Dec 17, 2024 - Disability Insurance by Seltzer & Associates
Addiction is a disease just like cancer, and it eats away at your physical and mental abilities in the same way that cancer does. However, disability insurance providers often make it much more difficult to collect the benefits you’re entitled to when the condition that prevents you from working stems from an addiction to drugs, alcohol, or prescription medication.
As a legal team dedicated to helping professionals receive the full amount of disability benefits they are owed under their policies, we know how reluctant insurers can be to pay claims that have any connection to addiction and the rationalizations they use to deny benefits. We also know how to overcome those hurdles. So in this post, we will review some of the key issues involved in private disability insurance claims that are connected with drug or alcohol addiction.
The Importance of Discretion
Professionals such as executives, attorneys, and accountants rely on a wide base of knowledge gained through years of intense experience. That expertise provides a reputation, and that reputation is extremely important. Anything that damages your reputation can destroy the credibility you’ve built up over the years. Those in the medical profession, including physicians, dentists, nurse anesthetists, and chiropractors, face even greater risk when their reputation is injured.
Many professionals rightly fear that exposing an addiction illness could cause irreparable harm to their reputation and careers, and that fear keeps them from seeking benefits. Sometimes, it keeps them from seeking treatment. Both behaviors, while understandable, are ultimately very harmful.
It is possible to seek treatment and obtain insurance benefits while maintaining privacy and discretion if you approach these challenges with appropriate care. An attorney experienced in these delicate matters can provide advice, guidance, and advocacy to achieve results without calling attention to matters that should remain private.
Accept the Fact that Addiction is an Illness That Can Affect Anyone
If you developed arthritis that prevented you from using your hands or learned that the reason you’ve felt too sick to work is that you have leukemia, you would not blame yourself or feel that you should be strong enough to overcome the illness on your own. You would seek medical treatment, rest, and give yourself the opportunity to recover without guilt.
Yet when a professional suffers from a disability stemming from an addiction, they often feel that they are at fault and that they deserve to suffer. Or they feel they should be able to fight the condition all on their own.
Medical science has shown that drug misuse, addiction, and alcohol use disorder are chronic medical conditions. They affect people of all ages in all walks of life.
When you admit to a problem and start taking steps to address the condition, it is a move that deserves praise rather than censure. While fear of harm to your reputation may prompt you to keep the struggle private, it should not prevent you from seeking the insurance benefits you are entitled to under your policy when a disability prevents you from working.
What if You Decide to Relocate During Treatment?
When you are focused on physical and mental recovery, it can be very difficult to try to understand the minutiae of your disability insurance policy or deal with questions from your insurance company. Working with a knowledgeable legal advocate can free up your energy to find solutions and restore your life balance while your attorney handles the details of your claim process.
If you decide to seek treatment out of the area or spend time away to gain a fresh perspective, your legal team will continue working locally to obtain the benefits you should be receiving from your disability insurance provider.
Are Addiction-Related Claims Covered Under Your Policy?
Many professionals assume that a disability will not be covered by insurance if it is related to a drug or alcohol addiction. If you ask your insurance company, you may get an answer that seems to confirm your assumption, but only because insurance representatives know how to weasel around the issues and say one thing that means something else.
Insurance companies are obligated to pay claims that are covered under the terms of the policies they issue. Quite often, long-term disability insurance policies will cover a disability that stems from an addiction so long as you provide the proper documentation and evidence. A disability insurance lawyer can review the details of your disability policy to determine whether you should be receiving benefits and any limitations on your policy. The terms of many policies are not written in clear language, particularly with respect to mental health issues. Insurance companies often try to use the vague language as an excuse to deny claims, but we know from experience that when these denials are challenged properly, the insurance company will be required to pay the claim.
Claims Based on Substance Abuse Disorder
The National Institute of Mental Health defines substance abuse disorder as a “mental disorder that affects a person’s brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications.” Addiction is considered to be the most severe form of this disorder.
One of the most common reasons insurance companies deny claims for disabilities stemming from substance abuse disorder is the supposed lack of causal connection between the inability to work and symptoms of the disorder or restrictions imposed by your doctor. This is another reason it can be so helpful to work with an experienced disability insurance attorney because we understand how to obtain and present the right evidence to demonstrate the necessary causal relationships. The same holds true when a denial is based on a lack of objective basis for a diagnosis or limitations. We know how to find and present the missing pieces of evidence to make a claim solid.
Policy language is not standard with regard to many of the issues, but we know how to tailor our arguments to demonstrate why policy language should be interpreted in our clients’ favor.
Insurance companies will generally not make it easy to succeed with a claim for disability benefits when an addiction is involved. In particular, they seem to create additional challenges for professionals in the medical profession. When you work with attorneys who understand how to overcome the obstacles, you reduce the burden on yourself so that you can move forward with your recovery.
Many policies set a time limit of 24 or 36 months on the duration of disability benefits related to substance abuse issues. However, disabilities often stem from multiple causes, so if the disability remains after treatment for substance abuse, it may be possible to file a claim for benefits based on other causes.
Seltzer & Associates Helps Professionals Receive Disability Insurance Benefits when Substance Abuse Disorder Prevents Them from Working
When your mental and physical condition are damaged and you are unable to function professionally, you need to take time to focus on yourself. Allow the team at Seltzer & Associates to assist. If you’ve paid for disability insurance to make up for lost income when you are not able to work, we can help you file a claim backed by the right evidence to succeed with your claim quietly and unobtrusively so that you can complete your recovery in private. If you have already filed a claim and been denied, we can advocate for you during the appeals process. We know how to fight effectively yet discreetly to gain the benefits you deserve.
For a complimentary, confidential consultation to discuss the ways Seltzer & Associates may be able to help, call us at 888-699-4222 or contact us online now.