Thursday, August 19, 2010

Panic/Anxiety & Depressive Disorder Disability claim with Private Insurance company denied. Advice please?

I am suffering from a panic/anxiety disorder which has brought about severe depression. I have been unable to concentrate, eat, sleep, work, or socialize with family or friends. I am seeing a therapist %26amp; we are working my way out from this black hole.





My question centers around the STD disability claim that I filed w/my employer's insurance company. They denied my claim citing lack of comprehensive doctor's notes to support the diagnosis; and they also said that I've been able to go to school without missing any classes (which is not true...I've had to fight to get to class and class is only 1 hour long, 3 nights a week...vs. work which is 8 hrs, 5 days).





So, my question is....has anyone else been denied from their private insurance carrier for STD due to anxiety %26amp;/or depression? And if yes, what would you suggest I do from here to get them to reopen my claim %26amp; approve it?





NOTE: Anything you can provide regarding my claim would be helpful. I only ask that everyone be kind.Panic/Anxiety %26amp; Depressive Disorder Disability claim with Private Insurance company denied. Advice please?
As good as it is to have insurance, sometimes insurance companies really suck.





My suggestion would be to have your therapist contact them (or whoever deals with insurance stuff in your doctor's office) and see if something can be worked out. Most likely your therapist is submitting notes that are brief and minimal (probably for confidentiality reasons for your sake) and that's why the insurance company is not covering your care.





I would also say that you need to contact your insurance company and talk to them as well. You will be the best person to lobby for your own care because you can best convey what's going with you. Insurance companies can be stubborn though, so don't be surprised if they're not willing to be flexible with you.





I completely understand your reasons for being frustrated with your insurance company. First of all, I don't believe it's any insurance company's business as to what I talk about in my therapy sessions (I've run into this problem before too - insurance was wanting my doctor's notes, a social history on me, results of psychological testing, etc. Fortunately, my therapist's office was able to sort out everything and I'm able to get coverage). Second of all, I also don't believe that insurance companies should dictate what kind of care they will cover and how long they will cover it for. When they become mental health specialists, then they can dictate that kind of stuff :) (Sorry, my own personal rant about insurance coverage :)) I work on an adolescent psychiatric unit and this is something the case managers are constantly dealing with when it comes to insurance companies - getting them to agree to coverage and getting them to understand that our patients really do need inpatient psychiatric care.





I don't feel as though I've been much help to you...all I can say is that I definitely understand where you're coming from and the frustration that comes with dealing with these companies. I understand the depression and anxiety as well, as I'm being treated for both right now. When a person is feeling that bad and is in desperate need of treatment, it can be scary that insurance could stand in the way of your care. Advocate for yourself, ask your therapist to talk to the insurance company as well. Hang in there and best of luck to you :)Panic/Anxiety %26amp; Depressive Disorder Disability claim with Private Insurance company denied. Advice please?
Almost all employers routinely deny the first filing of a disability claim. They do this because they know that a good percentage of the claimants will simply give up on the first go round. Appeal !! Hire an attorney specializing in medical claims - they can only accept a small, set fee. I had to fight my employer through an appeals process (it was for a different malady) but I eventually won. Good luck.

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