Bipolar is a mood disorder. Individuals with this condition experience fluctuating mood states that affect how they think, behave, and function. They have periods of depression where they experience loss of energy, insomnia or oversleeping, loss of interest in activities they previously enjoyed, inability to concentrate and suicidal ideation.
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They also have periods of mania/hypomania where they feel elated and seem to have a lot of energy. They may also have a hard time sleeping and taming racing thoughts.
Bipolar, like many other mood disorders, affects your ability to perform your daily activities and work-related obligations as you should. It is an invisible illness that makes it difficult to prove your claim when applying for Disability Benefits.
If you’re thinking of starting your long-term Disability claim, you need to know what lies on the road ahead. Getting a long-term disability lawyer to help you will improve your chances of getting the compensation you’re entitled to. Here’s everything you need to know.
Do People With Bipolar Qualify for Disability Benefits?
The short answer is – yes, they do. Canadian disability benefits providers recognize the condition as an impairment that qualifies for benefits. That said, a self-diagnosis isn’t enough to get you those benefits. You would have to prove that your condition prevents you from working.
Disability benefits providers focus on the severity of your symptoms when reviewing your claim. They consider your medical treatment history and any future treatment you’ll need. They analyze how the symptoms affect your work and the effort you’ve made to remain in the workforce. This information needs to be well-documented in the form of paperwork and the relevant supporting documents you’ll submit along with your claim.
How to Document Your Bipolar Disorder Diagnosis
To win a bipolar disorder claim for long-term disability benefits, you’ll need to implement a detailed strategy that takes into account three main factors:
- Your condition
- Your work
- Your disability benefits provider
First, you need to get a solid bipolar diagnosis before you can even think of initiating a disability claim with your provider. Bipolar disorder comes in different forms. Each type has its own set of unique symptoms, which is why they need to be well-documented as you go through the claims process.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the standard for diagnosing bipolar disorder. It lists the criteria medical professionals use to make an accurate diagnosis. The DSM-5 provides seven possible bipolar diagnoses. The three main ones are:
1. Bipolar I Disorder
For an individual to be diagnosed with bipolar I disorder, they need to have experienced one or more manic episodes, which may have been preceded or followed by major depressive or hypomanic episodes. Their mania symptoms must also have interrupted their life and led to subsequent hospitalization or triggered psychosis.
2. Bipolar II Disorder
For an individual to be diagnosed with bipolar II disorder, they need to have experienced one or more major depressive episodes that lasted a minimum of two weeks. These episodes should have been preceded or followed by at least one hypomanic episode that lasted four days or longer. They should also never have experienced a manic episode.
3. Cyclothymic Disorder
For an individual to be diagnosed with this particular type of bipolar disorder, they need to have experienced periods of major depressive and hypomania symptoms over two or more years. They must have experienced these symptoms for at least half the time, lasting two months or longer.
Getting a Bipolar Diagnosis
It is worth noting that bipolar-I isn’t a “more severe” version of bipolar-II. They are two completely different diagnoses. However, the manic episodes experienced by people with bipolar I can be dangerous, as are the depressive episodes in bipolar II. They can lead to significant impairment, and both conditions qualify for disability benefits.
If you believe that you may be suffering from bipolar, now is as good a time as any to work towards getting a firm diagnosis from a qualified medical practitioner. A bipolar diagnosis may not be enough to win you disability benefits. It’s a great starting point, but you must be diligent about it. Your medical records need to document all the clinical signs of your condition before you begin the claims process.
Securing a bipolar diagnosis can be extremely difficult, but it takes you one step closer to getting the disability benefits you’re rightfully entitled to. Most disability companies will do everything they can to avoid a payout. Having an experienced long-term disability lawyer on your side as you go up against your benefits provider will go a long way in helping you win your claim.
