3 Frequently Asked Disability Rights Questions | Disability Law Show TV – S6 E02

Episode Summary

3 FREQUENTLY ASKED DISABILITY RIGHTS QUESTIONS on Season 6 Episode 02 of the Disability Law Show with disability lawyer and Partner Tamar Agopian.

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

Episode Notes

Filing a disability claim

Is it a difficult process to resolve a disability claim after legal representation is retained?

• Disability claims and legal representation: After a disability lawyer is retained, claimants no longer have to communicate directly with the insurance adjuster. An efficient disability lawyer will ensure claimants are kept informed throughout the claim process, as well as provide any necessary information to treating doctors.

Repeated attempts at an LTD denial appeal

I was approved for short-term disability benefits, but the insurance company has denied my claim for long-term disability credits. I appealed twice but both appeals were rejected. Is the third time the charm?

• The appeals process: The appeals process was created by insurance companies despite the fact that the concept is not included in most disability policies. Appeals are rarely successful and often are not reviewed by an objective third party. A legal claim is far more beneficial for claimants hoping to receive disability benefits.
  
• Short-term disability claim: The definition and test to qualify for both short-term and the initial phase of long-term disability benefits is the same. Claimants who received approval for short-term benefits should receive approval for LTD, although they are often denied.

3 Frequently Asked Disability Rights Questions

• The difference between the “own occupation” and “any occupation”: The own occupation period consists of the first two years on long-term disability benefits. Individuals have to prove, with the support of their doctor, that they are unable to work in their own occupation due to their disability. After two years, the definition of disabled changes from an inability to work in one’s own occupation, to any occupation.
• Timeline to appeal and the limitation period: Claimants have two years after long-term disability benefits have been denied to file a legal claim. Appeals can waste valuable time as deadlines are often not clearly stated by the insurer.
•  Types of deductions: Insurers often deduct from a claimant’s benefits if they have received approval from CPPD. Individuals who receive benefits as a result of a workplace injury, such as Workers’ Compensation or WorkSafe benefits, might also experience deductions. It is also important for those who have recently lost their employment to understand that severance entitlements will affect disability benefits.

Cancer diagnosis but denied LTD due to lack of medical evidence

After a breast cancer diagnosis, I was unable to continue working. I’ve been on LTD and CPP disability benefits for over a year now, but I just got a letter from my insurer saying they’re cutting me off. They stated that my doctor had not provided enough medical evidence.

• CPP and LTD benefits: The test in order to qualify for CPP Disability asks that a claimant’s disability is severe and prolonged. This test is typically more difficult to pass than that of long-term disability. An approval for CPPD should strengthen a long-term disability claim. In the event of denial of LTD despite approval for CPPD, claimants should ensure their medical reports are detailed and relevant. 
  

PREVIOUS EPISODE: Disability Law Show S6 E01 – What to know…if awaiting treatment and applying for LTD

NEXT EPISODE: Disability Law Show S6 E03 – How to protect yourself from harassment from an adjuster