3 Things you can do if denied LTD | Disability Law Show TV – S3 E18

Episode Summary

THREE THINGS YOU CAN DO IF DENIED LONG-TERM DISABILITY on Season 3 Episode 18 of the Disability Law Show with disability lawyer and co-founding partner Sivan Tumarkin.

Watch above to discover the steps you need to take when the insurance company cuts off or denies your long-term disability claim in Ontario,  British Columbia,  or Alberta, on the only disability law show on TV and radio in Canada.

Episode Notes

Mental illnesses becoming significant during COVID-19

Many claimants who are struggling with a mental illness are being denied LTD and told by insurance companies to apply for wage subsidy programs.

Individuals who have short or long-term coverage of benefits, should not be denied disability benefits if they have their doctor’s support.

Segment starts at 2:15

Daily activities led to LTD denial

I have been on long-term disability for over a year after injuring my back. My insurance adjuster recently started asking me questions about my habits and daily routine that lead me to believe that I might be under some form of surveillance. I do engage in light housework and small errands, but always while experiencing some level of pain. Could they use that as evidence to deny my claim?

Insurance companies often conduct surveillance, but claimants and individuals on benefits should be truthful but also continue to go about their daily lives. Qualifications for disability benefits do not require individuals to be completely stationary and unable to do normal activities.

Segment starts at 6:48

3 Things you can do if you are denied LTD

1️⃣ Do nothing and accept the denial

Ultimately deciding not to do anything is a personal choice for individuals and many decide not to do anything as they are unaware of their options or they are scared of the outcome.

Segment starts at 11:30

2️⃣ Appeal the denial claim

Appeals are rarely effective and are not conducted by a third party but are typically internal processes conducted by the insurance company. Appeals were created by insurance companies with the intent to dissuade individuals from pursuing their benefits.

Segment starts at 13:14

3️⃣ Begin a legal claim for full compensation of benefits

Legal claims ensure the power is taken away from the insurance company. If the process is not resolved and settled, the claim will eventually end up in court before a judge.

Segment starts at 16:06

Benefits cut off after 2 years despite illness

I have been diagnosed with MS and have hit 2 years on LTD. One day the insurance company just decided to cut off my benefits! I feel like they’re pushing me back to work when I’m not ready. What happens if I make plans to return to work and my illness prevents me from doing so? What should I do?

At the two-year mark, there is usually a transition to any occupation test in order to continue with their disability benefits. It is important to note that many policies have a re-occurrence clause, in which within six months if an individual is unable to continue work they can go back on LTD benefits.

Segment starts at 21:30

Cut off benefits due to inadequate documentation

I’ve been struggling with fibromyalgia and fatigue for some years. I had to take a pause from my teaching job and go on long-term disability benefits. After being on LTD for less than a year, the insurance company said there was inadequate documentation to support additional payments, and cut me off. I haven’t had much luck in getting the union to help me reinstate my claim. What are my options here?

Unions don’t always have expertise with disability claims. In order to determine whether or not a disability lawyer can help a unionized employee, the collective agreement will have to be looked at closely. Do not assume the insurance company is automatically right and returning to work if you are not ready.

Segment starts at 25:06

Click Here For More Information About COVID-19 and Your Rights

Next Episode: Disability Law Show S3 E19 – 3 Tips for COVID-19 Long-haulers and LTD claims

Previous Episode: Disability Law Show S3 E17 – Conduct that constitutes as “Bad Faith” by your LTD insurer