Disability Law Show

How to protect yourself from harassment from an adjuster | Disability Law Show TV – S6 E03


Episode Summary

HOW TO PROTECT YOURSELF FROM BULLYING AND HARASSMENT FROM AN ADJUSTER on Season 6 Episode 03 of the Disability Law Show with disability lawyer and Partner James K. Fireman.

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

Impact of concussions on the disability insurance process

Often claimants suffering from a concussion are denied disability benefits by the insurance company. Disability insurers typically presume that a concussion will resolve quickly so benefits are not needed.

  • Concussions and brain injuries: While many individuals recover from a concussion or brain injury fairly quickly, many do not. Mild concussions might not be able to be detected in objective medical imaging. Concussions can lead to a deterioration of both physical and mental health. Claimants suffering from a concussion and have ongoing symptoms that have not resolved are entitled to disability benefits.

Disability benefits cut off due to non-compliance

I suffered a brain injury a year ago and have since experienced debilitating migraines. My doctors advised me to take time off from work to recover. I was initially approved for LTD, but my benefits were cut off as I allegedly failed to comply with the recommended treatment. I am on a waitlist to see a specialist. How is this possible?

  • Benefits cut off: Many disability claimants suffer extenuating symptoms after a brain injury occurs. These symptoms can be fatigue, memory loss, lack of focus, etc. Claimants who have the continued support of a treating doctor should continue to receive disability benefits. While reasonable treatment is required to access disability benefits, it is not uncommon for individuals to be on a waitlist for treatment, particularly in regard to seeing a specialist.

How to protect yourself from bullying or harassment from an adjuster

  • Insurer’s behaviour is documented in writing: Claimants should ensure all concerns regarding their insurer are documented in writing. Documentation should include applicable facts about communicating with an insurer and the impact on the claimant’s health. In some circumstances, claimants can request another claims adjuster to handle their file.
  • Contact your doctor: Claimants are within their rights to speak to their treating doctors if communication with an adjuster has led to health complications. This is particularly vital if the claimant is suffering from a mental health claim. Speaking to a treating medical team can further support a claim for ongoing benefits.
  • Seek legal advice from a disability lawyer: It is critical to speak to a disability lawyer no matter the stage of filing a claim. A disability lawyer can provide important support and information for claimants struggling to communicate with their adjusters.

Requested to attend an independent medical assessment

After almost six months on long-term disability with a herniated disk, the adjuster has requested I attend an independent assessment. I’ve been told it’s necessary for this next phase of disability benefits. Do I have to attend despite my own doctor’s and therapist’s belief I am unable to work?

  • Attending a medical assessment: Most disability policies will contain terms requiring a claimant to attend an independent medical assessment. Claimants must attend an evaluation if requested by an insurer however they are not required to receive treatment from an insurer-recommended specialist. There are limits to the amount of assessments an insurer can require.

PREVIOUS EPISODE: Disability Law Show S6 E02 – 3 Frequently Asked Disability Rights Questions

NEXT EPISODE: Disability Law Show S6 E04 – 3 Important facts about your medical reports

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