability lawyer and partner 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.

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