How Mental Health Claims Are Treated in Disability Insurance
Mental health conditions can be just as disabling as physical injuries — sometimes even more so. Depression, anxiety, post-traumatic stress disorder (PTSD), and burnout can make it impossible to focus, concentrate, or function in a workplace.
Yet in Alberta, **mental health disability claims are some of the most frequently denied** by insurance companies. Insurers often argue that symptoms are 'subjective,' temporary, or unsupported by 'objective medical evidence.'
As Alberta disability lawyers who once defended insurance companies, we've seen exactly how mental health claims are evaluated — and how to prove their legitimacy.
This article explains **how disability insurers treat mental health claims**, why they're often denied, what medical evidence matters most, and how to strengthen your case for approval or appeal.
This guide covers:
What Counts as a Mental Health Disability Claim?
Disability insurance provides income replacement when a medical condition — physical or psychological — prevents you from working. Mental health claims are covered under most Alberta short-term and long-term disability policies, including:
Common Mental Health Conditions:
How Mental Health Claims Differ From Physical Disability Claims
Mental health disability claims face unique barriers that physical injuries don't.
Lack of 'Objective' Tests
Unlike fractures or MRI-visible injuries, mental illness can't be proven with scans. Insurers exploit this by demanding impossible 'objective evidence.'
Stigma and Bias
Some adjusters underestimate the severity of mental illness, viewing it as 'temporary' or 'motivational.' This bias still affects many Alberta claims.
Policy Limitations
Many group disability policies include **24-month limits** on mental health conditions, unless your claim meets specific exceptions (e.g., hospitalization or confirmed chronic psychiatric diagnosis).
Recovery Expectations
Insurers often expect rapid improvement — but mental health recovery is nonlinear. Fluctuating symptoms are normal, not proof of ability to work.
Steps to Take If You're Filing a Mental Health Disability Claim
The way you prepare your file is often more important than the diagnosis itself. To strengthen your claim from the start:
See a Mental Health Specialist
A family doctor's note isn't enough. You'll need a psychiatrist, psychologist, or counsellor involved in your care.
Get a Clear Diagnosis
Insurers rarely accept claims based on 'stress' or 'burnout' alone — your doctor should use specific diagnostic criteria (e.g., major depressive disorder).
Document Symptoms and Limitations
Keep a journal describing how symptoms affect concentration, energy, motivation, or attendance.
Follow Treatment Plans
Attend therapy regularly, take prescribed medication, and document your progress.
Be Honest But Detailed
Don't minimize or exaggerate your condition — consistent, credible descriptions are key.
Consult an Alberta Disability Lawyer Early
We can guide your doctors on how to frame medical opinions that meet insurer expectations.
How a Lawyer Strengthens Mental Health Disability Claims
A disability lawyer bridges the gap between your doctor's medical findings and the insurer's legal definition of disability.
Clarify Policy Definitions
Identify whether your plan has a 24-month mental health cap or exceptions.
Coordinate Specialist Reports
Ensure psychiatrists and psychologists address functional limitations, not just symptoms.
Gather Objective Testing
Arrange neuropsychological or cognitive evaluations if needed.
Challenge Biased Insurer Assessments
Expose inconsistencies in insurer medical reviews.
Negotiate or Litigate
Secure reinstatement, back pay, or lump-sum settlement for denied claims.
Frequently Asked Questions
Conclusion
Mental health disabilities are real, serious, and deserving of fair compensation. Yet insurers often minimize or deny these claims due to outdated policies, stigma, or profit motives.
Mental health is covered under Alberta disability law.
Psychiatric evidence must link symptoms directly to work limitations.
Don't accept denials based on 'subjective symptoms' or 'lack of proof.'
Act quickly — appeal or start legal action before deadlines expire.
Still have questions?
Call or text us today for a free consultation. No fee unless we win.