Because obsessive-compulsive disorder (OCD) is more often characterized as a mental illness rather than physical, it can make getting disability approval more complicated. Your insurance company may limit or deny you your benefits unless you’re able to prove a physiological cause for your condition. Here’s what you need to know before filing your claim for OCD.
What is OCD?
Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. It’s characterized by unwanted, obsessive
thoughts and compulsive actions. These compulsions—referred to as “rituals”—are distressing, exhausting, and can interfere greatly with day-to-day life. For most who suffer from OCD, the condition is chronic and requires lifetime management. Depending on the severity of your diagnosis, OCD is a potentially disabling condition.
Disabling Symptoms of OCD
Severe OCD symptoms can negatively affect all aspects of a person’s life, including the ability to work. These symptoms can include:
Repetitive behaviors/obsessive compulsions (examples include cleaning, checking, counting, tapping)
Intense fear and anxiety when unable to follow routines
Intrusive, unwanted, and recurring thoughts
Derealization (feeling detached from your body)
OCD varies in severity on an individual basis. For severe cases, the compulsions involved can impact your ability to function in everyday life to the point of being disabling, even with treatment.
How is OCD Diagnosed?
It is essential before you submit a claim for your long term disability insurance that you have a proper OCD diagnosis from a doctor. The diagnosis process wіll likely іnclude:
A physical exam to see if your symptoms are due to a health condition;
Blood tests to check your blood count, how well your thyroid works, and any drugs or alcohol in your system;
A psychological evaluation about your feelings, fears, obsessions, compulsions, and actions.
Appropriate Treatment fоr OCD
The insurance company will require proof you are seeking appropriate treatment fоr уоur OCD. The two most common courses of treatment are talk therapy and medication.
Cognitive-behavioral thеrару іnvolves two components: 1) exposure and response prevention and 2) cognitive therapy. Exposure and response prevention requires repeated exposure to the source оf your obsession. You are asked to refrain from the compulsive behavior you’d usually perform to reduce your anxiety. Studies show that exposure and response prevention can actually “retrain” the brain, permanentlу reducing thе occurrence of OCD symptoms.
Mеdісаtіоn. Selective-serotonin reuptake inhibitors (SSRI) are most commonly prescribed for OCD, for example Prozac. Antidepressants can also be used for treatment. However, medication alone is rarely effective in relieving the symptoms of OCD.
Disability and Inability to Work Due to OCD
Your OCD symptoms may make it impossible to function at the level necessary for your job. The intrusive thoughts could be hindering your ability to focus mentally. Time-consuming rituals might be making your physical tasks impossible as well. In that case, you want to look at filing a claim on your long term disability insurance policy.
Keep in mind that most long term disability insurance policies have a stipulation that any illness found to be mental rather than physical will result in a limitation of twenty-four (24) months. After that time, your benefits will expire. This is why it’s important to establish your illness as physical.
What exactly causes OCD can be complex and difficult to pin down. You will need to gather evidence showing that your disability is physical and that you are unable to perform your job due to your illness. The insurance company will require the opinions of your treating doctor(s). They may weigh its decision very heavily on your doctor’s opinion – so your doctor’s support is essential to your claim.
You will need to provide medical records substantiating your claim, including your diagnosis and ongoing treatment. Your doctor’s reports should focus on the frequency and severity of your symptoms, their direct observations of you during your office visits, any objective physical examination findings, and your specific restrictions and limitations that prevent you from work.
In addition to your medical records and doctor’s reports, it is often beneficial to to explain exactly 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. Make sure your narrative addresses each of your symptoms by listing them separately.
Your narrative and your doctor’s support will go a long way in helping to prove your disability due to OCD.
As OCD can be a difficult disorder to treat, it is possible you will not be able to return to work despite your best efforts. You need to be prepared to prove to your insurance company that you are unable to perform your job as a result of the OCD. This means connecting the dots between your illness and your inability to work. It’s important to provide a detailed explanation of how your symptoms prevent you from performing your job duties. Don’t simply assume the insurance carrier will see the connection. You must explain it in clear detail.
An attorney specializing in long term disability insurance can help you with the claims process. They will know the best way to substantiate the disabling symptoms of your OCD to the insurance company.
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