The Challenges in Claiming Disability Benefits for Mental Illness

When most people imagine a condition that causes ‘disability’, they immediately think of a physical disability and only rarely consider a psychological disability.  This is surprising since about 20 percent of Canadians will experience mental illness at some point in their lives and most of us know at least one person who is struggling with a significant mental health condition.  And, for many of these individuals, their mental illness prevents them from being able to enjoy normal social interactions and function in their jobs.

A three-year study ending in 2014 by the Mental Health Commission of Canada reported that about half a million Canadians cannot work due to a mental health problem and one out of three disability claims are due to mental illness.  The relationship between mental illness and work can be complicated and circular: mental illness can prevent an individual from doing their job; and the difficulties in functioning effectively at work, being productive and interacting positively with co-workers often increases the person’s feelings of inadequacy which can, in turn, worsen their psychological symptoms. Sometimes, a stressful workplace can, in itself, lead to mental health problems.

The incidence of mental health problems continues to grow.  In November 2018, Addictions and Mental Health Ontario reported that there was a 21% increase in the number of hospital emergency visits due to mental health problems.  Also, the number of children and youth hospitalized for mental illness and addition has risen by 63 and 67%, respectively.

In Canada, the following types of mental illness are most common:

• Major depression
• Bi-polar disorder
• Anxiety / panic disorder, post-traumatic stress disorder (PTSD)
• Schizophrenia

The symptoms of mental illness vary with each condition, but shared symptoms often include:

• difficulty concentrating,
• sleep disturbances and insomnia,
• fatigue and weakness,
• memory problems
• a sense of hopelessness.

Different forms of mental illness also have some unique symptoms, such as hyperventilation, a feeling of impending doom, and heightened nervousness, which are typically experienced by persons with an anxiety disorder.  Further, there are several types of anxiety disorders, including PTSD, agoraphobia, panic disorder and obsessive-compulsive disorder, that have their own set of symptoms and challenging problems.

For persons with moderate to severe mental conditions, symptoms often substantially interfere with their ability to properly perform the mental and social functions required within many work environments, such as decision making, remembering and concentrating on job duties, and interacting with clients and coworkers.  And, reduced mental function combined with fatigue and weakness, can also undermine the ability to perform physical tasks.

According to Public Health Ontario, depression has the greatest impact on the health and life of Ontarians and results in the most years lost due to early mortality and reduced functioning.  And, the “the burden of depression alone is more than the combined burden of lung, colorectal, breast and prostrate cancers”.  Further, the World Health Organization predicts that, by 2020, depression will be the second leading cause of disability.

Despite compelling and verifiable statistics on the prevalence of mental illness and the recognition that mental illness can substantially interfere with a person’s ability to function on many levels, individuals suffering from a disabling mental condition are denied disability benefits more frequently than individuals who have a disabling illness or physical injury.  One reason is that it’s more difficult to provide objective proof of a psychological disability since a mental illness cannot be easily substantiated with a medical test such as an X-ray.  Mental illness is, in a sense, a transparent condition since there are generally no visible indicators of the illness. This circumstance makes it easier for disability insurers to deny a claim based on a lack of objective medical evidence and correspondingly, it creates challenges for persons making a disability claim for mental illness.

In order to be eligible for disability benefits for any condition, you must have been under the regular care of a physician for your particular condition and your doctor must provide documentation on how you responded to the various prescribed treatments.  However, when dealing with a mental illness, you are unlikely to be approved for disability benefits for depression, anxiety or another mental health condition unless you also sought a diagnosis and treatment from a mental health doctor such as a physiatrist.  Doing so communicates to your disability insurer that you believe your symptoms are seriously affecting your life and you truly want to get well.  Also, a trained mental health specialist has the expertise to perform psychological assessments which can corroborate your condition.  Further, the opinions held by a respected psychiatrist or psychologist will be accepted as more credible than those of a family doctor.

Many Canadians struggling with a mental health condition are afraid of being stigmatized or negatively perceived, so they avoid seeking treatment and try to deal with the illness on their own.  This often leads to missed days of work and reduced productivity which can weaken the person’s standing in their job but is rarely successful in resolving the condition.

If you are struggling with a mental health problem, don’t delay in getting help from your doctor and ideally, from a trained mental health professional.  The world has changed and employers cannot discriminate against persons with a disability, as long as accommodating the disabled person doesn’t generate hardship for the employer.  And, if you are having any difficulty in obtaining owed disability benefits while you are unable to work, get help from a compassionate Kitchener disability claims lawyer at Dietrich Law.

Sources:

https://www.publichealthontario.ca/-/media/documents/opening-eyes.pdf?la=en

https://www.mentalhealthcommission.ca/English/csrp-backgrounder

https://amho.ca/fall-economic-statement-2018/

https://cmha.ca/about-cmha/fast-facts-about-mental-illness