When you hear the term Post-Traumatic Stress Disorder (PTSD) you may think about a condition that affects war veterans or people who work in emergency services or those who have suffered abuse, disasters or major illnesses and accidents. However, the condition can also result from highly personal traumatic events like losing a job or a business, divorce, failing to achieve a goal, loss of a loved one, seeing, hearing or reading about of a death or other traumatic event, personal injury, childhood trauma or any other life-altering experience. PTSD can affect people of any age, culture or gender and that the condition may or may not rear its ugly head until months or years after a traumatic event.
In our experience representing clients with PTSD in their Long-Term Disability (LTD) benefit claims, we have known clients who have been continuously disabled due to PTSD from the time of the traumatic event and have struggled ever since to recover, despite many months and sometimes years of intensive, ongoing treatment.
However, more often than not, the clients we see have been only recently diagnosed with PTSD, many years after a traumatic event. The diagnosis comes when the trauma resurfaces due to some recent event in their lives such as harassment at work, spousal abuse, termination of employment, or some other occurrence that triggered or brought the original trauma back to the forefront of their lives.
While proving to an insurance company that you are unable to work due to any mental health-related condition can be challenging, if you are suffering from PTSD, you are likely to encounter some unique challenges, particularly when you have failed to prove your initial claim for LTD benefits and you are considering how to deal with the denial of your LTD claim; either by way of appeal or litigation.
In this article we will discuss why LTD claims for PTSD are likely to be denied by insurance companies; we will provide you with some practical tips on how to successfully prove long-term disability due to PTSD to your LTD insurance company, and we will also provide you with some important direction on how best to proceed if your LTD claim for PTSD has been denied. We hope that this information will help you navigate your LTD claim for PTSD and mitigate the worsening of your condition if your claim has been denied.
What is Post-Traumatic Stress Disorder (PTSD)?
According to the Centre for Addiction and Mental Health (CAMH), Post-traumatic stress disorder (PTSD) is a natural emotional response to frightening or dangerous experiences that involve actual or threatened serious harm to oneself or others. For example, PTSD may develop as a response to traumatic life events, such as car crashes, fires, bombings, rape, torture or seeing a family member, friend or other person harmed or killed. Being involved in a natural disaster, such as a hurricane, flood or earthquake, can also lead to PTSD.
Post-Traumatic Stress Disorder (PTSD) and COVID-19
In terms of traumatic events, in recent months, we have had inquiries from people who have been diagnosed with PTSD as a result of COVID-19. In some circumstances, the person had been diagnosed with COVID-19. In other cases, they have lost or feared losing a loved one to the virus. In more complicated cases, the pandemic itself triggered a response to a past traumatic event. Many of these inquiries have come from people who are either beginning the process of applying for LTD benefits and need guidance in terms of how to prove their LTD claim or from people whose short-term disability (STD) or LTD benefits have been denied.
Mental health-related disability claims during the pandemic have likely increased for conditions like anxiety and depression; conditions that have either been caused or aggravated in otherwise healthy people who may have been functioning well previously and who have no prior history of trauma or mental illness. However, for those who have suffered a past traumatic event, the COVID-19 pandemic has served to trigger the often much more serious and complicated mental health condition of PTSD.
Post-Traumatic Stress Disorder (PTSD) and COVID-19
In terms of traumatic events, in recent months, we have had inquiries from people who have been diagnosed with PTSD as a result of COVID-19. In some circumstances, the person had been diagnosed with COVID-19. In other cases, they have lost or feared losing a loved one to the virus. In more complicated cases, the pandemic itself triggered a response to a past traumatic event. Many of these inquiries have come from people who are either beginning the process of applying for LTD benefits and need guidance in terms of how to prove their LTD claim or from people whose short-term disability (STD) or LTD benefits have been denied.
Mental health-related disability claims during the pandemic have likely increased for conditions like anxiety and depression; conditions that have either been caused or aggravated in otherwise healthy people who may have been functioning well previously and who have no prior history of trauma or mental illness. However, for those who have suffered a past traumatic event, the COVID-19 pandemic has served to trigger the often much more serious and complicated mental health condition of PTSD.
In speaking to some of these individuals about their PTSD in the context of their LTD disputes, we understand that factors such as social and physical isolation; risk of illness and death; restrictions by government; continuous news and media reporting of the pandemic; mask wearing; and a whole host of other factors and circumstances associated with the COVID-19 pandemic have caused a triggering response a trauma they had suffered in the past.
Signs & Symptoms of Post-Traumatic Stress Disorder (PTSD)
According to CAMH, PTSD will usually appear within three months of the traumatic event, but sometimes symptoms may not appear until many years later. In many of the PTSD LTD benefit cases we have had, the condition and symptoms of PTSD have arisen long after the traumatic event. This may be partly the reason these LTD claims were denied.
Whether the condition has been continuous or whether it has arisen much later, the symptoms of PTSD can be debilitating and affect every area of a person’s life and functioning.
In terms of symptoms, CAMH provides the following list of common symptoms:
- re-experiencing the traumatic event over and over
- having recurring nightmares
- experiencing unwanted, disturbing memories of the event
- acting or feeling as if the event is happening again
- feeling upset when reminded of the event
- staying away from activities, places or people that are reminders of the traumatic experience
- avoiding friends and family
- losing interest in activities that used to be enjoyable
- experiencing difficulty having loving feelings
- being unable to feel pleasure
- constantly worrying
- having a hard time concentrating
- getting angry easily
- having trouble falling asleep or staying asleep
- fearing harm from others
- experiencing sudden attacks of dizziness, fast heartbeat or shortness of breath
- suicidal thoughts
- symptoms of anxiety and panic attacks
- having fears of dying.
