The National Alliance on Mental Illness was originally founded in Dane County–a stone’s throw from our firm’s Madison office) in 1977 to reduce stigma and improve the quality of lives for those affected by mental illness. NAMI Wisconsin’s annual conference includes dozens of workshops dedicated to mental health research, lived experience stories, advocacy updates, and crisis response systems. As disability attorneys, Jessa and Brook took advantage of this sold-out conference to share their first-hand experience of the ways in which mental health conditions are discriminatorily treated under long-term disability (LTD) insurance policies.
Long-Term Disability Policies for Mental Health
LTD policies provide essential financial security to individuals who have had to stop working due to their medical conditions, including mental health conditions, by paying a monthly benefit to the disabled individual. Generally, these benefits remain payable until the individual reaches age 65 (or later), provided they remain disabled. However, this does not hold true for individuals disabled by a mental health condition. Rather, as Jessa and Brook explained, LTD policies ubiquitously limit the payment of benefits for disabilities caused by or contributed to by a mental health condition to just 24 months. These provisions are referred to as “mental illness limitations.”
During their session, Jessa and Brook discussed the legality of these mental illness limitations under both federal and state law. Regrettably, such limitations do not violate current federal law. Therefore, it is up to the states to regulate and to date only Vermont has found these limitations illegal and unenforceable. Specifically, in 2008 the Vermont Department of Banking, Insurance, Securities and Health Care Administration determined that the inclusion of mental illness limitations constitute in disability insurance policies constituted an unfair and unjust policy provision, which is prohibited under Vermont law.
“So aside from moving to Vermont,” Jessa asked the audience, “what are we to do?”
- Develop a Greater Knowledge Base: We need to increase public awareness about the prevalence and discriminatory impact of mental illness limitations. We can’t solve a problem we know nothing about, and many individuals are unaware that their employer-sponsored LTD policy likely includes a mental illness limitation, let alone the practical impact of the same.
- Demand Change at the Consumer Level: A change in demand can compel a corresponding change in supply. Thus, if your employer-sponsored LTD plan includes a mental illness limitation, talk to your HR department about exploring alternative policies and/or carriers that do not apply the limitation.
- Advocate for a Change In the Law: Wisconsin’s mental health parity law (Wis. Stat. Sec. 632.89) should be made applicable to both health and disability insurance policies. Doing so will have the effect of improving financial security for Wisconsinites facing debilitating medical conditions while also standardizing the laws governing insurance policies. Such advocacy is especially pertinent in light of the fact that Governor Tony Evers declared in his State of the State address that 2023 shall be “the year of mental health” and pledged $500 million for mental health services.
Mental Health Crisis in Wisconsin
As Governor Evers noted, the state of Wisconsinites’’ mental health is “a quiet, burgeoning crisis that… will have catastrophic consequences for generations if we don’t treat it with the urgency it requires.” Certainly, an individual’s ability to pursue mental health treatment is rooted in their financial security and access to the funds to meet their basic needs. This fact underscores the importance of making sure LTD benefits are available to qualified individuals with debilitating mental health conditions, and that these benefits may not be arbitrarily capped at two years.
Jessa and Brook would like to thank NAMI Wisconsin for welcoming them as presenters at their annual conference and for providing a platform for them to share this important message. If you or someone you know is struggling with a debilitating mental health conditions and is considering filing a claim for disability benefits, don’t hesitate to contact us!
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