Claiming Long-Term Disability for PTSD cases
Post-Traumatic Stress Disorder (“PTSD”) is a mental health condition that can have a devastating effect on your life, causing significant problems in social situations, family relationships, and day-to-day functioning. PTSD can also seriously interfere with your ability to work. However, because PTSD is an “invisible disability” it can be challenging to diagnose and difficult to prove in a claim for long-term disability benefits. In this post, our experienced disability lawyer will discuss what you need to know about disability claims for PTSD.
What is PTSD?
PTSD is a trauma or stress related disorder that is triggered by directly experiencing or witnessing a traumatic event such as actual or threatened death, serious injury or sexual violation.
While PTSD is often associated with military personnel and combat duty, it is also increasingly common for frontline workers in certain occupations to experience PTSD (e.g. paramedics, firefighters, police officers, and other medical professionals). There are other ways that PTSD may be triggered – for example, PTSD may result from situations such as a being injured in a car accident, experiencing sudden illness, or witnessing the death of a loved one.
PTSD symptoms can be intense and life-altering, including flashbacks or nightmares, insomnia, severe anxiety, avoidance of situations, and uncontrollable thoughts about an event.
Compensation and disability claims for PTSD
Those who are prevented from working due to PTSD may be eligible to make short-term disability claims, long-term-disability claims, or receive compensation for PTSD from other sources, depending on the insurance coverage available to them and the cause of the PTSD.
Canada Pension Plan disability benefits cover mental illness and psychological disorders, as do private disability insurance plans. PTSD claims can also be accepted in Worker’s Compensation Board (WCB) claims, auto insurance claims, and personal injury lawsuits.
If you would like to discuss the sources of disability income and compensation that you are eligible to claim, we welcome you to contact us today to schedule a free consultation with our experienced disability lawyer.
Disability lawyer discusses challenges in proving an “invisible” illness
PTSD is a recognized medical diagnosis and there are defined symptoms and diagnostic criteria for PTSD set out in the Diagnostic and Statistical Manual of Mental Disorder (“DSM”).
However, as mentioned above, disability claims for PTSD can be particularly challenging as PTSD is an invisible illness. It is not visible like a physical injury or medical condition that can be “seen” in an X-ray, MRI, or blood test results.
It can be difficult for a person to prove first that they are suffering from PTSD and second, that their PTSD symptoms are severe and disabling.
Eligibility for disability claims for PTSD
Each long-term disability plan or program has its own eligibility criteria, and the burden is on the PTSD sufferer to prove that they are disabled and that they meet the eligibility requirements.
Generally speaking, eligibility for long-term disability claims for PTSD is rooted in the following basics:
- You are under the care of a qualified medical practitioner;
- You have a confirmed diagnosis of PTSD from a qualified medical practitioner; and
- You are able to provide the insurer with documentation of your condition and how it is limiting or preventing you from working (e.g., results of testing or mental health exams, reports from a treating psychiatrist).
If your long-term disability claim is approved, you will likely have to periodically provide updated information from your treatment providers in order to continue to receive disability benefits.
If you are seeking compensation for PTSD through a WCB claim or personal injury lawsuit (e.g. arising from a car accident), causation will also need to be established to prove that you are eligible for compensation (in other words, it will be necessary to prove a relationship between the development of PTSD and the compensable accident or workplace incident).
Denial of disability claims for PTSD
Long-term disability claims are rigorously scrutinized by insurance companies and many legitimate long-term disability claims for PTSD are denied due to insufficient medical evidence.
Valid PTSD claims may be denied due to lack of sufficient proof of the illness or symptoms or because there is not enough proof that the condition is disabling (in other words, proof that the PTSD is causing restrictions and limitations in work capacity).
If your disability claim for PTSD has been denied, Ludwar Law Firm can help you appeal the decision. We know how to get your claim taken seriously and prepare the necessary medical evidence to have your insurance company or the Canada Pension Plan to look at your claim again.
You may also have other legal options aside from an internal appeal to the insurance company. Consult with our disability lawyer to discuss your rights and remedies.
Contact Ludwar Law Firm for help with your disability claim for PTSD
Calgary-based Ludwar Law Firm focuses on helping clients in Alberta and Saskatchewan with long-term disability claims.
Long-term disability clients – particularly those who are suffering from PTSD – are dealing with much more than just the legal aspects of getting their claim approved.
Our clients appreciate being able to talk to people who can explain the process, their options, and what will happen during their claim. With more than 25 years of experience and an ongoing focus on long-term disability claims, Ludwar Law Firm stands out above the rest.
For more detailed information or to ask questions about your unique situation, we welcome you to contact us today to schedule a free consultation.