Three types of Disability Claims (specifically focused on Mental-Nervous claims).

Three main types of Disability Insurance claims will be covered in this post including special emphasis on mental-nervous claims.

The first type is know as a “Total Disability” claim.  This type of claim is exactly as it sounds–you are 100% disabled and unable to work, resulting in complete loss of income. A Total Disability Claim is usually very clear, and you would more than likely receive all of your promised disability benefits.

The second type of disability claim is known as a “Partial Disability” (or Residual Disability).  In this situation, you might be losing income due to an illness or injury but are still able to work within a limited scope.  With a Partial Disability claim, it’s likely that you would receive a portion of your disability benefits, which would be calculated and based on loss of monthly income.  Dependent upon the definitions and riders within one’s disability contract, however, there are some scenarios in which an individual might be partially disabled but still eligible to receive their full benefits as if they are totally disabled.

The third type of disability claim will be the main focus of this post and is known as a “Mental-Nervous” claim.  The majority of the insurance carriers classify out this particular segment of a claim.  Mental-Nervous claims are typically “psychiatric” in nature.  Examples would most commonly include: stress, anxiety, depression, and substance abuse.  This type of claim does not include “neurological traumas” or “Alzheimer’s disease”.  Neurological traumas and Alzheimer’s are typically covered under your traditional definitions, but we would want to check with the specifics of your disability contract to be sure.

It is very common for an insurance carrier to apply a 24 month limit to any disability benefits received for a Mental-Nervous claim.  If your disability contract has this 24 month limitation, you would only receive benefits for as long as you are disabled up to a maximum of 24 months at which time the benefits would cease to be paid out any longer. (If you recover before the 24 month limit, then your disability benefit would cease at the time.) The mental-nervous disability claim is very different than a traditional disability claim that lasts up to the full benefit period.  

There are a few select carriers that offer full coverage for Mental-Nervous claims (depending on your occupation and state of residency).  Even though the premiums are often higher when you opt for full Mental-Nervous coverage, it can prove well worth it to do so since roughly 10-15% of all disabled claims are filed as “mental-nervous claims”.  

If this is a benefit that is important to you, then we’ll make it a priority to explore the carriers that offer full coverage in this area, instead of the 24 month limit, so we can evaluate which type of coverage best fits your desires and create a disability plan tailor made for you.

As always, we’re here to help!

Chris Wimberly

The Disability Doc

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*This information is solely used for general market educational purposes.  It does not provide legal rights or actual carrier policy language.  Please review the respective policies for the complete terms and conditions.