Once you have gotten your medication under control, the disability people to believe that you and your doctor actually want you to get back to work, then at some point down the road (weeks, probably months) you will start to be ready to come back to earth.

This presents its own sets of challenges. If you are at the beginning of the journey, it may be hard to fathom being at this point, so I’ll try to describe it a bit. Any or all of these may apply. You are

• Bored with sitting around the house all day.
• Anxious to get moving, even if it is just a little.
• Start to feel jealous of other people being in your pulpit, and taking care of other pastoral duties for you.
• Longing for normalcy in a much more concrete way before. You can remember what it was really like.
• Not despairing over every event that takes place. You can start to do tasks, face responsibilities, and do some of those things you enjoyed before depression.

These are just a few. I’m sure a dozen more clinical answers could be provided. Here are a few things to consider on the way:

• DON’T GO TOO FAST. After two false starts at returning to work, I know of what I speak. Trust your doctor and your therapist. I’m not sure if you could move back too slowly. This is hard. Really hard. At least for me. My therapist, in their lovely non-directive sort of fashion, has had to head me off at the pass many many times.
• Trust your instincts. Now that is a very un-Lutheran thing to say, but in this case, it really is true. If you feel like you’re getting overwhelmed or that you are about to turn into a zombie (so to speak), you probably will. So stop before you get there.
• Start with easy things before the tough stuff. This too may appear obvious, but it is critical. Start with the easiest things for you, things that will give you satisfaction and confidence in who you are and what your Office is as pastor of the flock. For me, that means starting with doing the liturgy. It is the most natural thing for me, like breathing. After that comes Bible Class and Preaching. Those two are more exhausting, because they require more creativity, but on the other hand they are very satisfying, and they are two things I do pretty well (at least according to others). The hardest things for me parish wise are still making calls, conflict, and sort of general socializing. Those will come last, I expect.
• Focus on what is good and right, and recognize that the bad hours or days will pass. At the risk of misuing St. Paul, he speaks of this in Philippians four. I know how hard this is. It is a habitus of prayer and being soaked in the Word. But by the mercy of God, it will come in time.

That is what’s on my mind. What’s on yours?

-DMR

Once you have gotten your medication under control, the disability people to believe that you and your doctor actually want you to get back to work, then at some point down the road (weeks, probably months) you will start to be ready to come back to earth.

This presents its own sets of challenges. If you are at the beginning of the journey, it may be hard to fathom being at this point, so I’ll try to describe it a bit. Any or all of these may apply. You are

• Bored with sitting around the house all day.
• Anxious to get moving, even if it is just a little.
• Start to feel jealous of other people being in your pulpit, and taking care of other pastoral duties for you.
• Longing for normalcy in a much more concrete way before. You can remember what it was really like.
• Not despairing over every event that takes place. You can start to do tasks, face responsibilities, and do some of those things you enjoyed before depression.

These are just a few. I’m sure a dozen more clinical answers could be provided. Here are a few things to consider on the way:

• DON’T GO TOO FAST. After two false starts at returning to work, I know of what I speak. Trust your doctor and your therapist. I’m not sure if you could move back too slowly. This is hard. Really hard. At least for me. My therapist, in their lovely non-directive sort of fashion, has had to head me off at the pass many many times.
• Trust your instincts. Now that is a very un-Lutheran thing to say, but in this case, it really is true. If you feel like you’re getting overwhelmed or that you are about to turn into a zombie (so to speak), you probably will. So stop before you get there.
• Start with easy things before the tough stuff. This too may appear obvious, but it is critical. Start with the easiest things for you, things that will give you satisfaction and confidence in who you are and what your Office is as pastor of the flock. For me, that means starting with doing the liturgy. It is the most natural thing for me, like breathing. After that comes Bible Class and Preaching. Those two are more exhausting, because they require more creativity, but on the other hand they are very satisfying, and they are two things I do pretty well (at least according to others). The hardest things for me parish wise are still making calls, conflict, and sort of general socializing. Those will come last, I expect.
• Focus on what is good and right, and recognize that the bad hours or days will pass. At the risk of misuing St. Paul, he speaks of this in Philippians four. I know how hard this is. It is a habitus of prayer and being soaked in the Word. But by the mercy of God, it will come in time.

