What to know about LTD benefits and chronic pain | Disability Law Show TV – S6 E18

Episode Summary

WHAT TO KNOW ABOUT LTD BENEFITS AND CHRONIC PAIN on Season 6 Episode 18 of the Disability Law Show with disability lawyer, National practice leader and Partner James Fireman, and disability lawyer and Partner Tamar Agopian.

Watch above to discover the steps you must 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

Eligibility for LTD after short-term benefits

I applied for short-term disability benefits and received approval. The same insurance company, as a result of my short-term application, determined I was not eligible for long-term disability benefits. How is this possible if I’m still unable to work?

• Transitioning to long-term disability: In some situations a claimant can still apply for long-term disability benefits even if a deadline has passed. Insurance companies rarely permit this however courts have deemed it possible. To the best of their ability, individuals should apply for LTD benefits if they have the support of their doctors particularly if transitioning from short to long-term disability.

Volunteer work while on LTD leave

I’ve been on an extended disability leave from my employer. I have also been doing voluntary work as a board of directors member. Will this affect my benefits if my insurance adjuster becomes aware of this voluntary work?

• Working while on disability leave: Claimants should be open and honest with their insurance adjusters regarding their daily routine and limitations. Ultimately, the details and context of a claimant’s habits can influence whether or not an insurer cuts off benefits. Claimants should listen to their doctor’s advice and refrain from returning to work before they receive approval.

What you should know about LTD benefits and chronic pain

• Difficult to diagnose: Chronic pain can be difficult to diagnose as it develops over time and does not necessarily have a specific treatment plan. While there are diagnostic tools that can address treatment plans, chronic pain is subjectively reported and difficult to obtain objective medical evidence.
  
• Keeping updated medical documentation: Claimants must keep updated medical documentation concerning their ongoing symptoms and treatment. A record of long-term symptoms acts as evidence for an otherwise very subjective claim.
  
• Denial of chronic pain LTD claims: Insurance companies often deny chronic pain long-term disability claims despite the support of a medical team. This is largely due to the nature of the claim and a need for objective medical evidence.

Complying with insurer-recommended treatment

I’ve been receiving CPPD for the last 10 months. Recently my LTD insurer sent me for an independent medical exam. Their physician agreed that I’m disabled but recommended treatment my doctors feel would be unhelpful. Can the insurers cut me off if I do not comply?

• CPPD and long-term disability: An approval for CPP Disability is arguably much more difficult to receive than long-term disability. By receiving CPPD, an LTD claim should be strengthened.
• Cut off from benefits due to non-compliance: Claimants should ultimately follow the advice of their own treating doctors and medical professionals. While it is important to follow the terms outlined in a disability policy, claimants can ask their doctors to fill out a report detailing why they cannot follow certain treatment plans.

PREVIOUS EPISODE: Disability Law Show S6 E17 – 3 Benefits of applying for CPPD while on LTD