Physical and Mental Disability as Co-Morbid Conditions in a Disability Claim

Individuals with cardiac issues may find they are eligable to file a disability claim for work-related stress, according to medical literature.

Anxiety and depression suffered by a claimant that is secondary to a physical condition is an issue being seen with greater regularity in disability claims. This is often seen in cases where the claimant has had a cardiac event and returned to work after a period of recovery.

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Medical literature supports the position that stress negatively impacts one’s cardiac issues. The claimant finds returning to work brought back the stressors which possibly contributed to the original cardiac event. Unfortunately, the insurer is likely to take the position that the disability insurance coverage is available for the inability to work at the job, not the fear of dying from working in that job. As such, where a claimant also has anxiety or depression which impacts on their ability to focus or concentrate, the claim may be developed and supported through a mental health provider.

Often, the anxiety and depression can be the condition supporting payment of the claim, even if the insurer rejects the claimant’s contention of being subjected to inappropriate risk of a future cardiac event. The insurer is likely to fiercely contest the mental aspects, but such claims can be well supported and testing data can also support that aspect of the claim. Thus, a claimant who has sustained a disabling event and returned to work, but feels that they are unable to continue working without jeopardizing their continued recovery, can strengthen a potential claim by having the emotional aspects of their condition explored and treated. Receiving treatment from a mental health provider will become necessary to develop evidence to support this impairment.

Failing to receive appropriate treatment for such a condition will prevent a claimant from pursuing this aspect of the claim, since policies require that a claimant be under the care of a physician, other than themselves, for the disabling condition. Coming under the care of a mental health provider would be critical to supporting the claim. The nature and extent of the mental health treatment, and the articulation of the support for how and why a claimant cannot perform their work duties due to the mental health issues, would be significant.

Those who have unfortunately suffered a cardiac event, or another condition for which they have made some level of recovery, but are concerned about a relapse of the condition upon a return to work, should consider whether they are suffering from anxiety or depression.

Jason A. Newfield, Esq., is a founding partner at Frankel & Newfield, a national disability law firm, where he aggressively represents claimants in long term disability insurance, ERISA, and other insurance claims and litigation. He holds an AV® Preeminent Peer Review from Martindale-Hubbell and has been named to the Super Lawyer New York Metro list from 2013 — 2016. Mr. Newfield is frequently invited to speak before bar associations, medical organizations and other trade organizations regarding disability claims and has published numerous articles on Disability Insurance. He is a member of the American Conference Institute, regularly presenting to attorneys and claims personnel at national conferences on disability litigation.

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