Can people get ERISA disability benefits for mental health issues?

On Behalf of | Sep 2, 2023 | ERISA Disability Benefits

Some workers seek out jobs that offer higher pay and more comprehensive benefits packages. Supplemental disability benefits are of particular value for those in highly compensated professions. Basic disability benefits available through workers’ compensation or Social Security may fall far short of maintaining someone’s basic financial responsibilities if they are used to an executive level of compensation.

Employers frequently offer long-term disability benefits to those in better-paid positions. The Employee Retirement Income Security Act (ERISA) governs such benefits and helps to ensure that those offered disability insurance by an employer can make use of that protection should the need arise. Some forms of disability are very obvious and easy to prove, while others can be more of a challenge to establish in a convincing manner.

Can those with a debilitating mental health condition potentially qualify for ERISA disability benefits?

Qualifying can be a challenge

To qualify for disability benefits, an applicant generally needs to establish that they have a medical condition that currently prevents them from working at all. Documenting the impact of a mental health issue can prove very challenging for someone already struggling with their mental health. Records from medical appointments or from an involuntary psychiatric hold can help someone establish that their current mental health challenges are severe enough to warrant disability benefits.

There will be limits to the benefits

Unlike physical conditions, which may qualify someone for lifelong benefits, mental health claims and substance abuse claims for ERISA disability benefits often only result in limited coverage. While there are plans to review this matter in 2023, applicants must understand the current rules when they plan to apply. Most applicants will only be able to receive ERISA long-term disability benefits for a set amount of time if they qualify based on a mental health condition. Individuals denied ERISA disability coverage or worried about qualifying because they need to take a leave of absence from work may need to review their policy paperwork carefully to see if there are any specific limitations imposed on mental health claims.

Knowing the rules that govern ERISA disability benefits may help those in need of financial support to obtain the coverage that their employer has provided to them as a benefit. Seeking legal guidance can result in greater clarity on this subject matter.