3 Things you need to know before applying for LTD | Disability Law Show TV – S7 E01

Episode Summary

3 THINGS YOU NEED TO KNOW BEFORE APPLYING FOR LTD on Season 7 Episode 01 of the Disability Law Show with disability lawyer and co-founding Partner Sivan Tumarkin.

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

End of LTD at two-year mark

I’m a mechanic and I’m 48 years old. A few years ago I had a ski accident that led to a back injury, and now chronic pain and depression. I was on short-term disability and eventually transitioned to LTD. I’ve been following regular treatment but my insurer has informed me my benefits will end soon as it’s been two years. What can I do here?

• Change in definition of disability: Many claimants experience a cut-off from disability benefits at the two-year mark. After two years on long-term disability, the definition of “totally disabled” changes from an inability to work in one’s own occupation, to any occupation. Claimants who continue to have their doctor’s support and cannot work should not be pressured into returning to work early.

Deemed not “totally disabled” due to work history

I was recently told to take substantial time off work due to rheumatoid arthritis and fibromyalgia. I’ve been on medications for over 10 years and have experienced severe flair-ups. Despite this, I was denied LTD and told that I could work for years with this diagnosis, so I’m not considered “totally disabled”. What can I do?

• Terminology used in long-term disability policies: Insurance companies typically use the term “total disability” to discount a claim for disability benefits. In the context of disability benefits, “totally disabled” means an individual cannot perform the essential tasks of their current position. This phrase often confuses claimants and dissuades many from applying for benefits.

3 Things you need to know…before applying for LTD

• Treating doctor’s support is critical: The support of a treating doctor or specialist is critical to receiving LTD benefits. Insurers will question a claimant if they do not have the support of a medical team.
  
• Follow appropriate medical treatment: Claimants must continue to follow appropriate medical treatments throughout their application process, and during disability leave. A refusal to do so can lead to a cut-off from benefits.
  
• Deny a claim for many reasons: Insurers can deny a claim for any number of reasons. Often, despite a denial, a claimant can pursue legal action to pursue their benefits if they are unable to work. Claimants need to seek legal advice as soon as they receive a denial from their insurer.

Claimant on LTD worried about surveillance

My mom worked as a clerk for years. Nearly two years ago, she had to stop working due to chronic back pain and migraines. She suspects she’s being followed during the week while doing errands.  She’s worried this will lead to her benefits being cut off. What can she do?

• Surveillance and LTD benefits: It is normal for insurance companies to implement surveillance in some circumstances. For those who are honest about their disability and symptoms, surveillance should not be a worry. Surveillance is an expensive measure and typically is only conducted for a short period.

Ignoring requests to apply for CPP Disability

I’ve been getting disability insurance for over a year now due to a shoulder injury that will need surgery. My insurer is now pressuring me to apply for CPP Disability benefits. Can I just ignore them?

• Applying for CPP Disability benefits: Most long-term disability policies contain a provision that permits insurers to deduct from benefits based on a presumed CPP Disability credit. Approval for CPP Disability can strengthen a disability claim as it is a much more difficult test to pass than long-term disability.

PREVIOUS EPISODE: Disability Law Show S6 E20 – Guide to LTD benefits and employment