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Is Your Long-Term Disability Due to Depression or Chronic Fatigue?

Employees in Chicago receiving long-term disability benefits often have comorbid conditions. One of the most common combinations is depression or anxiety coupled with pain or fatigue. Frequently, it isn’t clear which came first. Sometimes people get depression and anxiety because of their pain or fatigue. Many long-term disability insurance policies limit payment to 24 months for mental health related claims, such as depression or anxiety, while not limiting them for disabilities caused by pain or fatigue. Insurers will often apply the 24-month limitation if depression or anxiety are any part of the claim. But you can overcome this by showing you would be disabled even without the contribution of the mental health condition, as one recent case demonstrated.

In Veronica L. v. Metropolitan Life Insurance Co., No. 3:21-cv-1260, 2022 WL 112586 (D. Ore. Dec. 28, 2022), Veronica L. suffered from chronic fatigue syndrome as well as mental health conditions. After years of pushing through her symptoms, she reached a wall and stopped working in 2017. MetLife approved the claim, but on the basis of her mental health conditions alone, applying the policy’s mental health limitation. After Veronica unsuccessfully appealed, she filed a lawsuit under ERISA § 502(a) to establish she was disabled independently by her chronic fatigue syndrome and won.

The court observed that while MetLife agreed Veronica L. had chronic fatigue syndrome, its conclusion that there was no objective evidence of any functional limitation was flawed. The court faulted MetLife for insisting on objective evidence of something that is inherently subjective in nature and depends highly on the credibility of the patient’s complaints. But MetLife never sought to have Veronica L. examined or sought to speak to any of her doctors.

If an insurance company terminated your long-term disability benefits on the basis of a mental health limitation and you also suffer from physical ailments, speak to a skilled long-term disability attorney today.

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