We have handled many different long term disability claims over the last 27 years. One challenging medical condition is post-traumatic stress disorder (PTSD). A person with this disorder has suffered a traumatic event which precludes full function in work environments. Many combat veterans experience PTSD. PTSD is not limited to combat veterans. Many who have not served have also experienced traumatic events and suffer PTSD as a result.
People with PTSD may function normally in most conditions but cannot function at all when exposed to certain conditions. One must remember that working in an occupation requires more than the physical ability to do the work. It also involves the mental and social ability to interact with others to perform the tasks and functions necessary in that occupation. One suffering with PTSD cannot “shake it off” any more than one who suffers a physical injury. There is treatment for both, but there is no switch to flip.
For example, we have had clients who are doctors, who through years of training and experience, are able to perform in very difficult life and death conditions. When they lose their patients, they carry on. However, they may be dramatically affected when they lose their daughter, son, spouse or other close relative. Seeing your loved one slip away or finding them deceased and not being able to revive them can be a horrible memory that is difficult to overcome even for someone who was accustomed to seeing people die. As a result, they experience PTSD and are unable to continue in their occupation as a treating physician. The stress of the occupation can trigger the PTSD.
We've also had a client who suffered a traumatic burn injury which caused dramatic disfigurement and incredible pain. He had numerous surgeries which significantly enhanced his physical appearance. And, he recovered most of his strength and stamina. However, driving close to industrial plants triggered memories of the horrible incident. He would be overcome with emotions to the point of incapacitation. Before long, the emotions would be triggered by other stressful events. He tried to control his emotions and continue working. But PTSD is real. And it can be disabling.
We know how to help people with PTSD. Someone can appear fine yet not be fully functional in a work environment. Someone may be able to perform some occupations, yet they could still qualify for disability because they are unable to function in their chosen occupation. It depends on the terms of the disability policy. Understanding the issues and the terms of the governing policy are the first steps in presenting a successful claim to the insurance company.
Also knowing the games that long-term disability insurers will play regarding PTSD is important. Some insurers know that litigation is stressful and that many clients with PTSD want to avoid stress. Many press these cases into litigation hoping those with PTSD will not want to continue. We tell our clients to let us worry. That's our job. We take the stress out of the situation.
Some insurers want to treat PTSD as a mental or nervous condition detached from the physical injury that may have caused it. This allows them to reduce the benefits paid because many policies or plans limit payment on a mental or nervous condition to 24 months. We regularly defend against this tactic as well.
Successfully collecting ERISA disability claims require more than reading the policies and perhaps some of the applicable law. ERISA experience is a must. This is especially true for PTSD claims. We have ERISA experience. This is what we do day in and day out in the courts throughout Alabama. No law firm has handled more ERISA litigation cases than we have in the last 5 years. We know ERISA and we know PTSD. And, I know that we can help you. Put our experience to work for you.
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