A Crohn’s disease disability lawyer can help if your short-term or long-term disability benefits have been denied, delayed or cut off.
Insurance companies may argue that Crohn’s disease is under control, your test results have improved or access to a bathroom should allow you to keep working.
Those arguments may overlook the reality of living with unpredictable bowel urgency, abdominal pain, fatigue, treatment side effects and recurring flare-ups. Even when inflammation improves, ongoing symptoms can make regular attendance and consistent productivity impossible.
Samfiru Tumarkin LLP represents people with denied and terminated disability claims throughout Canada, excluding Quebec.
On This Page:
- How a Lawyer Can Help
- When to Contact a Lawyer
- Why Crohn’s Claims Are Denied
- Evidence for Your Claim
- What Happens Next?
- Frequently Asked Questions
How Can a Crohn’s Disease Disability Lawyer Help?
A disability lawyer can review your insurance policy, medical records and denial letter to determine why the insurer refused or terminated your benefits.
A lawyer may help by:
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Explaining the definition of disability in your insurance policy
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Identifying problems or inconsistencies in the insurer’s decision
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Determining what medical and functional evidence is missing
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Connecting your symptoms to the demands of your occupation
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Addressing unpredictable flare-ups and attendance limitations
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Challenging the insurer’s reliance on improved test results or remission
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Communicating and negotiating directly with the insurance company
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Starting legal action when appropriate
Connecting Crohn’s Symptoms to Your Job
A disability claim should explain why your symptoms prevent you from meeting the specific requirements of your occupation.
Bowel urgency may make it difficult to drive, attend meetings, serve customers, teach a class or work away from a washroom. Pain and fatigue may interfere with concentration, physical activity and the ability to remain productive throughout a full day.
A lawyer can help show why your condition prevents you from maintaining the attendance, availability, pace and performance expected by your employer.
When Should You Contact a Crohn’s Disease Disability Lawyer?
Speak with a disability lawyer promptly if:
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Your short-term or long-term disability claim was denied
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Your approved benefits were later cut off
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The insurer says your Crohn’s disease is in remission
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Your colonoscopy, imaging or bloodwork has improved
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The insurer says bathroom access or remote work should be sufficient
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Fatigue, pain or treatment side effects are being overlooked
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You are being pressured to return before your doctor believes you are ready
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You are considering an internal appeal
You do not have to wait for another hospitalization, surgery or serious flare-up before getting legal advice.
Do You Have to Appeal to the Insurance Company?
An insurer may invite you to submit an internal appeal after denying your Crohn’s disease disability claim.
An internal appeal is not always the best option. The same insurance company that denied your claim will review the appeal, and resubmitting similar information may produce the same result.
You may not have to complete the insurer’s appeal process before pursuing legal action. A disability lawyer can explain the available options and help you choose the appropriate response.
Why Are Crohn’s Disease Disability Claims Denied?
An insurer may accept your Crohn’s diagnosis while arguing that the available evidence does not prove you remain unable to work.
Common denial reasons include:
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Testing shows reduced or limited inflammation
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The insurer says your condition is in remission
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Your symptoms improve between flare-ups
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Your medical records do not clearly explain your work restrictions
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The insurer says you can work near a washroom
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The insurer says you can work from home
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Fatigue and pain are described as subjective
The Insurer Says Your Crohn’s Disease Is in Remission
Remission may mean that inflammation or disease activity has improved. It does not necessarily mean that every symptom or functional limitation has resolved.
You may continue to experience bowel dysfunction, urgency, fatigue, abdominal pain, joint symptoms, nutritional problems or treatment side effects.
Your medical evidence should explain the limitations that remain and why they continue to interfere with reliable work.
The Insurer Relies on Improved Test Results
Bloodwork, imaging, endoscopy and other testing may help assess disease activity. No single result necessarily establishes your ability to work.
An insurer should also consider your reported symptoms, treatment history, physical limitations and ability to maintain a predictable schedule.
The Insurer Says You Can Work Near a Bathroom
Bathroom access may help, but it does not resolve every workplace limitation.
Frequent or urgent bowel movements may repeatedly interrupt calls, meetings, customer service, production work and other duties. Pain, accidents and the time required in the washroom may also interfere with normal performance.
The issue is not simply whether a washroom exists. It is whether you can remain available and productive enough to perform your occupation consistently.
The Insurer Says You Can Work From Home
Remote work may remove the commute and provide easier bathroom access. It does not eliminate pain, fatigue, treatment effects or frequent interruptions.
You may still be unable to attend virtual meetings, meet deadlines or remain productive throughout a normal workday.
The Insurer Dismisses Fatigue as Subjective
Fatigue is a common and potentially disabling symptom of inflammatory bowel disease. It may continue even when Crohn’s disease is inactive.
Medical records should explain how fatigue affects your stamina, concentration, pace and ability to complete activities repeatedly.
The Insurer Says Your Condition Is Episodic
An insurer may focus on periods when symptoms are manageable and argue that you remain capable of working.
The proper question is whether you can maintain regular employment despite the frequency, duration and unpredictability of your flare-ups.
Your Benefits Are Cut Off After Two Years
Many LTD policies change their definition of disability after approximately two years.
