Mental Health Conditions and Insurance Company Responsibility

Deeply embed in the Western medical tradition is a worldview that is far more willing to acknowledge physical illness than mental illness. In recent years in the U.S., that is slowly starting to change. But there is a long way to go.

In Michigan and across the country, mental health conditions can be so severe that they become disabling. To be sure, Social Security disability law does recognize this. But people who are facing mental health challenges still often face difficult struggles with insurance companies who resist paying for mental conditions.

In one recent case, a man had a son with bipolar disorder. The psychiatrist treating the son told the father that two psychotherapy sessions per week were necessary to treat the disorder effectively.

The fathers’ insurer, UnitedHealth Group Inc, initially paid for this. Then the insurer unilaterally decided it would only cover two sessions each month.

This decision simply did not make medical sense. It seemed to be solely based on saving money for the insurance company. And so the father joined a class-action lawsuit against UnitedHealth. The suit charges that United Health is violating federal law by treating mental health insurance claims differently from physical ones involving surgery or other medical issues.

The case is national in scope, with a strong Minnesota connection. The federal law is named after Paul Wellstone, the later U.S. senator from Minnesota. And UnitedHealth is based in Minnesota. People in Southeast Michigan and throughout the nation will be affected by what precedent the case sets on the responsibility of insurance companies to provide proper mental health coverage.

Source: “Suit against United Health tests mental health coverage rules,” Star Tribune, Jim Spencer, 4-6-13

Please visit our main Social Security disability page.