An insured posted a comment asking what the difference was between a “mental” and “nervous” disorder. (i.e. Mental and Nervous 24-Month Limitations) Actually, this is a very good question and I’m happy to provide the following response.
Mental disorders are generally associated with particular regions or functions of the brain or rest of the nervous system, often described in some sort of social context. Wikipedia defines mental disorders or mental illness as “a psychological pattern, potential reflected in behavior, that is generally associated with distress or disability, and which is not considered part of normal development of a person’s culture.
Bipolar I&II disorders, adjustment disorders, conversion disorder, personality disorders, etc. are considered to be mental disorders. Another example would be schizophrenia which is a breakdown of thought processes making it difficult to distinguish between real and unreal experiences. According to the World Health Organization nearly 33% of individuals in most countries have some type of mental illness.
In contrast nervous or anxiety disorder is a general term encompassing several different forms of mental illness characterized by psychological fear and panic. Anxiety disorders generally describe symptoms an individual may have such as mental apprehension, physical tension, dissociative anxiety, phobic disorder, panic disorder, each having its own symptoms requiring treatment.
Human emotions found to be present in anxiety disorders range from simple nervousness to bouts of terror. It is interesting to note conditions we now recognize as anxiety disorders have only been added to the aegis of psychiatry since the end of the 19th century. It is suggested by recent surveys that 18% of Americans may be affected by one or more anxiety disorders.
With respect to disability claims, insurers refuse to pay benefits beyond 24 months for both mental and nervous disorders. From an insurance perspective although most “mental illnesses” can be objectively diagnosed, nervous disorders are thought to be “somaticized” and therefore “all in the insureds head or imagination.”
Remember, most M&N defintions in disability policies exclude organic brain disease and Alzheimer’s from either definition. In general, most M&N conditions must be contained within the DSM-IV or Diagnostic and Statistical Manual of Mental Disorders in order to be claimed as meeting the M&N defintion of disability.
The above described philosophy is continually challenged by insureds, attorneys and regulators as discrimination coverage adverse to those who suffer from mental or nervous disorders which are often severe enough to cause permanent disability.
My own opinion is that the inclusion of a 24-month mental and nervous provision in group LTD policies gives insurers yet another loophole to allege certain disorders are “mental” and not “physical” for the purpose of paying claims for much shorter periods of time.
In the past, for example, UnumProvident, claimed heart transplant insureds who sought counseling after surgery should have 24-month limited benefits even though counseling and therapy is often an integral part of medical treatment plans for post-cardiac surgery patients.
In any case, there is a difference between “mental illness” and “nervous disorder” and I hope the above explanation helps to answer questions on the subject. Nearly all insurers limit benefits to 24-months for what THEY decide fits into the definition as written in their own policies.