The insurer may accept that you can’t return to your previous occupation but argue that you can perform another job.
It should consider whether another occupation is genuinely suitable and whether you can maintain the necessary attendance, concentration and productivity despite unpredictable symptoms.
What Evidence Supports a Crohn’s Disease Disability Claim?
A diagnosis is important, but it may not provide enough information about your work capacity.
Helpful evidence may include:
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Medical records from your family doctor and gastroenterologist
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Bloodwork, imaging, stool testing and endoscopy results
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The frequency and urgency of bowel movements
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The frequency, severity and duration of flare-ups
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Records of hospitalizations, surgery and complications
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Your treatment history and medication side effects
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A detailed description of your occupational duties
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Workplace accommodations and unsuccessful return-to-work attempts
Document the Frequency and Urgency of Symptoms
Your records should explain how often you need a washroom, whether the need is immediate and how much time your symptoms take away from work.
Document accidents, false urges, pain and situations where you could not safely travel or remain in a meeting.
Keep a Symptom Record
A daily record may help show patterns that are not obvious from occasional appointments.
Consider recording:
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The number and urgency of bowel movements
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Pain and cramping
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Fatigue and sleep disruption
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Meals and activities affected by symptoms
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Appointments, treatment and recovery time
Share relevant information with your treatment providers so that your medical records accurately reflect your functional limitations.
Explain Your Failed Accommodations
If flexible hours, remote work, reduced travel or additional bathroom breaks did not allow you to continue working, explain why.
Document which symptoms continued, how often work was interrupted and whether the arrangement reduced your productivity or caused your condition to worsen.
Address Your Complete Medical Condition
Your claim should address every medical condition affecting your work capacity.
This may include anemia, joint pain, chronic fatigue, sleep difficulties, anxiety or depression.
What Happens After You Contact a Crohn’s Disease Disability Lawyer?
During an initial consultation, a disability lawyer may ask about your symptoms, occupation, treatment and the insurer’s reason for denying or terminating your benefits.
The lawyer may review:
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Your denial or termination letter
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The definition of disability in your policy
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Your medical evidence and functional restrictions
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Your job duties and accommodation history
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Important dates and potential legal deadlines
The lawyer can then explain whether the insurer’s decision may be challenged and what additional evidence could strengthen your case.
How Can a Crohn’s Disability Claim Be Resolved?
Depending on the circumstances, a denied claim may be resolved through reinstatement of monthly benefits, payment of benefits previously withheld or a negotiated settlement.
There is no standard Crohn’s disease disability settlement. The result depends on the policy, monthly benefit, medical evidence, prognosis, age and other circumstances.
How Long Does a Crohn’s Disability Case Take?
There is no universal timeline. The length of the case may depend on the available medical evidence, the insurer’s response, whether additional assessments are required and whether the claim settles or proceeds further through the legal process.
Is There a Fee to Speak With a Disability Lawyer?
Samfiru Tumarkin LLP offers a free initial consultation for denied short-term and long-term disability claims.
There are no upfront legal fees. You only pay if we successfully resolve your disability claim.
Frequently Asked Questions About Crohn’s Disease Disability Lawyers
What does a Crohn’s disease disability lawyer do?
A disability lawyer reviews your insurance policy, medical evidence and denial letter and helps challenge the insurer’s refusal to pay benefits.
When should you contact a disability lawyer?
Speak with a lawyer after your benefits are denied or cut off, before filing an internal appeal or when the insurer pressures you to return to work against medical advice.
Can Crohn’s qualify for LTD benefits while in remission?
Potentially. Ongoing bowel dysfunction, fatigue, pain, complications or treatment side effects may remain disabling after inflammation improves.
Can the insurer deny a claim because you can work from home?
An insurer may argue that remote work is possible, but it should still consider whether your symptoms allow you to maintain regular attendance, concentration and productivity.
Can bathroom access prevent an LTD claim?
Not necessarily. Access to a washroom does not resolve frequent interruptions, urgency, pain, accidents, fatigue or an inability to remain available for your duties.
Do you have to appeal to the insurer first?
Not necessarily. An internal appeal is only one option. Speak with a disability lawyer before deciding how to challenge the denial.
Can a lawyer help before your benefits are terminated?
A lawyer may provide advice when the insurer requests additional information, schedules an assessment or warns that your benefits may end.
How long do you have to challenge a denied claim?
Legal deadlines apply and may vary based on the province, policy and circumstances. Get legal advice promptly to protect your options.
Speak With a Crohn’s Disease Disability Lawyer
Managing unpredictable bowel symptoms, pain, fatigue and treatment is difficult enough. You should not have to fight an insurance company alone while facing financial uncertainty and pressure to return to work.
Samfiru Tumarkin LLP represents people with denied and terminated disability claims throughout Canada, excluding Quebec.
Some members of our legal team previously worked for insurance companies. We understand why chronic and episodic disability claims are challenged and what evidence may be needed to dispute a denial.
For more information about eligibility and available benefits, read our guide to Crohn’s disease disability claims in Canada.
Contact us for a free consultation if your short-term or long-term disability claim has been denied or cut off.