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Bipolar Disorder is a Physical Illness, Says Judge

Trial Court Ruling Could Lead to Major Changes

By Kimberly Read & Marcia Purse, About.com

Updated: December 14, 2006

About.com Health's Disease and Condition content is reviewed by Steven Gans, MD

by Marcia Purse

According to a report in the March 12, 2002 issue of The Wall Street Journal, a ruling by U.S. District Judge Henry H. Kennedy Jr. opened up new possibilities in the fight to obtain insurance coverage for bipolar disorder. The case was Fitts v. Federal National Mortgage Association.

Jane Fitts was diagnosed bipolar in 1995 and had to leave her job with Fannie Mae after working there 13 years. Her disability insurance coverage stopped after just two years - because she was disabled by a mental, not a physical illness. This left her with only Social Security income and with prescription bills totaling $800-900 a month - close to half her remaining income. So she took the insurance company to court.

Her first lawsuit charged that mental health insurance caps violate the Americans with Disabilities Act (ADA). Like many others, this attempt failed. Courts have ruled that there is nothing in the ADA preventing one type of disability from being given lesser insurance coverage.

But this time the question was whether bipolar disorder should be covered under the mental illness or physical illness portion of the insurance policy. Judge Kennedy examined scientific evidence and ruled that Ms. Fitts is entitled to disability insurance payments until age 65, according to policy provisions, because bipolar disorder is a physical illness.

Among the scientific evidence the judge noted:

  • Scientific research has shown that bipolar disorder can be inherited, and in Ms. Fitts case, two immediate family members have BP symptoms.

  • The disorder was visible on brain scans.

  • Bipolar disorder is a neurobiological disorder characterized by chemical imbalances in the brain.
Lawyers for the defense had argued that because bipolar disorder is listed in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), it must be a mental illness. But the judge pointed out that the DSM-IV itself suggests that "the distinction between mental and physical disorders is a false one."

Because this was a trial court, this ruling doesn't mean other judges have to follow Judge Kennedy's decision automatically, but it does give those with mental illnesses a new weapon in the arsenal.

NAMI's legal director Ron Honberg hailed the decision as "another step toward ending discrimination based on myths and stigma."

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