Personal Finance

Need advice on disability insurance for depression

  • Last Updated:
  • Sep 7th, 2021 11:41 pm
[OP]
Member
Jul 6, 2008
228 posts
28 upvotes
Toronto

Need advice on disability insurance for depression

I've been paying into disability insurance for 15 years, mainly in case of physical injury.
Recently though, I've been having a very tough time mentally. It's become almost impossible for
me to go through my daily routine - even the smallest things - and I've had to stop work until I can figure this out.

I'm wondering how difficult it is to claim depression for disability insurance and what steps are involved?
It certainly isn't as easy as proving a physical injury and I imagine the insurance company won't exactly make this a simple process and there will probably be a lot of hoops to jump through.

Do any of you have experience with this?

I am self-employed btw.
11 replies
Deal Expert
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Dec 12, 2009
27600 posts
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Toronto
I would assume that each case is unique because mental illness is not as concretely identifiable as a physical disability. Given the large number of law firms that specialize in disability claims, I would imagine that the legal process is a popular/necessary path to take for non physical disabilities. It appears to be quite the racket when they all claim to charge nothing unless the customer wins. I would imagine that law firms might provide insight into potential success as who would engage in a case with no prospects of profit. It starts with making a claim. Give it a go and see where it lands. Be ready to seek legal counsel.
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Deal Addict
Nov 13, 2013
4189 posts
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Ottawa
I’d question the value of doing this. They generally expect total disability and you can’t do anything work like orbit can get you in trouble. So for example had a friend who couldn’t sit at a desk for 8 hours but wanted to freelance. Nope.unpaid volunteer work. Nope.

Now think about depression. While there are different treatment theories and less or more use of drugs almost any practitioner would agree being more active is better. You want to sit at home the rest of your life but collecting a nice disability payment.

No two people are the same so “getting out there” being more active” might not work and you might need medication but life at on on a monthly payment is not much better than being unemployed and forced back to work when you still feel lousy dragging yourself up every morning.
Deal Fanatic
Dec 12, 2009
5780 posts
3266 upvotes
Toronto
It is going to be a long haul (years) if it winds up being a permanent disability. A review of your disability policy is in order.

Step 1. See your MD for an assessment/diagnosis - a diagnosis of depression usually requires X symptoms over Y time.
Step 2. Your MD will likely try a few prescriptions to see how you respond.
Step 3. A referral to a mental health professional may be in order or required. (could be step 2).
Step 4. They may suggest a certain amount of time off work in the interim (this is where some temporary disability coverage may kick in)
You are going to need the diagnosis to make a claim.

The legal route that @will888 speaks of does not kick in until you have been denied coverage. They (insurance [edit] ) will want to see you have done the 1st 3 steps as suggested by your MD.

An early initial legal consult may help in ensuring you take the right steps and keep the appropriate documentation.
Last edited by ROYinTO on Jul 9th, 2021 3:21 pm, edited 1 time in total.
Deal Expert
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Dec 12, 2009
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ROYinTO wrote: It is going to be a long haul (years) if it winds up being a permanent disability. A review of your disability policy is in order.

Step 1. See your MD for an assessment/diagnosis - a diagnosis of depression usually requires X symptoms over Y time.
Step 2. Your MD will likely try a few prescriptions to see how you respond.
Step 3. A referral to a mental health professional may be in order or required. (could be step 2).
Step 4. They may suggest a certain amount of time off work in the interim (this is where some temporary disability coverage may kick in)
You are going to need the diagnosis to make a claim.

The legal route that @will888 speaks of does not kick in until you have been denied coverage. They will want to see you have done the 1st 3 steps as suggested by your MD.

An early initial legal consult may help in ensuring you take the right steps and keep the appropriate documentation.
I kind of over simplified things a lot. My post is informed by all the ads on 680 news about disability claims. At the end of the day, the foundation for a claim is a strong medical opinion/diagnosis. It likely needs a healthy dose of legal support as the insurance companies would be offering differing medical opinions via their experts.
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Deal Fanatic
Jan 15, 2017
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Ottawa
A claim for disability for mental health is no different than a claim for disability due to a physical illness. Mental illness is an illness.

