Patients with organic mental disorders may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their organic mental 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.
Difference Between Organic Mental Disorders and Mental Illness
Organic mental disorders are not the same thing as mental illness. Although both affect the brain and show usually show minimal if any physical symptoms, they are caused by two different events. It is important to know the difference and use a doctor that can articulate the difference through the documentation, so your diagnosis isn’t questionable to the insurance company.
Mental illness refers to mood or nervous disorders that can be triggered by an environmental factor that affects a person’s mental stability. This can be things like drug addiction or eating disorders that can cause mental illness. Another example could be the loss of a child or spouse. In the cases where mental illness is determined, most long term disability policies will limit your benefits to 24 months (or two years).
Mental disorders refer to a brain disorder that has a direct physical cause. Organic mental disorders can be directly linked to something traumatic in your life. Like in the example above, this person was injured when an explosion occurred at their workplace. They have healed physically but mentally, still suffer from severe symptoms that prohibit them from working.
Other examples of organic mental disorders:
- Blood clot or bleeding in the brain;
- Low or loss of oxygen to the brain;
- Exposure to high levels of carbon dioxide; and
- Degenerative diseases like Alzheimer’s disease or Parkinson’s.
All of these can cause different levels of symptoms, including:
- Behavior changes including unprovoked aggression;
- Impaired cognitive ability; and
- Language/speech impairments.
How to Prove Your Case
Seek Treatment From An Organic Mental Disorder Specialist
Because mental illness and mental disorders are harder to prove, it is essential that you seek treatment from doctors that are experienced in diagnosing and treating organic mental disorders. When your trauma occurs, you will likely see a specialist at the hospital. When you are well enough to go home, you need to find a mental disorder specialist to follow up with and develop your treatment plan. Your primary doctor ( or family doctor) is not training in caring for people with a mental disorder. In fact, they are more familiar with mental illness and are more likely to misdiagnose you or give you a treatment plan that will not be helpful. This would hurt your chances of winning your long term disability case. Seek a specialist.
Save Your Documents
When applying for long term disability benefits, you will need to provide a lot of documents to the insurance company. Be sure to obtain copies of everything from start to finish in your case.
Obtain copies of:
- The accident report;
- Complete medical files from the hospital you stay in, including notes from the speech therapist, occupational therapist, and physical therapist;
- Your medical file from any of the specialists that you follow up with for your disability;
- If you need additional physical therapy, occupational therapy, or speech therapy, obtain notes regularly and keep them in a safe place;
- Lab results – blood work, x-rays, CT scans; and
- Doctor’s notes – this is something that can easily be overlooked even by the doctor. Many times the doctors listen to your concerns but don’t write them all down in their notes. To show evidence of your symptoms, you need to make sure your doctor is taking detailed notes during your visits.
Your mental disorder is a serious condition that will need years of treatment to recover from if recovery is possible. In the most severe cases, your brain may never fully heal. Proving your mental disorder is not a mental illness can be tricky, but using a specialist and seeking help from an experienced long-term disability attorney will get you started off right.
Consult An Attorney
Since you are so limited by the appeals process, consider consulting a disability attorney very early on. Even with a claim for an organic mental disorder, 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 organic mental disorder 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.