Bipolar Disorder and Long-Term Disability Insurance Claims

If bipolar disorder prevents you from maintaining steady employment, you may be eligible for long-term disability (LTD) benefits. However, these claims can be complex, and insurance companies often challenge or deny them. This guide explains the symptoms, diagnosis, and impact of bipolar disorder—and how to build a strong LTD claim.

What Is Bipolar Disorder?

Bipolar disorder (formerly known as manic-depressive illness or manic depression) is a mood disorder and mental health condition that causes severe fluctuations in mood, energy, and behavior. People with bipolar disorder experience periods of:

• Mania or hypomania: Elevated mood, impulsivity, reduced need for sleep, and sometimes psychosis
• Depression: Intense sadness, hopelessness, fatigue, and suicidal thoughts

Bipolar disorder can begin in adolescence or early adulthood and typically requires lifelong management. Without proper diagnosis and treatment, the condition can worsen, leading to increasingly severe episodes and functional decline.

Types of Bipolar Disorder

Bipolar disorder is classified into several types based on symptom patterns:

• Bipolar I Disorder: Involves manic episodes lasting at least 7 days (or requiring hospitalization), often alternating with depressive episodes lasting 2 weeks or longer.
• Bipolar II Disorder: Involves at least one major depressive episode and one hypomanic episode, but no full manic episodes.
• Cyclothymic Disorder (Cyclothymia): A milder form involving recurring hypomanic and depressive symptoms that persist for at least 2 years but don’t meet full diagnostic criteria.
• Bipolar Disorder Not Otherwise Specified (BP-NOS): Diagnosed when symptoms don’t meet full criteria for Bipolar I or II but are clearly outside the person’s normal behavior.

Symptoms of Bipolar Disorder

Bipolar disorder affects more than mood. It can impair judgment, concentration, sleep, energy, and social functioning. Mood episodes may last for days, weeks, or even longer and often result in serious disruptions at work, school, or home.

Symptoms of Mania or Hypomania:

• Elevated or irritable mood
• Racing thoughts and fast speech
• Decreased need for sleep
• Grandiosity or inflated self-esteem
• Risky or impulsive behavior (e.g., spending sprees, reckless driving, substance use)
• Delusions or hallucinations (in severe cases)

Symptoms of Depression:

• Persistent sadness or emptiness
• Fatigue and lack of motivation
• Changes in sleep or appetite
• Difficulty concentrating or making decisions
• Feelings of guilt, worthlessness, or hopelessness
• Suicidal thoughts or behavior

Many individuals also experience mixed episodes, where symptoms of both mania and depression occur simultaneously.

Co-Occurring Conditions

People with bipolar disorder often face additional challenges, including:

• Anxiety disorders (e.g., PTSD, social anxiety)
• ADHD, which shares symptoms like restlessness and distractibility
• Substance abuse, often as an attempt to self-medicate
• Physical illnesses such as heart disease, thyroid dysfunction, migraines, and diabetes

These co-occurring conditions can intensify mood episodes and complicate treatment.

Diagnosing Bipolar Disorder

Diagnosis is based on a comprehensive evaluation that includes:

• A clinical interview and detailed medical history
• Input from family or close contacts (if available)
• Ruling out other conditions through lab tests (e.g., thyroid problems or neurological disorders)
• Evaluation by a psychiatrist or psychologist using DSM-5 diagnostic criteria

Bipolar disorder is often misdiagnosed as major depression, especially when individuals seek treatment only during depressive episodes. Accurate diagnosis is crucial for effective treatment and disability evaluation.

Treatment of Bipolar Disorder

Bipolar disorder is typically managed with:

• Mood stabilizers (e.g., lithium)
• Antipsychotic medications
• Psychotherapy, including cognitive behavioral therapy (CBT)
• Lifestyle changes, such as sleep hygiene and stress reduction

Treatment helps reduce the severity and frequency of episodes, but many individuals still struggle with ongoing symptoms that interfere with work and daily activities.

Is Bipolar Disorder Considered a Disability?

Yes. If bipolar disorder prevents you from performing your job or any job for which you are reasonably qualified, it may be considered a disabling condition under your LTD policy.

Many policies define disability in two phases:

• “Own occupation” period (typically first 24 months): You are unable to perform the duties of your specific job.
• “Any occupation” period (after 24 months): You are unable to perform the duties of any occupation you are reasonably suited for by education, training, or experience.

If your mental residual functional capacity is significantly limited, such as being unable to sustain focus, follow instructions, or manage interpersonal interactions, you may qualify for LTD benefits.

Evidence Needed for a Successful LTD Claim

Your LTD claim will hinge on consistent and credible medical evidence, including:

Medical Records

• Mental health treatment notes
• Psychiatric evaluations and psychological testing
• Hospitalization records (if applicable)
• Medication history and side effects

Residual Functional Capacity (RFC) Assessment

An RFC completed by your psychiatrist or psychologist can describe how bipolar disorder limits your ability to:

• Concentrate, remember, and complete tasks
• Maintain regular attendance
• Tolerate workplace stress or changes
• Interact appropriately with supervisors or coworkers

Treatment History

Ongoing care is essential. Gaps in treatment longer than 90 days can undermine your claim. Ideally, you should be under the regular care of a psychiatrist or psychologist (not just a counselor), as some insurance companies do not recognize counselors as acceptable medical sources.

Appealing a Denied Disability Claim for Bipolar Disorder

Mental health claims like bipolar disorder are often denied initially due to the subjective nature of the symptoms. Common insurer arguments include:

• Lack of “objective” medical evidence
• Gaps in treatment
• Evidence that you appeared “functional” in medical notes
• Surveillance suggesting your condition isn’t severe

If your claim is denied, don’t give up. You have the right to file an appeal—and this is your opportunity to submit stronger evidence, including updated medical records, RFCs, and statements from treating providers.

RELATED POST: Objective vs. Subjective Evidence in LTD Claims

Why You Should Work with a Disability Attorney

Appealing a denial for bipolar disorder can be complex. A disability attorney can:

• Review your LTD policy and denial letter
• Help gather and organize medical evidence
• Coordinate RFC forms and provider letters
• Handle insurer communication and deadlines
• Represent you through appeals or litigation

At the Ortiz Law Firm, we have experience handling bipolar disorder disability claims across the United States. We work on a contingency fee basis, meaning you don’t pay unless we win your case.

Contact Ortiz Law Firm for a Free Case Review

If bipolar disorder has made it impossible for you to work, we’re here to help. Whether you’re applying for benefits or appealing a denial, we’ll fight to get you the support you deserve.

Call us today at (888) 321-8131 to schedule your free consultation. We’ll review your case, explain your options, and guide you every step of the way.