That is what’s on my mind. What’s on yours?

-DMR

There is one thing which is important to understand when it comes to insurance companies: money is what the point is. It doesn’t matter if it’s CPS or any of the other myriad of health insurance companies out there. They are there to make money.

So for them, disability is a very bad thing. (For the sick, it is a very good thing.)

What this means in English is that in all likelihood they will push you to get off of disability sooner than you are ready, just like they will try and force you to get off of non-generic drugs. Those are more expensive. So what they will do is come up with most any reason they can to take you off of disability. A slightly positive comment from your therapist or doctor. You saying in a phone interview “I really think I could work some”. They will glom on to anything possible.

I write this not to denigrate our healthcare system. The LCMS has one of the best healthcare programs in the country. I shudder to think of the hoops one might have to jump through with some of these others.

So in understanding these things, you need to know your rights. Here are at least some of them as I have come to understand it:

1. You have the right to be sick. They can’t make you better on a piece of paper. Mental illness is real, painful, and debilitating. They cannot pretend this isn’t an illness.
2. Your doctors and you determine when you need to go on disability, not them. Certainly there are requirements, etc, etc, etc. But the bottom line is that if your doctors say you are not ready to go back to work, then you’re not ready, and no “peer review” can trump an actual doctor’s professional opinion.
3. Your goal is to get better, not to freeload off of “the system”. This may be obvious to you, but part of the reason why health care companies are so skittish about disability is it’s abuse. If you make it clear to them that you want to get back to work, that will be one of the things they want to hear.
4. Disability is intended for healing, not heartache. Every time they make it more difficult for you to stay on disability, they are probably prolonging your sickness. This needs to be repeated to them over and over again. It is costing them money, they will be legally liable with any problems, and the like.
5. God is merciful, and he will take care of you. Ok, that’s not a “right”, but it is a gift given to you in the waters of Holy Baptism. You may confidently trust that our Lord will take care of you through thick and thin, as he best sees fit.

So what am I missing, friends?

-DMR

There is one thing which is important to understand when it comes to insurance companies: money is what the point is. It doesn’t matter if it’s CPS or any of the other myriad of health insurance companies out there. They are there to make money.

So for them, disability is a very bad thing. (For the sick, it is a very good thing.)

What this means in English is that in all likelihood they will push you to get off of disability sooner than you are ready, just like they will try and force you to get off of non-generic drugs. Those are more expensive. So what they will do is come up with most any reason they can to take you off of disability. A slightly positive comment from your therapist or doctor. You saying in a phone interview “I really think I could work some”. They will glom on to anything possible.

I write this not to denigrate our healthcare system. The LCMS has one of the best healthcare programs in the country. I shudder to think of the hoops one might have to jump through with some of these others.

So in understanding these things, you need to know your rights. Here are at least some of them as I have come to understand it:

1. You have the right to be sick. They can’t make you better on a piece of paper. Mental illness is real, painful, and debilitating. They cannot pretend this isn’t an illness.
2. Your doctors and you determine when you need to go on disability, not them. Certainly there are requirements, etc, etc, etc. But the bottom line is that if your doctors say you are not ready to go back to work, then you’re not ready, and no “peer review” can trump an actual doctor’s professional opinion.
3. Your goal is to get better, not to freeload off of “the system”. This may be obvious to you, but part of the reason why health care companies are so skittish about disability is it’s abuse. If you make it clear to them that you want to get back to work, that will be one of the things they want to hear.
4. Disability is intended for healing, not heartache. Every time they make it more difficult for you to stay on disability, they are probably prolonging your sickness. This needs to be repeated to them over and over again. It is costing them money, they will be legally liable with any problems, and the like.
5. God is merciful, and he will take care of you. Ok, that’s not a “right”, but it is a gift given to you in the waters of Holy Baptism. You may confidently trust that our Lord will take care of you through thick and thin, as he best sees fit.