Types of Disability Benefits Available for Bipolar Disorder
Once you’re diagnosed with bipolar mood disorder, you might be eligible for disability benefits from your insurance provider, employer, or the government. Below is a list of the options available for Canadian nationals:
Long-Term Disability Insurance
Individuals who win an LTD claim are entitled to receive payments for a specific number of years or until they reach a certain age, usually 65. The terms of the payouts are usually defined in the policy.
Short-Term Disability Insurance
This is a temporary disability payment that typically pays out between 50% and 67% of your regular income for up to 17 weeks or longer, depending on the policy terms.
Employment Insurance (EI) Sickness Benefits
These offer temporary income to individuals unable to work due to their condition. The federal government’s employment insurance program would pay 55% of your salary for 15 weeks.
Workers Compensation
Every province has a workers comp program that pays long-term and short-term benefits to individuals who take time off their job due to a work-related illness or injury. That said, proving that your bipolar disorder resulted from or was made worse by a workplace injury is hard but not impossible.
Veterans Affairs Canada
Current or former Canadian Forces members can qualify for short-term and long-term disability benefits if they can prove that their bipolar resulted from or was made worse by a service-related injury.
CPP Disability
The Canadian Pension Plan (CPP) provides disability benefits from when you become disabled until you turn 65. At that point, the benefits are converted into a regular pension.
Provincial Disability Benefits
Every province in Canada has an income support benefits program that makes fixed payments for life to individuals that can’t work due to a disability, including bipolar. People who have never worked also qualify for these payouts if their cumulative household income falls below a certain threshold.
Disability Tax Credit
This benefits program lowers the taxable income for people with a disability. You must prove that your bipolar disorder has caused significant restrictions or prolonged impairment or that you require “life-sustaining” therapy.
How to File a Disability Benefits Claim for Bipolar Disorder
Bipolar is an invisible illness. Disability benefits providers often have difficulty verifying the severity of symptoms for people with the condition. After all, anyone with sinister motives can exaggerate their symptoms to appear more disabled than they are.
Most people diagnosed with bipolar successfully manage their symptoms with medication, allowing them to keep working. If your condition impairs your ability to work, the challenge lies in proving that your claim is different. Here’s what you need to do:
1. Get an Official Medical Diagnosis
As mentioned earlier, you need an appropriate medical diagnosis that meets the DSM-5 criteria for bipolar mood disorder. Your psychiatrist or psychologist also needs to provide a detailed medical history along with a list of measures they took to rule out all other possibilities.
2. Follow the Recommended Treatments
Disability benefits providers check to see if you received and followed the appropriate treatment for your condition. They may deny your claim if they find evidence suggesting that you failed to comply with the recommended treatment plan by:
- Refusing treatment, or
- Your doctor fails to follow the required standards for treatment.
3. Document Your Treatment Plan
You must have a well-documented treatment plan prepared by your psychiatrist and psychologist. This includes proof of your medication, which may include mood stabilizers, antidepressants, and antipsychotics.
If you’re not on any medication, disability benefits providers will likely conclude that your condition isn’t severe enough to qualify for benefits. They will not approve your claim without supporting documentation accompanying it.
4. Provide Proof of Work-Related Limitations
Disability benefits providers place a huge emphasis on the effort you made to remain in the workforce. Saying that you can’t perform your job isn’t enough. You should be able to show that you asked your employer for help or support to stay at work. This could be anything from working fewer hours to being assigned fewer duties or even changing roles entirely.
5. Maintain Your Credibility
Credibility refers to your believability or trustworthiness. The decision-maker needs to believe you; they must find you trustworthy to rule in your favour.
Ensure that everything you say matches the information provided in your medical records and supporting documentation. They also need to see that you tried your best to stay at work and followed your doctor’s treatment plan to manage your condition.
Your Claim Was Denied. What Next?
If, despite your best efforts, your disability benefits provider denied your claim, you still have legal recourse. Get in touch with us for a free case review by an experienced long-term disability lawyer, and we’ll explore your options.
In the meantime, read more about burnouts, breakdowns, and long-term disability benefits here.
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