Navigating Disability Certification for Mental Health Issues in Taiwan

Labor Insurance Disability Diagnosis Certificate

Four years ago, I self-harmed due to family and relationship issues, and it was only about two and a half years ago that I began receiving treatment at Taipei City Hospital.
However, about two years ago, the doctor I was seeing opened his own psychiatric clinic, which was more affordable, so I started going there.
In November of last year, I attempted suicide twice in a row.
My work environment was quite stressful, so this year, after listening to the advice of friends and family, I left my job in the electronics industry in March and began receiving psychological therapy.
When I mentioned to my psychiatrist that I wanted to apply for a disability certificate for labor insurance, he immediately became hostile.
I don't understand why he reacted that way; he was the one who initially treated my condition, and I continued to see him at his clinic.
He is only willing to provide a diagnosis certificate stating that I have major depressive disorder.
I have consulted the labor bureau, and I can attempt to apply for a disability allowance for 440 days (due to functional decline, I can only perform light work for life).
However, the doctor is unwilling to fill out the necessary form.
When I asked the doctors at the city hospital, they said they wouldn't acknowledge my treatment at the clinic and also refused to help me with the form.
The labor bureau indicated that as long as I have more than two years of medical records and have undergone treatment with three or more antidepressant medications within the last three months (using the Wechsler Adult Intelligence Scale), I have a good chance of being approved.

I now need to rest and adjust my condition before moving forward, but leaving my job has brought about another set of worries.
I don't know what impact issuing this certificate would have on the doctor, but does it take a patient to have a serious incident before any action is taken? I have left that stressful work environment, but financial concerns are another issue for me.
Should I immediately return to work? Jobs are not hard to find, but the environments are generally stressful.

1.
Who should I ask to issue this certificate? The clinic doctor has already confirmed he will not help me.
2.
I want to apply for a major illness card to help with long-term medical expenses, as I believe this could alleviate my financial issues.
Since I left my job due to health problems, it is considered voluntary resignation, which means I cannot participate in labor bureau vocational training.
I want to participate in vocational training to change my future work environment.
How should I apply for the major illness card? I have seen information that major depression is eligible for application.
I hope I won't have to return to the original clinic for this, as I doubt they will assist me.
3.
Are there any other ways for me to obtain these two certificates?

Jian, 20~29 year old female. Ask Date: 2009/04/16

Dr. Su Zongwei reply Psychiatry

1.
The clinic cannot issue this certificate.

2.
Given your situation, the likelihood of being able to obtain a certificate for depression is low (as it does not meet the disability criteria) because depression is difficult to assess.
You may only be able to engage in light work for your entire life, and you may not even qualify for a severe illness card, as your work history during your treatment period indicates that the biological aspect of your illness is unclear.

3.
Major depressive disorder can be applied for, but not every case qualifies.
Only a very small portion of major depressive disorder cases meet the criteria, specifically those with severe cognitive decline.
Your fluent expression in writing suggests that you do not fall into this category.

4.
These two types of certificates are solely based on the biological aspect of the illness.
Factors such as stress, financial issues, and suicidal behavior are not directly related to the determination of this certificate.

Reply Date: 2009/04/16

More Info

Navigating the process of disability certification for mental health issues in Taiwan can be quite challenging, especially given the complexities of the healthcare system and the varying responses from healthcare providers. Based on your situation, here are some insights and recommendations that may help you in your journey.

1. Finding the Right Healthcare Provider for Certification: It seems that you have encountered difficulties with your current psychiatrist at the clinic who is unwilling to provide the necessary documentation for your labor insurance disability claim. In Taiwan, it is essential to have a healthcare provider who is willing to support your application. If your current psychiatrist is not cooperative, consider seeking a second opinion from another psychiatrist or mental health professional. You might want to visit a public hospital or a different clinic where the doctors may be more familiar with the requirements for disability certification. It is crucial to find a provider who understands the importance of your documentation for both your mental health and financial stability.

2. Applying for Major Illness Card: The Major Illness Card (重大傷病卡) can indeed alleviate some of your financial burdens by providing access to subsidized medical care. To apply for this card, you typically need a diagnosis from a qualified physician, along with supporting medical records that demonstrate the severity and duration of your condition. Since you mentioned that you have been diagnosed with severe depression, you should gather all relevant medical documentation, including treatment history and any prescribed medications. If your current psychiatrist is unwilling to assist, you may need to seek another doctor who can provide the necessary diagnosis and support for your application.

3. Alternative Routes for Documentation: If you are unable to obtain the required documentation from your current psychiatrist, consider reaching out to mental health organizations or support groups in Taiwan. They may have resources or recommendations for healthcare providers who are more understanding of the disability certification process. Additionally, some organizations may offer advocacy services that can assist you in navigating the healthcare system and obtaining the necessary documentation.

4. Understanding the Impact of Certification on Healthcare Providers: It is understandable to be concerned about how requesting a disability certification might affect your relationship with your healthcare provider. However, it is essential to prioritize your health and well-being. A responsible healthcare provider should understand that their role includes supporting patients in accessing the resources they need for recovery. If you feel that your current provider is not supportive, it may be in your best interest to find someone who is more aligned with your needs.

5. Financial Concerns and Employment: It is also important to address your financial concerns. While returning to work may seem like a solution, it is crucial to consider your mental health first. If the work environment is too stressful, it may exacerbate your condition. Look for job opportunities that offer a supportive environment or consider part-time work as you continue your recovery. Additionally, explore any available social services or community resources that can provide temporary financial assistance while you focus on your mental health.

6. Documentation for Labor Insurance: Regarding your labor insurance application, ensure that you have all required documentation, including proof of your treatment history and any assessments that demonstrate your condition. If you can obtain a letter from a new psychiatrist or mental health professional that outlines your diagnosis and treatment plan, this may strengthen your application.

In summary, navigating the disability certification process for mental health issues in Taiwan requires persistence and the right support. Seek out healthcare providers who are willing to assist you, gather all necessary documentation, and consider alternative resources for financial and emotional support. Your mental health is paramount, and taking the time to find the right path forward is essential for your recovery and well-being.

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