Court: State Law On Disability Insurance Not Discriminatory
July 2004

ALBANY, N.Y. -- Disability insurance policies written in New York do not have to provide the same coverage levels for mental and emotional conditions as they do for physical injuries, the state's top court ruled Thursday.

The Court of Appeals' 7-0 ruling touched on one of the hottest public policy issues at the state Capitol -- insurance "parity" for people suffering from mental or substance abuse problems -- and proponents said the decision shows the need for the Legislature to step in and mandate equitable coverage.

"It is fairly unlikely that we'd be able to do that through the courts," said Joseph Glazer, head of the state Mental Health Association. "We have no choice but to get these changes done in the Legislature."

The Court of Appeals ruled 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 Thursday. She once worked for MetPath, which has since become known as Quest Diagnostic Inc.

Polon's lawyer Robert Schonfeld said he was disappointed by the ruling and that the Court of Appeals has the last word in this case.

"The only place to really take this (issue) would be the New York state Legislature," Schonfeld said.

Advocates for expanded health care coverage say physical and emotional problems often go hand in hand and that mental disabilities are now seen as just as damaging professionally as physical injuries. Glazer pointed out that policies will provide coverage for the physical damage people with eating disorders do to their bodies, but offer little or no coverage for the underlying emotional problems that drive those conditions.

Mental health advocates are pushing what they call "Timothy's Law," a bill to equalize coverage for physical injuries with that for emotional or substance abuse problems. It is named in honor of Timothy O'Clair, an Albany-area 12-year-old who killed himself in 2001 after his parents had to give up custody of him so he could get public-funded treatment for emotional problems.

Tom O'Clair, Timothy's father, said the court ruling affirms the need for the legislation named after his son.

"Today's Court of Appeals' decision reinforces our motives for enacting Timothy's Law in New York state to put an end to this kind of discrimination," O'Clair said. "For people who suffer from mental illness, as in the case involving Ms. Polon, it is only through our legislative houses that this will change and it must change."

As currently written, "Timothy's Law" does not apply to long-term disability policies.

The Senate and Assembly have been unable to reach agreement on a parity bill. Republicans in the state Senate say they are sympathetic to the victims of substance abuse or mental illness, but want to prevent significant increases in already high health care costs for businesses.

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