Patients with post-traumatic stress disorder may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their post-traumatic stress 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 Post-Traumatic Stress Disorder?
Post-traumatic stress disorder, or PTSD, is an anxiety disorder that is triggered by traumatic events. While many people associate PTSD with our military servicemen and women, the disorder can be triggered by any traumatic event. Sexual assault survivors, victims of gang violence, and witnesses to violent crimes are some of the wide range of people affected by PTSD. While not every person that experiences trauma will develop PTSD, trauma is a requirement for diagnosis. The kind of trauma varies between patients and what they experience.
Symptoms can be triggered by events that remind the person of their trauma or by stress. Nightmares, reoccurring flashbacks, anxiety, and panic attacks can occur without warning. People with PTSD can have difficulties sleeping, leaving the house, or completing tasks that remind them of their trauma. As it can be difficult to predict when flare-ups will occur, it can be hard for those with severe PTSD to live normal lives.
People with PTSD are at increased risk of developing other conditions such as depression and addictions. Suicide is not uncommon with people with untreated PTSD. Physical conditions like chronic pain, heart disease, and rheumatoid arthritis are also linked to PTSD. Patients can find themselves isolated and unable to relate to their peers, making recovery even more difficult.
Diagnosis of post-traumatic stress disorder is done through clinical assessment, usually by a mental health professional such as a psychologist or psychiatrist. Physical exams may be needed to rule out other conditions that can cause similar symptoms.
Treatment of PTSD usually requires a mix of talk therapy and medications. For those with severe PTSD, experimental treatments such as deep-brain stimulation or eye-movement desensitization. Many patients need a combination of multiple therapies to find relief from their symptoms. Treating PTSD is not a quick process and it is normal to experience a slow recovery process. Some patients never experience full relief from their symptoms and must learn how to live with their PTSD.
Disability Evaluation of PTSD
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 PTSD
Patients seeking disability payments for their PTSD 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.
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 PTSD. 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. Notes from therapy sessions may be particularly helpful. 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 Long Term Disability Attorney
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your post-traumatic stress disorder. Even if you have been denied benefits, your chance is not over. Many people are denied benefits the first time they apply. You have the right to file an appeal and try to get more information that may help your case. Getting expert help is often the difference between being denied and being approved for benefits.
While the process can be daunting, your expert disability attorney will be able to guide you through the process. 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 with an experienced disability lawyer about your PTSD and its impact on your ability to work, call us at (888) 321-8131. We would be happy to evaluate your case and to discuss how to help you through the appeal process.