What are mental and nervous policy limits in an LTD plan?

The mental and nervous limitation is one of the most common grounds for LTD benefit termination, and it catches claimants off guard because the 24-month clock often runs quietly while the insurer continues paying. Once the limit is reached, the insurer issues a termination letter that feels sudden even though it was written into the policy from day one.

The limitation applies to a defined list of diagnoses. Depression, generalized anxiety disorder, bipolar disorder, PTSD, and similar conditions typically fall within it. The critical question is whether your disability is primarily caused by a mental or nervous condition, or whether a co-occurring physical condition is the true driver of your incapacity. Courts in the S.D.N.Y. and Second Circuit have issued nuanced decisions on this question — insurers often attribute disability entirely to the mental diagnosis even when a physical condition is equally or more disabling.

If your insurer is approaching or has reached the 24-month limit, the time to act is before the termination letter arrives. Your treating psychiatrist and primary care physician should document the interaction between your psychiatric and physical conditions clearly, establishing that the physical condition independently limits your functional capacity. Under Glenn, the structural conflict of interest in an insurer-funded review supports a closer look by a reviewing court.

After termination, you have 180 days under 29 CFR 2560.503-1 to appeal. We handle ERISA mental-nervous appeals on contingency. No fee unless we win.