Long-term disability claims for mental illness have been on the rise. This could be due to a broader understanding and acceptance of these conditions in the mainstream, resulting in more people being open to discussing their mental health with their treatment provides and seeking the help they need. It could also be due to the added stressors of the pandemic and the challenge of finding mental health treatment during that time.

Mental illness is complicated. Proving it shouldn’t be.

Unfortunately in our legal practice, LTD claims for mental illness are the most frequently denied or terminated claims. The very nature of these conditions make them difficult to prove. Before coming to us, our clients have struggled to demonstrate to the insurance company the severity of their “self-reported” or “subjective” symptoms. Psychological conditions are typically diagnosed by medical doctors and specialists based on a patients’ self-reported symptoms but insurance companies are not so easily satisfied.

The Mulqueen Disability Law team knows the longer you go without an income, the worse your mental health conditions will become. We will hold the insurance company accountable for your benefits, as well as any damages for your emotional and financial distress. We will also discuss how you will support yourself and your family through the litigation process and provide you with options for other disability benefits and help apply for those. 

Mental illness-based LTD claims in Ontario

Almost ALL of our clients have a mental illness. Our clients may be disabled due to a mental illness or they may have a number of other conditions of which mental illness is but one.

There are many types of mental illnesses that can cause disability, including:

Major Depressive Disorder

A mental illness characterized by persistent feelings of sadness, hopelessness, and loss of interest in activities.

Anxiety disorders

A group of mental illnesses characterized by excessive worry, fear, and apprehension.

Post-Traumatic Stress Disorder (PTSD)

A psychiatric disorder that can develop after experiencing or witnessing a traumatic event. See our special section below dedicated to PTSD.

Bipolar Disorder

A mood disorder characterized by episodes of mania and depression.

Obsessive-Compulsive Disorder (OCD)

A mental illness that causes repetitive, intrusive thoughts and compulsive behaviours to alleviate anxiety.

Borderline Personality Disorder (BPD)

A mental illness characterized by unstable interpersonal relationships, intense emotions, and impulsive behaviour.

Eating disorders

A group of mental illnesses that involve disturbances in eating behaviour or body image, such as anorexia, bulimia, and binge-eating disorder.

Schizophrenia

A severe mental disorder characterized by a disconnection from reality, delusions, and hallucinations.

Post-Traumatic Stress Disorder (PTSD) & LTD

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after a person experiences or witnesses a traumatic event such as combat, sexual assault, physical violence, or a natural disaster. PTSD can cause a range of symptoms including flashbacks, nightmares, avoidance behaviour, irritability, and hyper-arousal.

To prove disability due to PTSD, it is important that you provide detailed medical documentation of your symptoms and how those symptoms impact your daily activities, as well as any treatments and their effectiveness. This may include medical records, doctor’s notes, and your own self-reported symptoms and level of function.

It is also important to show that the symptoms of PTSD are severe enough to impair your ability to work or perform daily activities. This can be done by providing information about your job performance, difficulties you may have with social interactions or relationships, difficulties you may have with respect to being in certain settings or situations that can be triggering, as well as your ability to manage stress, and any other ways in which the symptoms have interfered with your daily life and functioning.

Applying for LTD based on mental illness

Insurance companies often apply a “one-size-fits-all” approach to assessing disability. Requiring “objective” evidence to prove LTD claims for mental illness is like forcing a round peg into a square hole. They may tell you that they require medical evidence to approve claims and when it is provided, they will deny mental illness claims on non-medical evidence (like a person’s daily activities). This leaves our clients and their doctors shocked by how the insurance company could have reached its decision to deny the claim.