It starts with getting yourself to a doctor and receiving a diagnosis of a mental illness. You insurance company will require that you complete an application for benefits and it will want to contact your physician for confirmation of the diagnosis, as it does with all applications for benefits that it receives.

One thing that the insurer will be looking for is your doctor's evaluation of your GAF score. Generally anything 70 and above is considered a reason to reject an application for benefits. https://www.webmd.com/mental-health/gaf-scale-facts

Best of luck.
Deal Addict
Jan 13, 2014
2749 posts
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Calgary
skeet50 wrote: A claim for disability for mental health is no different than a claim for disability due to a physical illness. Mental illness is an illness.

It starts with getting yourself to a doctor and receiving a diagnosis of a mental illness. You insurance company will require that you complete an application for benefits and it will want to contact your physician for confirmation of the diagnosis, as it does with all applications for benefits that it receives.

One thing that the insurer will be looking for is your doctor's evaluation of your GAF score. Generally anything 70 and above is considered a reason to reject an application for benefits. https://www.webmd.com/mental-health/gaf-scale-facts

Best of luck.
My spouse went through this and this is the best advice.
Sr. Member
Dec 5, 2011
993 posts
1116 upvotes
skeet50 wrote: A claim for disability for mental health is no different than a claim for disability due to a physical illness. Mental illness is an illness.

It starts with getting yourself to a doctor and receiving a diagnosis of a mental illness. You insurance company will require that you complete an application for benefits and it will want to contact your physician for confirmation of the diagnosis, as it does with all applications for benefits that it receives.

One thing that the insurer will be looking for is your doctor's evaluation of your GAF score. Generally anything 70 and above is considered a reason to reject an application for benefits. https://www.webmd.com/mental-health/gaf-scale-facts

Best of luck.
Wow, I have never heard of the GAF score. I was just reading through that and holy cow that's such an "easier" test to pass than what you need for the federal disability tax credit! In order to get approved for the DTC with a mental illness, you would need to be at a score of under 30 at least 90% of the time. I can't wait for the DTC changes to happen - it seems crazy to me that the private sector would have such different qualification criteria than the federal government. Very interesting, thanks for pointing it out.
Deal Fanatic
Jan 15, 2017
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islander59 wrote: Wow, I have never heard of the GAF score. I was just reading through that and holy cow that's such an "easier" test to pass than what you need for the federal disability tax credit! In order to get approved for the DTC with a mental illness, you would need to be at a score of under 30 at least 90% of the time. I can't wait for the DTC changes to happen - it seems crazy to me that the private sector would have such different qualification criteria than the federal government. Very interesting, thanks for pointing it out.
The threshold for the DTC in general is quite high. For mental illness and DTC it is very high. My now deceased BIL who lived with schizophrenia spent years appealing to eventually get the DTC. Many people are surprised to discover the even though they qualify for their private disability plan that they do not qualify for the CPP disability plan. And those who do manage to qualify for the CPP disability plan may not qualify for the DTC.
Newbie
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Jul 17, 2012
16 posts
11 upvotes
TORONTO
The answer would depend on the wording of the policy. Assuming there are no depression or mental nervous exclusions and your condition has you unable to work you should be eligible for a claim. The definition of disability is also an important variable if you have a regular occupation definition and you can’t do that occupation do to your depression you should qualify. The process is generally you submit a claim form to your insurance provider. The insurance company will also likely write your doctor to confirm the extent of your condition and your ability to work.
Deal Addict
May 28, 2007
1729 posts
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You can watch The Disability Law Show that airs on the weekend for information. There's also The Employment Law Show that plays on the weekend too. The information on the show is very informative in my opinion. Although it will get repetitive after you've watched numerous episodes.

https://globalnews.ca/toronto/program/t ... y-law-show

https://globalnews.ca/national/program/ ... ow-900chml

Past episodes are even on YouTube.
Deal Addict
Oct 22, 2016
1006 posts
946 upvotes
Comox Valley
One idea is to look for metal health clinics, in your city. Sometimes these services are free, ask for an appointment, and bring up your concern, with disability insurance, and see what they say. Or if they refer you to some where else.

It is a difficult thing to go through, even more do in these times.

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