When it comes to filing a long-term disability (LTD) claim, understanding how psychological conditions are evaluated is critical. Psychological conditions often carry a stigma, and many claimants worry about whether their struggles will be taken seriously. However, these conditions can be just as debilitating as physical illnesses, affecting your ability to perform daily activities and maintain employment. In this blog, Bartolic Law aims to empower you with knowledge about the evaluation process, helping you advocate for the benefits you rightfully deserve.
Psychological conditions like depression, anxiety, and post-traumatic stress disorder (PTSD) are some of the most common reasons individuals file for LTD benefits. Unfortunately, mental health issues can often be harder to prove compared to physical impairments, largely because they lack obvious physical evidence like lab results or imaging tests. Insurers might question the severity of your condition or attribute your challenges to temporary stress. This makes it essential to understand what insurers look for, how evidence is evaluated, and what you can do to strengthen your claim.
Long-term disability insurers typically assess psychological conditions using a combination of medical evidence, clinical evaluations, and documentation of your daily life. Below is a breakdown of the key components:
Your treating physician or psychiatrist plays a crucial role. Their diagnoses, treatment records, and specific examples of how your condition impacts your functionality serve as primary evidence. For example, a psychiatrist noting that your depression causes an inability to concentrate or complete tasks supports the argument that you can’t fulfill job responsibilities.
Insurers rely on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or similar frameworks to determine whether your condition meets specific criteria. This helps establish that your condition is recognized as legitimate in the medical community.
Your insurer may request an evaluation by a third-party specialist. While these evaluations should be impartial, remember that their purpose is often to confirm or refute your claims. You have the right to seek legal support before undergoing an IME.
Your claim will often hinge on how your condition affects your ability to work. Employers, coworkers, or family may be asked to provide statements about noticeable changes in your performance or behavior. Insurers may also look at vocational expert assessments to understand whether your job’s demands are manageable given your symptoms.
Below are common psychological conditions that LTD insurers evaluate:
Reduced energy, inability to focus, or sleep disturbances that impact work performance.
Intrusive thoughts, flashbacks, or emotional triggers that disrupt concentration or interpersonal relationships.
Severe mood swings that interfere with maintaining a stable work schedule.
Intrusive obsessions or compulsions that consume excess time, limiting productivity.
To improve the likelihood of approval, consider the following:
Include documentation like physician notes, treatment plans, and progress reports.
Ensure your healthcare provider understands precisely how your symptoms affect your daily functioning and job performance.
A detailed journal showing how your condition impacts your daily life can serve as compelling evidence.
Insurers often argue that lack of consistent treatment shows your condition is not severe. Ensure you adhere to prescribed therapies.
A knowledgeable attorney can help you avoid common pitfalls, appeal denials, and guide you toward the evidence insurers require.
Filing a long-term disability claim for a psychological condition can feel daunting, but securing the benefits you earned is possible with the right preparation. At Bartolic Law, we’ve successfully helped clients whose mental health has prevented them from working. Whether your condition is anxiety, PTSD, or depression, we’re here to guide you through the process and hold insurers accountable. Contact us today for a consultation, and allow us to help you secure the financial stability you deserve.
Attorney Advertising. This information is designed for general information only. The information presented should not be construed to be formal legal advice nor the formation of a lawyer/client relationship. Past results and testimonials are not a guarantee, warranty, or prediction of the outcome of your case, and should not be construed as such. Past results cannot guarantee future performance. Any result in a single case is not meant to create an expectation of similar results in future matters because each case involves many different factors, therefore, results will differ on a case-by-case basis. By providing contact information, users acknowledge and give explicit consent to be contacted via the methods of communication provided, including SMS. Message and data rates may apply. Message frequency may vary. Reply STOP to opt out.
NUVEW | Copyright 2025 All Rights Reserved | Privacy Policy
