Many people afflicted with bipolar disorder find themselves struggling to carry out their daily activities. The fluctuating symptoms may lead to serious complications in functioning and problems with personal relationships – making it difficult to hold down a job. Even with proper treatment, bipolar disorder can be problematic to manage.
If you’re unable to continue working due to your bipolar disorder symptoms, you may consider filing a long term disability insurance claim. But you might have questions: Is bipolar disorder considered a disability? What are your chances of receiving disability for bipolar disorder? How do you get approved for bipolar disorder disability benefits?
Here’s what you need to know before filing your bipolar disorder long term disability claim.
What Are the Disabling Symptoms of Bipolar Disorder?
Bipolar disorder is a disabling condition caused by a chemical imbalance in the brain resulting in severe mood swings. It is characterized by periods of manic activity punctuated by exceptionally bad periods of depression. Both the highs and lows of bipolar disorder are intense and can interfere with all aspects of your daily life.
You can absolutely qualify for long term disability benefits due to bipolar disorder. However, you will need to provide strong evidence to your insurance company of your disabling symptoms to get your claim approved.
Understanding Your Unique Symptoms
When filing your long term disability claim, the insurance company will want to know about your bipolar disorder symptoms. They must understand how your symptoms are disabling to you and your career. Remember, bipolar disorder presents differently in different people. Each person will have a different cycling pattern, and the pattern may change unexpectedly. It is not fair to broadly categorize people with bipolar disorder because it is a unique condition that affects different people differently. To fairly evaluate your bipolar disorder long term disability claim, the insurance company must understand how your condition personally affects your functioning.
Bipolar Disorder Episodes and Cycling
Your personal symptoms will depend on the way your bipolar disorder manifests itself. You may have a bipolar disorder episode that is manic or depressive. Other times, you may “cycle” between these episodes with symptoms of both. It is common for those with bipolar disorder to experience extreme emotional highs and lows, or for these mood swings to occur quickly and without notice or apparent reason.
Bipolar Manic Episodes
In the manic phase, you may experience euphoria or mania. This is considered a “high” compared to the depressive “low.” Symptoms of a bipolar manic episode can include:
- Euphoric mood
- Decreased need for sleep
- Racing thoughts/distractibility
- Increased energy
- Very high self-esteem
- Engaging in risky behaviors
- Making poor decisions
Bipolar Depressive Episodes
In the depressive stage, you may feel extremely down or like the world is about collapse in on you. During these low swings, you may move and speak more slowly than usual. You may also sleep more than normal. It’s very possible you may even experience hallucinations, delusions, and paranoia. Symptoms of a depressive episode can include:
- Deep sadness/depressed mood
- Low energy
- Slow speech
- Problems with concentration and attention
- Insomnia and/or periods of too much sleep
- Feeling hopelessness and/or worthless
- Lack of interest/feeling no pleasure
- Weight loss and/or changes in appetite
- Thoughts of suicide
Bipolar Disorder Mixed State
One common phenomenon of bipolar disorder is a “mixed state.” That is, an episode where an individual simultaneously experiences characteristics of both the manic and depressive stages. Symptoms of a bipolar mixed state can include:
- Anxiety and confusion
- Losing touch with reality
- Suicidal thoughts
- Manic behavior
- Clinical depression
- Excessive anger and belligerence
How is Bipolar Disorder Diagnosed?
The insurance company will require proof of your diagnosis for your bipolar disorder long term disability claim.
The first step in getting the correct diagnosis is to talk to a doctor. Your doctor may conduct a physical examination, an interview, and lab tests.
Bipolar disorder cannot be identified through a blood test or a brain scan, but these tests can help rule out other contributing factors, such as a stroke or brain tumor. If your symptoms are not caused by other illnesses, your doctor may conduct a mental health evaluation. Your doctor may also provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating bipolar disorder.
Your doctor or mental health professional will likely conduct a complete diagnostic evaluation. A careful and complete history of symptoms is needed to assure your bipolar disorder is not mistakenly diagnosed as a major depressive disorder.
In addition, your doctor or mental health professional will likely discuss any family history of bipolar disorder or other mental illnesses. Your doctor or mental health professional may also talk to your close relatives or spouse to see how they describe your symptoms and family medical history.
