Reasons Why Your Mental Health Claim Was Denied

BY: Koszdin | Friday, August 24, 2018.

Having a mental illness is very tough. It’s still somewhat stigmatized in the world we live in today. Often times your mental health claim may be outright denied. This is because mental illness is far more difficult to prove than physical ailments. You risk your long-term disability benefits getting cut off. There are several common reasons why your health claim was denied and what you can do to alleviate it.

You’re not being treated or seen by a psychiatrist

You have to specifically be treated or seen by a psychiatrist in order for your claim to be accepted. This is necessary because psychiatrists are experts and specialists on mental illness. Insurance and disability companies can claim that your condition isn’t serious enough if you are not seeing a psychiatrist. If there are no signs of mental health improvement, then the insurance company may deny you disability benefits. In order to alleviate this, make sure you ask your doctor to refer you to a psychiatrist to be evaluated at the very least. This will definitely help your claim.

Not having the proper documentation

In order to bring a mental health claim, you must have everything written in medical charts and filed. If your mental illness is undocumented or inadequately documented, then in the eyes of the insurance company, you haven’t received high-quality care. You need to make sure that your doctor explains the treatment options given to you, your response to them, how they have adjusted the treatment based upon your response, and their plan for the future with your mental health. The documentation needs to be detailed so that there is no room for misinterpretation.

Not receiving regular care from your family doctor

All insurance companies and disability programs require that you receive “regular care” from a physician. This typically means that you are going to your family doctor at least bi-weekly or monthly. Your treatment needs to be monitored. You have to show that you are working to get better or that you have at least explored all the options in order to improve your medical condition and function in the workplace. In order to alleviate this, insist that your doctor schedule regular appointments and that your medication is monitored. Also, make sure you don’t miss any appointments with your doctor.

Mental illness is a very real and serious matter. When your mental health claim gets denied, it can be frustrating. Insurance companies often think that you are just trying to find a reason to be out of work. It’s unfair. You deserve someone to fight for you to get your claim approved. You need someone with experience and expertise in mental health claims. The Law Offices of Koszdin, Fields & Sherry have been working on cases like yours since 1955. When looking for a Van Nuys mental health claim attorney, we will be a good match in providing you with the expertise to help you get through this hard time. Schedule a free initial consultation using the contact form or by calling us at 818-812-5639 or 800-747-3447. Se Habla Español.

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