Is Burnout A disability? Can You Claim Disability Benefits For Burnout?

Being stressed due to your job is not rare, but the hustle culture, overtime, and infrequent leaves have taken this stress to a new level.

Taking time off work for physical injuries or surgeries is common, but what about mental health issues? Conditions like trauma reactions or major depression can be debilitating, requiring extended treatment.

A fact that the majority of businesses around the U.S. overlook is that anxiety and depression linked to workplace stress harm employees’ well-being and reduce organizational productivity. Depression-related absenteeism costs U.S. businesses an average of $51 billion annually. Short-term disability offers an effective solution for obtaining a break from work-related mental health conditions. If you’re curious about how it works and the qualifying conditions, our comprehensive has all the information you need to navigate the burnout disability benefits.

Can burnout be considered a disability?

Burnout is characterized by feelings of exhaustion, cynicism, and reduced professional efficacy. It typically arises from prolonged exposure to excessive job demands, limited control or autonomy, and insufficient support systems. While burnout may not be universally recognized as a disability, its severe manifestations can affect an individual’s overall well-being and ability to perform their job duties.

According to this article, healthcanal.com/supplements/259980-gundry-md-energy-renew.html, respondents said they usually felt chronic stress and fatigue in their 20s. Burnout seriously affects the individual’s mental and physical health and can result in life-altering consequences.

In the legal realm, determining whether burnout qualifies as a disability depends on the jurisdiction and applicable laws. For instance, in the United States, the Americans with Disabilities Act (ADA) protects individuals with disabilities from discrimination and requires employers to provide reasonable accommodations. However, the ADA does not explicitly list burnout as a standalone disability. Instead, it recognizes certain mental health conditions, such as depression or anxiety, that may arise from burnout as potential disabilities. Therefore severe cases of burnout leading to diagnosed mental health disorders may be covered under the ADA.

From a medical standpoint, burnout is not classified as a standalone mental health disorder in widely recognized diagnostic manuals such as the  Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Classification of Diseases (ICD-10). Nevertheless, burnout shares overlapping symptoms and risk factors with mental health conditions like depression or anxiety. These are recognized disabilities in many jurisdictions. Consequently, if burnout results in a diagnosed mental health disorder, it may be considered a disability from a medical perspective.

Insurance coverage, including burnout as a disability, depends on the specific policy and its terms. Long-term disability insurance policies often cover disabilities that prevent individuals from performing their job duties. Suppose severe burnout leads to a diagnosed mental health disorder that substantially impairs an individual’s ability to work. In that case, some insurance policies may cover related medical expenses, rehabilitation, and income replacement.

What is Short-Term Disability?

A short-term disability policy provides financial protection for employees who cannot work temporarily due to health conditions. It offers coverage for a portion of their salary when they experience non-work related injuries, stress-related mental health conditions, or other temporary medical issues that hinder their ability to perform their job duties.

The duration of coverage under short-term disability insurance typically ranges from three to 12 months.

Unforeseen disabilities can occur at any time, disrupting our lives unexpectedly. According to the Council for Disability Awareness, approximately 5% of employed Americans face short-term disabilities yearly due to illness, injury, or similar circumstances. Short-term disability insurance provides a consistent and dependable source of income during this period, playing a crucial role in aiding individuals in their recovery process.

Claiming Disability Benefits for Burnout

The law permits an individual the right to apply for disability benefits if their work has impacted their physical or mental condition severely. You can learn more specifically about the details of what your insurance policy covers by reading through the procedure provided by your employer. There are two types of disability coverage from which you may have one or both types of coverage. Here’s how you can claim your disability benefits for burnout.

Determining Your Eligibility

The first step is to confirm if your employer provides short-term disability coverage. Contact your Human Resources department to inquire about this benefit, as not all employers include short-term disability insurance in their benefits package.

Eligibility for short-term disability depends on meeting specific criteria, including a minimum number of working hours and having a qualifying condition covered by your policy. Reviewing your plan documents to determine if mental health conditions are included in your coverage is important.

Once you have confirmed that your employer offers short-term disability coverage and that mental health conditions are included, you can proceed with the claims process.

Collect Supporting Documentation

You must gather documentation to demonstrate that your mental health condition prevents you from fulfilling your job’s essential duties. Contact your company’s HR department or the claims administrator of your insurance company to obtain information on the required documentation.

Typically you’ll need to complete three forms, including:

1. An Employee Statement (to be filled out by you)
2. An Employer Statement (to be completed by your company)
3. An Attending Physician Statement (to be filled out by your doctor)

Note: if you are consulting multiple doctors for your condition, each one will need to complete an Attending Physician Statement. Similarly, if you have multiple therapists or both a therapist and a psychiatrist, they should all complete the necessary forms.

Submit Forms to the Claims Administrator

Once you have completed the forms, you will generally submit them to the claims administrator. However, it’s essential to carefully review any instructions on the forms to ensure proper submission.