Types of Bipolar Disorder
The insurance company may also want to know what type of Bipolar Disorder you suffer from. Health experts classify bipolar disorder into four types:
- Bipolar Affective Disorder 1: This type is diagnosed when you have had at least one manic episode, which could be followed or preceded by a major depressive or hypomanic episode. Individuals with Bipolar 1 experience full-blown mania. Symptoms may include high energy, insomnia, racing thoughts, extreme talkative behavior, hallucinations and delusions.
- Bipolar Affective Disorder 2: Sometimes referred to as “Swinging Bipolar,” you may be diagnosed with Bipolar 2 if you experience at least one depressive episode and one hypomanic episode. Unlike Bipolar 1, those diagnosed with Bipolar 2 aren’t known to have psychotic episodes. They can, however, suffer badly from depression.
- Cyclothymic Disorder: Cycolthymic Disorder is characterized by at least a two-year history of periods of both hypomania/mania and depression, but not to a major extent. Your manic and depressive episodes can go back and forth over a period of time, but not enough to meet full criteria of major depression. Those diagnosed with Cyclothymic Disorder do have trouble functioning at times.
- Bipolar Affective Disorder – NOS (not otherwise specified): This type is diagnosed when you experience some characteristics of bipolar disorder, but none of which can be classified as one of the three other types.
Both men and women can suffer from bipolar disorder, and it can hit at any age. However, most people seem to start noticing the symptoms in their twenties. Approximately 85% of people suffering from bipolar have a family history of depression.
How Do I Prove My Disability Due to Bipolar Disorder?
Bipolar disorder can be extremely distressing and disabling. It is a condition that can ruin your career and relationships alike. However, you should never assume the insurance company will understand how your individual symptoms impact you and your job. To increase your chances of claim approval, you must explain why each of your symptoms prevents you from performing your job duties.
For example, during a depressive episode, you be unable to get out of bed due to your severely depressed mood and fatigue forcing you to call in sick. You may be preoccupied with your debilitating symptoms and unable to focus, concentrate, or pay attention during an important meeting or telephone call with your biggest client. Or your lack of interests, low energy and feelings of hopelessness may make routine tasks seem overly stressful or cause you to procrastinate and miss a strict deadline.
During a manic episode, you may decide to “blow off” work for the day. If you do make it to work, your heightened energy may cause you to speak rapidly and scare off a potential client, or fail to put your best foot forward during a presentation. Your irritability may lead to fights with co-workers, disruptive behavior in a meeting, or an inability to accept criticism from your boss. Your racing thoughts and easy distractibility may cause you to miss an important piece of information from a document, which is particularly troublesome if your job requires attention to detail.
There are many ways bipolar disorder symptoms can impair your ability to work. These need to be explicitly outlined in your evidence when submitting your claim.
Writing A Personal Narrative
Given the varying symptoms of bipolar disorder, you should explain to your insurance company how your individual symptoms prevent you from performing your job duties. You can do this by preparing a detailed, written narrative for the insurance company. In many cases, it is helpful if the narrative addresses all of your symptoms by listing them separately first. Because most symptoms of bipolar disorder are subjective in nature, your narrative can also address the severity of your symptoms, as well as factors that trigger or exacerbate your symptoms.
Medical Records From Your Doctor(s)
When determining whether your bipolar disorder is disabling, your insurance company will likely also want the opinions of your treating doctor(s). Your doctor’s support is key. Your doctor’s reports should focus on:
- The frequency and severity of your symptoms;
- Any positive mental status exam findings;
- Their direct observations of you during office visits; and
The specific restrictions and limitations that prevent you from working.
In addition to a personal narrative and supportive reports from your treating doctor(s), you may consider undergoing a Neuropsychological Evaluation. A neuropsychological evaluation will measure your cognitive deficits.
Neuropsychological testing objectively and scientifically measures how your disability is impacting your memory, learning perception, problem solving, speed processing, verbal functioning, and executive functioning, among other things. The evaluation usually also includes IQ testing and screening for any primary or secondary psychological diagnoses. It also will include validity testing to demonstrate the reliability of the test results.
