Legal

Common Reasons Mental Illness Claims are denied

People battling with mental illness such as major depression, bipolar, anxiety disorders, post-traumatic stress disorder, and more may be eligible for a mental illness claim. Like most disputed claims, mental illnesses are difficult to prove and sometimes are considered ‘invisible’ disabilities. Individuals who have mental illness are stigmatised and face hardships especially when those around them can’t understand the reasons they can’t work.

They have no physical disabilities, and anyone may wonder why they can’t pull themselves together and get work done. These misconceptions and assumptions may apply to most people, but mental illness is an exception. Unfortunately, many insurance companies tend to misinterpret the challenges faced by people with mental illnesses. That’s one of the reasons most of these claims are disapproved. To be on the safe side, hire a St Petersburg long term disability lawyer to help you understand all your legal options before filing your case.

Here are the common reasons most these claims are denied.

Noncompliance with the right course treatment and medical prescriptions

A mental health care provider will recommend a particular course of treatment like group therapy, counselling sessions, and more. Such recommendations should be recorded in the claimant’s medical records. If these records indicate that the claimant failed to show up for the group therapies, counselling sessions, or any other recommended treatment, the claim may be rejected.

In some instances, the claimant may be diagnosed with a particular mental illness, and a medical practitioner prescribes a specific medication. If the claimant’s medical records indicate that he or she didn’t take the drug, that’s considered noncompliance with the recommended course of treatment or prescribed medication.

Note that this is a significant problem for people battling with mental disorders. This is because the Social Security Administration majorly focuses what you (the claimant) can do despite the limitations of your condition. The limitations associated with mental disorders can be measured accurately if you aren’t adhering to the prescribed medication.

Poor or inaccurate treatment information

One of the major challenges most people face in mental illness claims is the fact that counsellors, psychologists, and other psychological healthcare service provider keep poor or inaccurate client information. Sometimes, the medical notes are too abbreviated, and that makes it difficult for anyone to collect useful medical information.

Probably the notes are illegible or impossible to read. Some doctors and other medical practitioners submit summarised information. That makes it difficult for the insurance company to establish if the claimant’s application should be approved or denied.

No medical record at all

Some people with mental illness file disability claims and they have no single medical record to prove any of the conditions listed in the claim. For example, someone diagnosed with depression is likely to get antidepressants from the nearest pharmacy. The claimant may have never been referred to any mental specialist such as psychologist, counsellor, or a psychiatrist. In such cases, the claimant won’t have medical records to support the claim, and that means that the case may be disapproved.

If you intend to maximise your chances of winning a case related to disability insurance payments for mental health issues, you should ensure that you have accurate medical records. Besides, you should adhere to all the recommended course of treatment and prescribed medi