Short-term disability benefits

This coverage begins after an initial waiting period which could last up to two weeks and typically covers from 17 to 52 weeks. Although you can be approved for longer periods, it is best to check what policy your employer has offered you. Under this coverage, the individual may receive 50 to 67 percent of their salary, which will be made bi-weekly.

Long-term disability benefits

It covers periods much longer than short-term disability, which can last until the individual returns to work, reaches the age of 65, and/or no longer meets the criteria of specified disability as per the benefit plan. Long-term disability burnout pays 50 to 67 percent of the individual’s monthly salary rather than bi-weekly.

Supporting disability claims

It is essential to pay attention to the fact that to claim benefits; the person must provide credible proof of their issues. A medical report is necessary to furnish evidence that they cannot work. The insurer needs solid proof that the employee’s mental or physical condition is severe enough to interfere with the core tasks of their job. Make sure to collect all kinds of medical documentation that might be helpful in any way to support your claim. The more detailed the record is, the more chances of your claim getting approved smoothly.

In your medical documents, the following points must be described:

1. Your symptoms
2. In what way do these symptoms interfere with your work

If your claim gets approved, the insurance company will continue observing more proof that you keep seeing your doctor(s) and receive proper treatment.

In most cases, the chances of obtaining support are close to zero. Thus, it is best to get proper legal guidance to compose the ideal responses in this legal minefield. The most common reasons for denying disability claims include inadequate medical evidence, unclear diagnosis, and not following the prescribed course of treatment. Also, for cases involving conditions like anxiety or depression, the probability of support being granted is low. But the good news is that it is possible to appeal an insurance claim denial. After your appeal, you must pay meticulous attention to your online activity since that can be used against you.

The Insurer’s Investigation Process

Physicians are often taken aback by the extensive nature of the claims investigation conducted by insurance companies. Here are some key points physicians may need to be aware of.

• Immediate Investigation: Insurance companies initiate the investigation as soon as you request claim forms, which typically involves a phone call. This allows the insurer to conduct an impromptu interview and gather as much information as possible before you have a chance to review the claim forms, assess the policy, or seek guidance from a disability insurance attorney who specializes in the claims process.
• Communication with various parties: Insurers will contact your treatment providers, family members, friends, and co-workers to discuss your condition. By obtaining signed authorizations, the insurance company gains broad authority to directly communicate with numerous individuals involved in your life, including past and current healthcare providers, pharmacies, benefit plan administrators, insurance agents, financial institutions, the Social Security Administration, family, friends, co-workers, and employees.
• Request for extensive personal information: The authorizations granted to the disability insurer enable them to request a wide range of personal information beyond medical records. This may include prescription history, substance abuse treatment records, court records, occupational data, employment history, driving history, financial statements, and earnings history.
• Face-to-face interviews: Insurers may schedule in-person interviews, often conducted in your home, to examine your surroundings and potentially identify inconsistencies in your claim. These interviews can be stressful, especially if you have never experienced them. Discussing your mental health condition(s) and related details with a stranger can pose additional challenges.
• In-person examinations: Insurance companies may require you to undergo an in-person medical examination. While they may state that it is to confirm your disability, these exams can also serve as a platform for the insurer to criticize your healthcare provider’s chosen treatment course or dispute their conclusions and diagnoses. Refusal to participate in such an examination can lead to a claim denial or benefit termination, as stated in most disability policies.
• Surveillance by private investigators: Insurers might hire private investigators to conduct surveillance through photography, video footage, or online monitoring. The purpose is to uncover any inconsistencies in your claim or gather evidence of “malingering.” This can be particularly challenging for mental health claims, as symptoms may significantly improve once you step away from your medical practice.
• Determining the appropriateness of investigation tactics: It can be difficult for policyholders, mainly those unfamiliar with the claims process, to gauge whether an insurer is crossing boundaries. While the investigative tactics mentioned above may not inherently indicate bad faith, they may only sometimes be suitable for some claims. With mental health claims specifically, it is crucial to establish reasonable boundaries that do not interfere with the policyholder’s treatment. If you believe your insurance company is overly aggressive in its approach, consulting an experienced disability insurance attorney can help assess the scope of the investigation and determine if the insurer’s conduct is appropriate.

Some Tips and Tricks for Managing Workplace Stress

Dealing with burnout can be challenging, particularly when the stressors are external, and you lack control. However, recognizing the signs of burnout is the first step toward addressing the issue. Consider the following tips to help manage workplace stress.

1. Take a temporary break: If you have vacation or personal time off, step away from work and prioritize self-care completely.
2. Prioritize sufficient sleep: Aim to get at least 8 hours of quality sleep each night. A healthy sleep routine can significantly impact your energy levels, alertness, and overall mood.
3. Engage in regular exercise: Regular physical activity can assist in stress management and provide a temporary escape from work-related concerns. Find an exercise routine that suits your preferences, whether running, practicing yoga, cycling, or any other activity that helps you relax.
4. Maintaining a balanced diet: Proper nutrition is vital in sustaining energy levels and overall well-being. Focus on consuming a healthy, well-rounded diet to support your body’s needs and promote a positive mood.
5. Engage in relaxing activities: Dedicate time to hobbies or activities that promote relaxation and personal enjoyment. This can include meditation, yoga, reading, or engaging in creative outlets.
6. Open up to your supervisor: If you feel comfortable, have a conversation with your supervisor about your job expectations. Explore alternative options to help alleviate stress, such as flexible working hours, reassigning specific responsibilities, or additional support mechanisms.
7. Seek professional help when needed: If burnout significantly impacts your well-being and self-care efforts and does not provide sufficient relief, do not hesitate to seek medical evaluation and treatment. Support is available from healthcare professionals who can provide guidance and assistance tailored to your needs.

