Is addiction a disability?

You may be surprised to hear that the symptoms of addiction qualify for long term disability claims coverage - however as research is done to understand addiction further, we are beginning to understand addiction as an illness like many others, with internal and external factors that impact the severity of symptoms. At Share Lawyers, we know that the people who have chronic illness and disabilities need care and support, and will often need expert legal assistance to ensure that their long term disability claims are not wrongly denied by their insurance company. These disabilities are serious and hinder those who have them in their daily lives.

In this video, disability lawyer Samantha Share explains why addiction is considered a legitimate disability eligible for disability benefits from the insurance company.

Addiction and long term disability benefits

Living with addiction is now generally recognized to be an illness. Whether the addiction will entitle a person to a long term disability claim from the insurance company will depend on the specific provisions of the individual insurance policy. Under the typical group benefit policy for long term disability benefits, a substance abuse addiction to drugs or alcohol can form the basis of a disabling condition that would entitle an individual to disability benefits, provided that they are compliant with medical treatment. This may often include the necessity to be actively participating in a drug or alcohol treatment program.

Treatment for addiction

Getting help to combat an alcohol or drug addiction can open up many new doors and opportunities. Confronting alcohol and drug problems in your life gives you and your loved ones the opportunity to experience a healthier and more productive life and to walk a road paved with the support needed and necessary to discover a better way of living. Recovery from alcohol and drug addiction is happening every day for millions of people, and help can take many forms.

In your community, there are professionals who are specifically trained and successfully experienced in providing help to individuals and family members struggling with alcohol and drug related problems, including addiction treatment programs, psychiatrists, psychologists, social workers, credentialed alcohol and substance abuse counsellors and other certified specialists. Rehabilitation treatment centers, both inpatient and outpatient, as well as other local resources are usually close by or not too far from where you reside, but a roadblock for many is often the price.

The cost of addiction treatment

Before you make the decision to undergo addiction treatment, it's important to determine whether it's covered under your current health insurance policy. If it's not, you could end up with a large bill or even have your treatment cut short due to non-payment. You can learn more about your insurance coverage for addiction treatment by reading through your benefits guide or contacting your insurance company directly.

In this video, disability lawyer Samantha Share talks about the importance of addiction treatment for disability benefits

Share Lawyers client denied LTD claim for addiction

John, 50, lives just outside of Winnipeg, Manitoba, where he was employed as a Production Supervisor. Although he made a good living, he suffered from severe depression which made it difficult for him to function. Overwhelmed and unable to deal with his depression, John has resorted to drinking alcohol at work to get through the day. He kept telling himself he needs to seek professional help instead of making the situation worse by drinking, but his shame has prevented him from making the right decision.

When John was caught drinking at work, his supervisor confronted him, insisting that John stop working and seek help immediately. John was so grateful that he wasn’t fired, he immediately went home and made an appointment with a psychologist. The psychologist was kind and sympathetic and suggested an inpatient rehab program. John also applied for and received short term disability benefits from his workplace. He was relieved to finally be able to focus on getting better instead of worrying about work.

Unfortunately, the waiting list to be approved for the rehab program was long, which meant John would have to wait several months before he could start the program. He applied for long term disability benefits and was devastated when his long term disability claim was wrongly denied. His insurance company told him that he must actively be attending the rehab program in order to qualify for long term disability benefits. They insisted that in the meantime, he was more than capable of returning to work.

Rehabilitation programs and access

Participation in a rehabilitation program or staying in a rehabilitation facility is something many insurance companies require in order for applicants to qualify for disability benefits. Unfortunately, rehab programs have waiting lists ranging from a few months to a year. Finding a rehab program can be even more difficult for those who live in rural areas.

Even if someone suffering from addiction demonstrates their desire to be enrolled in rehab and their doctor has recommended it, they often cannot get access to the program quickly enough. When an insurance company reviews a long term disability claim for addiction and the applicant isn’t already in rehab, it can often result in an automatic denial.

Share Lawyers is here to help

Here at Share Lawyers, we represent a large number of clients who have addictions and have been denied disability benefits under either a group disability insurance policy or a private policy. These cases are usually heavily dependent on obtaining the necessary medical evidence to prove the disability in a way contemplated by the policy in question. Most policies contain time limits that can be difficult to interpret and so as soon as your long term disability claim has been denied, we would encourage you to contact a long term disability lawyer at Share Lawyers to discuss your disability benefits case to see if we can be of assistance to you and your family.