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We appeal wrongful long term disability insurance and Social Security Disability denials.

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Obsessive Compulsive Disorder and Long Term Disability


Patients with obsessive compulsive disorder may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their obsessive compulsive disorder may qualify for long term disability (LTD) benefits. The insurance company will review their claim to see if they qualify under the conditions of that plan.

What is Obsessive Compulsive Disorder?

Obsessive compulsive disorder, or OCD, is a mental condition characterized by obsessive thoughts and fears that cause compulsive behaviors. Someone with OCD may have obsessions, compulsions, or both. Obsessions are reoccurring thoughts or an urge that causes distress. Common obsessions include fear of germs, straightening or organizing things, and thoughts of harm to self or others. The person may develop compulsive behaviors in order to find some relief from the obsessions. Compulsive behavior can be obvious or more subtle, but all compulsive behavior can inhibit a person’s quality of life. Compulsions include repetitive hand washing or cleaning, organizing things in a precise fashion, repetitive counting, or touching objects in a particular order.

While many people claim to “be OCD,” obsessive compulsive disorder is more than a simple love of cleanliness or order. People with OCD frequently spend at least an hour a day on their behaviors, finding little relief in the very compulsion that is meant to soothe their fears.

Diagnosing Obsessive Compulsive Disorder

A general practitioner may be able to diagnose someone with OCD, but most are referred to mental health specialists. There are no definitive diagnostic tests, such as MRIs or blood work, so the patient must rely on the doctor’s clinical assessment. Common screening tests include the Yale-Brown Obsessive Compulsive Scale and Florida Obsessive-Compulsive Inventory. Researchers have found a link between previous trauma and OCD, but there is no definitive cause. Some patients have noticeable difference in brain structure, but there is not yet a way to diagnose patients through brain scans.

Treating Obsessive Compulsive Disorder

Treatments for OCD include talk therapy and medications. Most patients require a combination of both talk therapies and medication in order to manage their symptoms. Avoiding triggers and changing lifestyle in order to minimize stresses can also help with quality of life. Some therapists use exposure therapy, where the patient is exposed to increasing levels of their triggers in order to learn how to manage their symptoms and desensitize themselves to the trigger. Exposure therapy should only be done with a qualified professional, as it can backfire if not done correctly.

Obsessive compulsive disorder is not curable, but with the correct treatment many patients find significant relief of their symptoms. Other patients may find that their OCD is severe enough to limit them from working or participating in normal life activities. These patients may qualify for disability for obsessive compulsive disorder.

Disability Evaluation of Obsessive Compulsive Disorder

Patients with obsessive compulsive disorder may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their OCD may qualify for long term disability (LTD) benefits. The insurance company will review their claim to see if they qualify under the conditions of that plan.

Definition of Disability

Most LTD plans consider a person disabled if they have a medical condition that causes them to 1) be unable to perform their work duties for the first two years of the policy and 2) be unable to complete the work duties of almost any occupation for the years following the initial 2-year period. Each LTD plan defines disability as slightly different, so look over your plan policy to see how your plan determines “disabled.”

Evaluating Disability for People with Obsessive Compulsive Disorder

Patients seeking disability payments for their obsessive compulsive disorder will have to prove that they are impacted in a way that they cannot perform their old job or any job that they could be trained to work. To qualify for disability benefits, the condition must prevent the person from working for a least one full year. They will need a Residual Functional Capacity (RFC) assessment that indicates how their symptoms affect and limit their life activities.

Someone with OCD may need to leave work for doctor visits and therapy appointments. Side effects from medications can make patients sluggish and fatigued. It may be difficult for them to concentrate on complicated tasks. Compulsions can interrupt work tasks and make it difficult to complete assignments. Those with obsessions about germs may find it difficult to work with the public or in conditions they consider dirty.

What the Insurance Company Needs from You and Your Medical Providers

You should tell the insurance company about any doctor that has treated you for your obsessive compulsive disorder. The insurance company will need to obtain all relevant medical records to get the full picture of your health. These records include office notes, clinical exams, diagnostic tests, and lab results. Records of therapy sessions may be particularly helpful for proving a disability case for OCD.  If for any reason they cannot get these records from your doctors, you should request them and provide them to the insurance company yourself.

You will need to provide proof of your diagnosis and your ongoing symptoms, as well as proof of how you are affected by your symptoms. Providing detailed documentation is key to a successful claim. Residual Functional Capacity (RFC) assessments determine how you are affected by the condition and what you can do despite your limitations. It is used to determine what jobs you may still be qualified to perform. Make sure that you are as honest as possible with your doctors so that they can complete an accurate RFC for you.

Working with a Disability Attorney

Since you are so limited by the appeals process, consider consulting a disability attorney very early on. Even with a claim for OCD, it can be tricky to navigate the claims and appeals process. Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve. If you have been denied disability benefits, do not lose hope. Many people are denied benefits the first time they apply. You have the right to file an appeal and to get more information that may help your case.

While the process can be daunting, your expert disability attorney will be able to guide you through the process. Getting expert help is often the difference between being denied and being approved for benefits. An experienced long term disability attorney can help you stay on top of your deadlines, help you gather your documents, assist you during field interviews, and give you guidance that will help you get your claim approved. They do not get paid until you win your case. You can seek help without worrying about upfront costs or unexpected bills.

The Ortiz Law Firm has successfully represented people in disability cases across the United States. If you would like to talk to an experienced disability lawyer about your OCD and its impact on your ability to work, the Ortiz Law Firm offers a free consultation with no obligation to use our firm. During the call, you can ask any questions you have regarding your claim, and we will answer them. To see how we can help you win your long-term disability case, call us at (888) 321- 8131.

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Lavanda T.

I highly recommend Ortiz Law Firm. Very friendly staff. They helped me win my appeal against Liberty Mutual. Thank you all for being the best!!

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