Remember, managing workplace stress and burnout is an ongoing process. Be patient with yourself, and prioritize your well-being as you navigate through the challenges.

Acknowledged Mental Health Disabilities

If you face a mental health condition in the workplace, you are not alone. Workplace stress and harassment can significantly impact various nervous disorders, especially during the COVID-19 pandemic.

Anxiety and nervous disorders are among the most common mental illnesses, which encompass:

• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)
• Phobias or irrational fears
• General or social anxiety disorder
• Panic disorders
• Depression

Depression is a prevalent disability that many people frequently file legitimate claims. Even before 2020, the World Health Organization (WHO) identified depression as a leading cause of disability worldwide, affecting approximately 300 million individuals. Moreover, different forms of depression can result in disability, such as

• Major depression
• Persistent depressive disorder
• Bipolar disorder
• Seasonal affective disorder
• Psychotic depression
• “Situational” depression
• Atypical depression and other types

Many types of depression share common symptoms, such as irritability, fatigue, difficulty concentrating, and feelings of pessimism.

Burnout vs. Depression

Many individuals have mentioned “burnout” as the reason they cannot continue working, but this argument is generally unsuccessful and is likely to be denied. Making a personal choice not to work is seen as a voluntary decision and not considered an illness. We understand that people have experienced increased mental exhaustion over the past few years. Adjusting to remote work often means long hours, navigating schedules and designated workspaces, attending numerous Zoom meetings throughout the day, and establishing healthy work-life boundaries can be challenging, especially amid a pandemic.

While stress and burnout are symptoms associated with depression, they are not officially recognized as disabling medical conditions. While one can lead to another, having only one sign will likely result in denying a disability claim. The terms “stress” and “burnout” are too ambiguous, allowing insurance providers to manipulate them to avoid paying monthly benefits.

Although companies may claim no bias against depressive conditions, and perhaps none consciously exists, the burden of proof required for disability claims tends to favor clear physical conditions. While depression can manifest physical symptoms, it is primarily an internal illness. Mental health claims are difficult to substantiate as they are essentially “invisible” ailments. Providing tangible evidence of a distressed mental state to an insurance company is challenging. Therefore, ensuring that your therapist and/or psychiatrist can confirm all of your symptoms is crucial.

If you are experiencing depression-like symptoms, exploring available options, such as telemedicine and virtual services, is important. The American Psychiatric Association’s Center for Workplace Mental Health suggests that a diagnosis of depression is typically made if a person experiences symptoms for more than two weeks. Like other health conditions, early detection and effective treatment can reduce the severity and impact of the illness, facilitating a quicker recovery.

To explore these options, consider contacting your general practitioner to discuss the possibility of telemedicine or reach out to your health insurance company to find out which doctors in your area accept your insurance and offer virtual services. If you receive a diagnosis of clinical depression or another mental illness that prevents you from working, you may be eligible to file a disability claim.

FAQs

What Triggers Short-Term Disability?

Short-term disability claims typically arise from non-work-related injuries or illnesses. It is also possible for maternity leave to qualify as a trigger for short-term disability.

How can we differentiate between short-term disability and FMLA?

Short-term disability and the Family Medical Leave Act (FMLA) differ in several ways. One key distinction is that short-term disability provides paid leave, whereas FMLA does not. Other differences include:

• The duration.
• The qualifying reasons for leave.
• The eligibility criteria for employees.

What is the given elimination period for short-term disability?

The elimination period for short-term disability commonly ranges from seven to 30 days for illness or accidents. In some instances, benefits may be distributed on the day of the injury in accidents.

What is the eligibility for short-term disability with anxiety, depression, or stress?

Short-term disability typically covers behavioral health issues, encompassing anxiety, depression, or stress. However, the claims process for these conditions can be more challenging. Claims analysts may require comprehensive medical records related to the diagnosis to assess how the condition prevents the employee from working.

How can I ask my doctor for short-term disability?

To apply for short-term disability, employees need to inform their attending physicians about their intentions. This allows the physicians to gather the necessary forms and supporting records for the application process.

Conclusion

Burnout is a serious issue with significant health consequences, resulting in negative repercussions. It can affect anyone at any time. If you, unfortunately, find yourself in such a situation where your health is affected by work and eventually the work by your deteriorated health, then finding a way to ensure your financial security is most likely the first step you must take. If you cannot physically or emotionally return to work due to your health issues and your disability claims get denied, consider seeking legal aid from insurance denial lawyers.