So what am I missing, friends?

-DMR

This is I think one of the hardest decisions when you suffer from depression. There are lots of reasons you dont want to talk about it: You’re ashamed, think you’re weak, don’t want to let others in, don’t want to receive “the look,” and a thousand others.

I guess that for the pastor (and really for most people), there are two layers of this question. If you are simply taking medication and therapy, you can probably keep the circle of people “in-the-know” fairly small. I’ve known a number of pastors who never told anyone in the congregation through the entire process. The advantage to this is that your illness won’t have a potentially detrimental effect on receiving calls, etc. In the business world, pretty much everyone will tell you never let anyone know you’re taking anti-depressants. I find this truly a sad commentary on our culture. For a culture that talks so much about being inclusive and receptive of people with “differing abilities”, mental illness is the exception. I have found that this is often true in the church. I would never begrudge a pastor who chose not to speak with his congregation about a mental illness.

Disability, however, is a different matter. If you apply for disability, then it is really impossible not to speak with your congregation about the matter. Your circuit counselor, with your input, will have to find someone to fill in for you while you are on disability, and someone, maybe several someones, will need to come into your parish to give them a little catechesis on mental illness and depression.

This is hard. I admit it. It is admitting what will be viewed by many as a weakness or even as a failure. You’re depressed because you aren’t strong enough to make yourself better (tell that to someone with a heart condition). No one likes that level of self-disclosure, least of all super-pastors. It’s a lesson in humility that is a good one, but painful at the time.

Yet in this disclosure lies freedom. It frees you to recognize your own illness. You don’t have to hide and pretend and act and do a show for everyone. You can actually be sick. Recognizing your sickness is the first step to healing. Sharing your sickness allows others to bear your burden with you. I think that’s in the Bible somewhere. Look it up. It is through our weakensses and trials that Christ is at work, showing the world His own suffering for us.

For myself, telling my congregation has been the best thing for my ministry since I was ordained. I won’t say that it has been picture perfect, that everyone has embraced us, or any kind of fairy tale ending. It has taught me (and my family) to look to Christ for strength, and not to ourselves, or even finally to my parish. My parish has taken care of me with generosity beyond expectation, and despite the bumps along the road, it has been a blessing for all of us.

I know it does not always work out this way. I know of pastors who have been forced to resign, undergo enforced psychological evaluation by their district, or worse. It’s sad, but true. Having said that, being straightforward and honest is always the best thing to do. That doesn’t mean make your whole life and psyche an open book. It does mean, however, not pretending or acting as if nothing is wrong when there is.

Christ is merciful. He will take care of you. Be at peace and bask in the glow of our Lord’s incarnation for you.

-DMR

Here is the short and sweet version of what short term disability means and how it works.

The first step to get on disability is to call the mental health services number on the back of your Concordia Plan Services healthcare card. It is CIGNA Behavioral Health. These are the people that give you prior authorization to see a psychiatrist or a psychologist On my card the number is 1-866-726-5267.

One of the big questions is: who determines whether you are disabled? A good question. You actually make the call to apply for disability, but it is your doctors that recommend you for disability. Finally, there is supposed to be a group of doctors who impartially determine whether you qualify for short term disability. They have two weeks to make that determination. It is helpful in this process (and they’ll give you all the addresses, etc…) to have numerous witnesses lined up. These should include as many of the following as possible:

• Physician
• Psychiatrist
• Psychologist/Counselor
• Circuit Counselor or some other district rep
• Spouse
• Congregational President and/or Head Elder
• Anyone else who can speak intelligently as to your medical condition.

This obviously requires more organizing that I wish. Frankly, it’s asking a lot at the exact time when you may have no energy or mental ability to handle it. You need someone to help you with this. It may be your spouse. It may be your counselor. It may be your circuit counselor. But someone else needs to help you get through it. That will bring us to our next topic: who do you tell and why?

Be at peace, friends. Our Lord is coming soon to release us from the bonds of sin and darkness which so beset us.

-DMR