What to know about transitioning from short-term disability to LTD | Disability Law Show TV – S4 E12

Episode Summary

WHAT TO KNOW ABOUT TRANSITIONING FROM SHORT-TERM DISABILITY TO LTD on Season 4 Episode 12 of the Disability Law Show with disability lawyer and 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

Disability benefits cut off despite approval from insurer’s doctor

I suffer from a depressive disorder that worsened due to COVID. I’ve been on LTD for almost two years. I recently attended a medical assessment by the insurance company’s psychologist. The psychologist agreed I was unable to work yet I had my benefits cut off. How is this possible?

• Sent for an IME: Often at the two-year mark, claimants who are on long-term disability benefits have their benefits cut off. This is due to the fact that after two years the test in order to qualify for disability benefits changes from claimants unable to perform the tasks of their own occupation, to any occupation. It is important for claimants who are able to work in another position to be given comparable positions, not only on a skill-level basis but also a comparable salary. Insurance companies who have ignored their own medical professionals’ advice have operated in bad faith and could owe a claimant punitive damages.
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    Depression and Long-term Disability Benefits

Surveillance while on long-term disability

I have been on LTD for the last six months following a car accident. I am in no condition to hold down my regular duties at work. My fear is that the insurance company, who warned me that they sometimes do surveillance, will interpret my daily activities as proof that I am ready to go back. What are my rights?

• Daily activities while on LTD: Claimants should continue to receive benefits as long as they are truthful and are incapable of returning to work. Insurance adjusters are permitted to surveil claimants however they cannot interact with claimants and there are limits to surveillance. Claimants should continue to go about their daily lives and listen to their treating doctor’s advice regarding what they are able to do or not. Claimants who have had their benefits cut off due to surveillance should contact a disability lawyer as soon as possible.

What you need to know about transitioning from Short-term Disability to LTD

• Unable to return to work after going on STD, apply for LTD: The criteria in order to qualify for short-term disability are often similar to long-term disability. There are typically some problems in transitioning to LTD from short-term disability as the insurers are not always the same. Claimants who are legitimately disabled are owed their disability benefits.
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    Short-term disability claims and denials

• No automatic approval of long-term disability: It is important to understand that claimants who have been on short-term disability should continue to receive treatments and medical documentation to provide to the insurance company. It is important to make sure that the information provided to insurance adjusters is up to date and that treatment has not stopped.
• A disability lawyer can help you get compensation: By beginning the legal process and contacting a disability lawyer, the power between a claimant and an insurance adjuster is shifted to the claimant. Claimants who decide to appeal or pursue legal action on their own can face an uphill battle.

Disability benefits cut off despite anxiety disorder

After two years on LTD for a generalized anxiety disorder, the insurance company decided to cut off my payments. They said that when my rehabilitation program ends, I will be able to perform the required demands of my regular occupation. Is there anything I can do about this right now?

• Change in definition period: Claimants who are unable to work should speak to their treating doctors to determine if they are ready to return to work. Claimants should not return to work without their medical team’s approval as their health can regress. Insurance companies have a duty to treat claimants in good faith and must consider the documentation provided by claimants. Doctors that believe claimants are ready to work should include possible accommodations and specify whether or not they believe the claimant will be successful.
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    Anxiety disorders and long-term disability

Repeated failed appeals for Long-term disability benefits

My friend was denied long-term disability benefits one-and-a-half years ago. She is still unwell and extremely stressed and still fighting the insurance company to get her benefits. In fact, she just filed her third appeal. Is there anything I can do to help her?

• Repeated appeal attempts: The appeals process is often ineffective and a waste of a claimant’s time. Appeals were created by insurance companies and are not investigated by an objective third party. It is important for claimants to remember that they have up to two years after the initial date of the denial to pursue their benefits. Repeated appeals are often processed by the same individuals at the insurance company that initially denied the claim. Rather than appeal, claimants should contact a disability lawyer as soon as possible to pursue their rights.

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Previous Episode: Disability Law Show S4 E11 – 3 Things you should know before filing an LTD Claim