3 Myths about Invisible Disabilities | Disability Law Show TV – S7 E10

Episode Summary

3 MYTHS ABOUT INVISIBLE DISABILITIES on Season 7 Episode 10 of the Disability Law Show with Disability Lawyer and National co-Managing 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

“Own occupation” period in a private disability policy

I’m a family doctor and work in a rural area. I’ve been on LTD for almost 3 years with major anxiety. I have a private disability policy; not through my employer. I have a new adjuster on my claim, who wants me to be evaluated by their psychiatrist. Could my benefits be cut off?

• Opinions of other medical professionals: Some private policies can be high-paying, depending on the profession, and thus targeted by insurers. Despite this, insurance companies can request claimants attend evaluations. Claimants should continue to undergo appropriate treatment and do their best to recover, regardless of the opinion of a professional not part of their medical team.

End of benefits leads to job loss

I suffered a major stroke and was initially approved for long-term disability. However, I only received benefits for one month before losing contact with the insurer. I returned to work, where I faced criticism from my boss, eventually leading to my resignation. Do I have any legal recourse against the insurer?

• Employment and disability issues: It is important to only return to work if approval is given by treating doctors. Many who suffer from a medical condition can lead to a regression in recovery; this can impact performance at work. As there can be an overlap between employment and disability issues, it becomes vital not to wait to seek legal advice after benefits are cut off or there are complications.

3 Myths about Invisible Disabilities

• Qualify for disability benefits: Some medical conditions and disabilities may seem invisible; such as various mental health conditions or chronic back pain. Insurance companies often argue there is no objective medical documentation. It is not a requirement for a disability to be visible for an individual to be affected by it and unable to work due to ongoing symptoms.
  
• Fair when evaluating claims: Insurers often discriminate against invisible disability claims. Although insurance companies have a duty under the law to act in good faith, many prioritize profit over administering benefits.
  
• Denied LTD despite support from your doctor: Claimants who have the support of treating medical professionals should not adhere to the opinion of their insurers. The support of a treating doctor or specialist should lead to the approval of disability benefits. Claimants should seek legal advice if their claim has been denied.

Communicating with a hostile disability insurer

I returned to work on modified hours after 9 months of disability benefits following a spinal fusion. I don’t think I can resume full-time hours as planned. When I told my insurer about my challenges, their tone became hostile. I’m concerned they will deny my benefits if I need to resume leave.

• Obligations of disability insurers: Insurance companies are supposed to be a safety net for individuals. Most disability policies contain a recurrence clause, allowing claimants to resume benefits if a return to work was unsuccessful. Claimants should document all forms of communication with their insurance adjusters in writing. Detailed documentation could strengthen a future legal claim if it is determined an insurer was not acting in good faith and causing harm.

Deemed “totally disabled” but denied LTD

After appealing their denial of my LTD after two years, I’m waiting to hear back from my insurer. I’ve sent letters from my specialist and family doctor confirming I’m totally disabled—a term I still find confusing. What should I do if they reject my appeal?

• Terminology of disability policies: The term “total disability” was created by insurance companies to confuse claimants. The term in the long-term disability context simply means an individual is disabled from performing the essential tasks of their occupation.
• Appealing a claim: Appealing a denial of benefits is typically not successful. Appeals are often conducted by the same adjuster who initially denied benefits and not an external third party. It is far more beneficial to file a legal claim.

Travelling while on long-term disability

My doctor has recommended some travel to visit family that he believes will help my ongoing mental health symptoms. After informing my insurance company of this, they believe this proves I am not “totally disabled” and should be able to work. What can I do here, as I am following medical advice?

• Complying with the insurance company: Claimants can request a letter from their treating doctors confirming that they are following their recommendations to pursue certain activities, such as travelling while on claim. Disability policies require claimants to seek appropriate treatment and follow recommendations to remain receiving dis

PREVIOUS EPISODE: Disability Law Show S7 E9 – Understanding insurance company surveillance