3 Common mistakes to avoid when applying for LTD | Disability Law Show TV – S7 E06

Episode Summary

3 COMMON MISTAKES TO AVOID WHEN APPLYING FOR LTD on Season 7 Episode 06 of the Disability Law Show with 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

Critical illness claim denied

I was diagnosed with cancer but denied a critical illness claim. How is this possible and what do I do?

• Critical illness policies: Due to the nature of many cancer diagnoses, many critical illness policies contain various exclusions. Some policies can deny claims based on a recurrent condition. Insurance companies will often use a technical reason to deny claims. Denied claimants need to seek legal advice from a disability lawyer to determine their next steps.
  

End of employment and disability benefits

My employer wouldn’t accommodate me after discovering I have a degenerative disc in my neck. After a year and a half on long-term disability benefits, I was informed that my employment would end. This also resulted in the premature end of my disability benefits.

• Employment and disability leave interaction: Disability and employment matters can often overlap—individuals who lose their employment while on disability leave should continue to receive benefits. Employees should note that employers must accommodate a disability up until the point of undue hardship. Severance payments as a result of termination of employment, however, can impact disability benefits.

3 Common mistakes to avoid when applying for LTD

• Necessary information regarding medical condition: Claimants must ensure their insurance provider is given all necessary medical reports and documentation. This can include symptoms that have been progressing with time, not just documentation regarding their main medical condition.
  
• Missing deadlines for application: Insurance companies pay close attention to deadlines. A missed deadline is an easy justification to deny a disability claim. Deadlines are important but somewhat arbitrary. Claimants should communicate with their adjuster regarding upcoming appointments and updated records.
  
• Diagnosis and daily activities: Claimants should ensure information provided to the insurer connects a possible medical condition and ongoing symptoms, with their inability to work. A diagnosis is not necessary to receive approval for long-term disability.

Request to appeal from insurer

I suffered a heart attack last year due to stress. Despite my doctor’s advice that I wasn’t ready, I was pressured to return to work. I tried but found my health quickly deteriorated. Now, the disability insurer has refused to reinstate my benefits but said I could try appealing. Do I have any other options here?

• Union claimant rights: Unionized employees do not necessarily have to appeal a denial of long-term disability benefits. Despite their union environment, some employees can seek external legal advice from a disability lawyer.
• Pressured to appeal: The appeals process, created by insurers, is typically not successful for claimants. Appeals are often not conducted by an external party and can waste valuable time for claimants.

Early return to work from disability leave

My insurer asked me to complete a form about my skills and submit a resume. I’ve been on LTD for 6 months with a herniated disk causing extreme pain from my lower back down to my foot. While I’ve had an MRI and finally spoke to a neurosurgeon, I’m still awaiting treatment. Can I be pressured into working before I’ve recovered?

• Approval to return to work: Claimants should not feel pressured to return to work by their insurance adjuster or their employer. Only a treating doctor or medical team should provide approval for a claimant to return to work from disability leave. Insurance companies are often impatient and likely do not want to wait for treatments to commence.
• Reviewing skillset for the next period of disability: After two years of long-term disability, most policies will contain a change in the definition of disability. Claimants will have to prove they are unable to work in any occupation, not just their own.

PREVIOUS EPISODE: Disability Law Show S7 E5 – What to know about a disability lawyer’s role in LTD claims