MMC Benefits Handbook
Mental Health and Substance Abuse
Mental Health
Can I receive benefits from the Individual Disability Insurance Plan if I have a mental health condition?
You may be eligible for benefits from the Individual Disability Insurance Plan if your mental health condition prevents you from performing your job. As with any disability, you must satisfy the requirements of an eligible disability, and your disability must be approved by the Claims Administrator.
There is a two year maximum benefit for mental health conditions, if not hospitalized.
Are benefits limited for mental health conditions?
If you become disabled (as determined by the Claims Administrator) because of a mental health condition that results from any cause, then, subject to all other Plan provisions, benefits will be payable:
- only for so long as you are confined in a hospital or other place licensed to provide medical care for the disabling condition; or
- when you are not so confined, a total of 24 months (excluding the 180 day elimination period) for all such disabilities during your lifetime.
Mental health condition means any psychological, behavioral or emotional disorder or ailment of the mind, including physical manifestations of psychological, behavioral or emotional disorders, but excluding demonstrable, structural brain damage.
Substance Abuse
Can I receive benefits under the Individual Disability Insurance Plan if I have a substance abuse problem?
You may be eligible for benefits from the Individual Disability Insurance Plan if your substance abuse problem prevents you from performing your job. As with any disability, you must satisfy the requirements of an eligible disability, and your disability must be approved by the Claims Administrator.
There is a two year maximum benefit, if not hospitalized.
Are benefits limited for substance abuse?
If you become disabled (as determined by the Claims Administrator) because of alcoholism or the non-medical use of narcotics, sedatives, stimulants, hallucinogens, or any other such substance then, subject to all other Plan provisions, benefits will be payable:
- only for so long as you are confined in a hospital or other place licensed to provide medical care for the disabling condition; or
- when you are not so confined, a total of 24 months (excluding the 180 day elimination period) for all such disabilities during your lifetime.
What is the Catastrophic Disability Benefit?
The Catastrophic Disability Benefit provides a monthly benefit in addition to the base policy benefit in the event of certain catastrophic disabilities that are likely to increase your living expenses. A Catastrophic Disability is defined as the loss of two or more Activities of Daily Living, including bathing, dressing, eating, toileting, continence and transferring; cognitive impairment; or presumptive disability (the total and permanent loss of hearing, sight, speech or the use of two limbs.