Why Do Insurers Misrepresent a Physical Disability as Mental Disability?

We are often contacted by individuals when they learn their insurance company has mischaracterized their claim from being a claim for a physical disability, to a claim for a mental disability. Why would they do that?

As our video states, most disability insurance policies have a clause that limits mental health disorders, or “mental / nervous conditions,” to a pay period of only 2 years or less. Although most disabling mental disorders will outlive 24 months, the insurance carrier will not pay benefits beyond what the policy says.

It only follows that some insurance companies use this to their advantage. Many insurers will try to apply the mental health limitation when a physical disorder produces disabling symptoms such as anxiety, depression, confusion or cognitive decline.

This tactic is also a convenient way for insurers to deny claims for subjective disorders, such as complex regional pain syndrome or fibromyalgia, where there are few diagnostic tools to produce objective evidence, and proof must be in the form of clinical exams, patient history and other assessments.

No matter what your disabling physical condition may be, you have the right to fight back when the insurance company wrongly labels it as a mental disorder as a way to reduce your benefit payout.

Our disability attorneys have significant experience in this area of law, and can help you overturn the insurer’s misrepresentation. We will establish that the medical conditions causing your disability are physical, not mental.

Mental Health Disorders May Be Secondary to Your Physical Disorder

Sometimes mental issues are the result of an underlying physical disorder.

For example, someone stricken with a chronic and painful disabling condition such as cancer, degenerative disc disease or nerve damage, is likely to become depressed or anxious as they learn to deal with a life changing disability. Insurance companies can take advantage of this situation to mischaracterize a physical disability as a mental impairment.

You may be taking prescription narcotics for the pain. Insurers can falsely characterize the side effects from narcotic pain meds or sedatives, such as confusion or cognitive impairment, as a mental health disorder – all so that benefits will only be paid for 24 months, and not to age 65 or more.

These symptoms are not a disorder of the mind, but instead they are a complication of a painful and lasting physical condition.

For a free legal consultation, call 800-562-9830

Be Sure the Insurance Company does not Misrepresent Your Physical Disability as Mental

Most insurance companies play by the rules. We are prepared for the ones who do not.

Some claim reviewers are coached to discretely push claims as being due to mental disorders rather than the actual physical condition, all for the purpose of limiting benefits.

In-house doctors and medical experts retained by insurers may only be asked to give a paper review of your disability claim, or otherwise form a “decision” that supports that a mental impairment is the actual grounds for disability.

Insurance companies will even argue that you can return to work, that your physical impairment is not totally disabling, and assign any persisting disability to a mental or nervous condition.

Our Disability Attorneys Can Help You Now

For claimants who must deal with a disabling physical condition, the anguish added by an insurer’s unfair denial is overwhelming. It is wrong for an insurer to exploit someone’s mental strain, or to mischaracterize a physical disability as a mental disorder in order to limit disability insurance coverage

Do not give in to bad faith insurers and forfeit your rightful benefits. That is what they hope you will do.

We can help you prevail over any attempts the insurance company makes to unfairly apply the mental health limitation. Our disability insurance attorneys will assemble all the evidence that is essential to prove that physical disability is the basis of your claim, and meets your policy’s requirements.

If you need assistance or simply have questions, contact us without delay for answers.

Call or text 800-562-9830 or complete a Free Case Evaluation form