However, there are certain steps you can take to improve your chances of having your LTD claim based on a mental illness approved:

• Seek a diagnosis: The first step in proving disability due to mental illness is to seek a diagnosis from a qualified mental health professional. This diagnosis should be documented in your medical records.
• Seek treatment: It is important to seek treatment for your mental illness, which can include therapy, medication, and other forms of support. Treatment can help improve your symptoms and demonstrate that you are actively seeking to manage your condition.
• Keep detailed records: Keep detailed records of your mental health treatment, including medical records, therapy notes, and medication logs. These records can help demonstrate the severity and impact of your condition on your daily life.
• Obtain supporting documentation: Obtain letters and reports from your mental health providers that describe your diagnosis, treatment, and functional limitations. You may also want to obtain letters from family members, friends, or coworkers who can describe how your mental illness affects your daily life.
• Apply for disability benefits: You can apply for disability benefits through your private/individual insurance policy, your employer’s group policy, provincial social assistance, and Canada Pension Plan Disability. Be prepared to provide extensive documentation of your mental illness, including medical records, treatment records, and supporting documentation.
• Attend evaluations: The insurance company may require you to attend evaluations with their own doctors or mental health professionals to assess your disability. It is important to be honest and thorough during these evaluations.
• Participate in insurance company-sponsored rehabilitation or Employee Assistance Plan treatment programs: These are aimed at returning you to work. It is important to have medical clearance from your own treatment providers to participate in these programs. With mental illness, these programs may cause more harm than good and interfere with your own treatment and recovery.
• Seek legal assistance: If your disability claim is denied, you may want to seek legal assistance from an attorney who specializes in disability law.

Denials of mental illness-based LTD claims

Insurance companies will support their denial on the basis that they do not have sufficient evidence to support a severe condition. They may go so far as to say that our client is not disabled because it is not severe based on factors such as they are not seeing a psychiatrist (long waitlist); not taking medication (for various valid reasons); not seeing a therapist (too expensive); not hospitalized (not necessary for LTD); or because they are able to go grocery shopping; take care of their children or parents; do their taxes; spend time with family and friends; or workout.

By failing to properly assess LTD claims for mental illness, insurance companies cause our clients serious harm and set them back in their recovery.

Clients with mental illness will tell us that, had the insurance company paid their LTD benefits, they might have been able to return to work. Instead, the way the insurance company has treated them and by denying them benefits, their condition has worsened, and is now prolonged, and returning to work is not even on their radar.

At Mulqueen Disabilty Law, will argue that our clients’ insurance companies have not fulfilled their duty of good faith to our clients. That they have mischaracterized (cherry-picked) medical evidence and self-reported evidence, ignored relevant evidence and relied on irrelevant evidence to construct a basis for denying our clients’ claims. In the process, they have caused our clients serious emotional and financial distress.

Trauma-informed service for trauma-based disability

Our clients are often surprised to learn that the details of their trauma are not relevant to the insurance company’s assessment of their LTD claim. In our experience, insurance companies do not appreciate or understand that their interactions with our clients can be triggering and re-traumatizing. They may also not understand that medication is not always the recommended treatment and failing to take medication for PTSD does not a basis to deny a claim for PTSD. 

In fact, the insurance company should know better than to ask and risk triggering a trauma response. Some insurance companies will not only ask for details of the trauma but will then proceed to evaluate or judge whether the trauma was “objectively” so bad as to cause the person’s mental illness or PTSD. They may find that the person’s response to the trauma is not “reasonable” or that the trauma was not so serious as to cause PTSD. This approach is shocking and demonstrates a very serious lack of concern and lack of knowledge of PTSD, resulting in serious harm to our clients. 

We provide trauma-informed legal services and our team is certified in Psychological First Aid. We are not mental health treatment providers, but we do know how to provide legal services to our clients who have mental illnesses to ensure that we will not cause them more harm.

Contact Mulqueen Disability Law in Markham & Toronto for experienced representation in mental illness-based LTD claims

If you are making an LTD claim for mental illness (such as PTSD), the sooner you contact us, the less impact the insurance company will have on your conditions and the sooner we will be able to take this fight off your plate, allowing you the time (because we know it takes a lot of time) to focus your energy and efforts on your recovery.

At Mulqueen Disability Law, Courtney Mulqueen has over 20 years of experience litigating mental health LTD claims. She has resolved thousands of LTD claims for mental illness, in that time. She knows the law and legal strategy and uses her skills and experience to successfully argue these cases. She also knows how to ensure that her clients are protected in the process and requires all members of her team to be certified in trauma-informed practice and Mental Health First Aid to ensure that we do not accidentally cause further harm to our clients. To schedule a free initial consultation, please contact us online or by phone at 416-900-0368 (or toll-free at 833-363-3LAW [3529]).