Many conclusions can be drawn from a valid neuropsychological evaluation, including your primary diagnosis, secondary diagnosis (if applicable), and your deficits in specific areas of cognitive functioning. The results provide the insurance company with strong and objective evidence to demonstrate how and why your bipolar disorder impacts your ability to work.
Your narrative, doctor’s support, and additional neuropsychological testing will all go a long way in helping to prove your bipolar disorder long term disability claim.
What Is Considered "Appropriate Treatment" for Bipolar Disorder?
When evaluating your bipolar disorder long term disability claim, the insurance company will want to see you’re receiving appropriate treatment. Even if your claim is approved, they will still require proof of ongoing treatment for your condition. The insurance company can easily use non-compliance and lack of appropriate care as a reason to deny or terminate your bipolar disorder long term disability claim.
To demonstrate appropriate treatment, your treatment team should include specialists such as a psychiatrist and/or psychologist. Treatment options may include:
- Medications: Your doctor may prescribe mood stabilizers; antipsychotics; antidepressants; and anti-anxiety medications. It may take some time (and trial and error) before you and your doctors find the right medication or medications.
- Psychotherapy: Your doctor may recommend psychotherapy, which may include individual counseling (to help you address specific problem areas, recognize your symptoms and manage your stress); cognitive behavioral therapy (to help identify negative thoughts, change your behaviors and come up with coping strategies); interpersonal and social rhythm therapy (to help come up with a routine for daily activities such as sleeping, eating, diet and exercise); and family-focused therapy (to educate your family about Bipolar disorder and how to recognize warning signs of a manic or depressive episode).
- Day Treatment Programs: Your doctor may suggest an out-patient day treatment program designed to help you recognize and control your symptoms.
- Hospitalization: If you are experiencing suicidal ideas, acting dangerously, or experiencing psychotic episodes (g., paranoia, delusions, irrational thoughts, hallucinations), your doctor may recommend an in-patient hospitalization. In-patient treatment may help address your symptoms, stabilize your mood, and keep you calm and safe while doing so.
- Electroconvulsive Therapy: Electroconvulsive therapy, while rarely used, can be helpful if you are experiencing severe depression or mania that is not relieved by medications or other treatment methods.
Again, it is important to follow your doctor’s recommendation. Your insurance company will want to see you are in treatment and doing everything in your power to improve your symptoms.
LTD Policies and Mental Illness Limitations
One thing to keep in mind when filing for long term disability is whether your long term disability insurance policy includes a Mental Illness Limitation.
Policies that contain a Mental Illness Limitation typically limit your benefits to two years if you are disabled due to a psychiatric condition such as depression or anxiety. Of course, each policy is different, so the prescribed maximum period may be shorter or longer depending on the terms of your particular policy.
Some policies with Mental Illness Limitations contain exemptions for certain mental conditions – including, occasionally, bipolar disorder. It’s important to review your policy closely to see whether your bipolar disorder will fall under the Mental Illness Limitation.
If you are solely disabled due to bipolar disorder and your policy contains a Mental Illness Limitation that does not exempt it, your benefits will most likely stop when the maximum allowable period expires. Unfortunately, the severity of your mental illness will become irrelevant after the maximum allowable period expires.
However, if you can demonstrate that you are disabled due to objective cognitive problems, your benefits may extend beyond limitation period. A neuropsychological evaluation, as discussed earlier, can provide this evidence.
If your policy includes bipolar disorder as an exempted mental condition, you may continue receiving benefits beyond the limited period.
Bipolar disorder is a serious medical condition that may result in disability. Knowing how to substantiate your claim will significantly increase your chances of approval. To get your bipolar disorder long term disability claim approved, your claim should be supported by sufficient medical evidence and proof of appropriate treatment. It is also important to explain (in detail) how your symptoms prevent you from performing your job duties. Don’t assume the insurance company understands. You have to explain it.
If you are suffering from any of the symptoms above or if you have already been denied disability insurance benefits but have bipolar disorder, our New York long term disability lawyers can help. Call Riemer Hess LLC at (212) 297-0700 for a consultation on your disability case.
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