N.Y. Disability Coverage for Mental Health Upheld

July 6, 2004

New York state law does not require disability insurance policies to include the same benefit levels for physical injuries and for disabling mental and emotional conditions, the state’s highest court ruled last week.

The Court of Appeals ruled 7-0 that Charlene Polon is not being discriminated against because her disability policy provided her with 24 months of coverage for the chronic depression that forced her off the job in March 1994. Had she suffered a physical injury, the policy would have covered her up to 22 more years, until she reached age 65, or until her condition improved enough to allow her to return to work.

The court said Polon was not individually singled out for a shorter coverage period in a discriminatory manner. It said the 24-month provision “preceded her disability.” All others covered under her employer’s policy faced the same limitations, the court said in a decision written by Judge Susan Philips Read.

Read wrote that New York’s anti-discrimination law is similar to those in several other states, including Texas and Maine. Courts in those states “have generally declined to interpret these statutes to require equivalent coverages for mental and physical disabilities,” Read said.

Polon continues to be unable to work because of chronic depression, the court noted. She once worked for MetPath, which has since become known as Quest Diagnostic Inc.

The question of mandating equal health policy coverage in New York for mental health and substance abuse problems as for physical injuries has led to intense lobbying in Albany in recent years. Proponents are pushing a bill they call “Timothy’s Law” after a troubled Albany-area teen who killed himself in 2001 after his parents, no longer able to afford his treatments, gave up custody so he would qualify for public-funded coverage.

So far, the state Assembly and Senate have been unable to agree on a health coverage parity bill.

The policy covering Polon was initially issued by the Travelers Indemnity Co. and later taken over by the Metropolitan Life Insurance Co., according to court papers.

Copyright 2004 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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