COVID-19: Failure to participate in treatments and long-term disability

During the coronavirus I can’t get into see my doctor. How will that impact my Long-term Disability Claim?

I represent people in Ontario and British Columbia whose short-term disability (STD) and long-term disability (LTD) claims have been denied or terminated. A number of STD and LTD claims are denied on the basis that the insured has either been (a) not been receiving enough treatment or (b) not receiving the right treatment. This is typically a requirement under your insurance Policy.

During this period of self-isolation and social distancing due to COVID-19, and with fewer doctors scheduling appointments during this time, this requirement to get treatment becomes more difficult.

I’ve been receiving a number of phone calls from concerned clients who have told me that they are having trouble getting into see their doctors. In addition to their health getting worse by virtue of not seeing their doctors and not getting treatment, they are worried about the impact that not seeing their doctors will have on their LTD Claims. Hopefully this short blog post will help tell you understand your rights during this difficult time.

My condition is worsening because I can’t see my doctor, what do I do?

You definitely want to let your insurer know that you’re having difficulties seeing your doctor, and do so in writing.  At the very least, if your struggles are documented, that will help your case down the road.  The same goes for when your condition is worsening.  This also needs to be documented.

To that end, you may want to see if you can correspond with your doctor via email.  That keeps a paper trail of your symptoms and complaints.  It also shows the insurer that you were trying to see your doctor. If, still in spite of that, you can’t get in to see your doctors, there are a number of electronic services that you should look to, including online doctors such as Teladoc or Maple that provide online medical consultations.

Doing all of this will make your claim stronger in the event that your insurer does cut off your benefits.  Of course, if your insurer stops your LTD payments at any point, you should immediately contact a lawyer.

I’m on LTD but I’ve been unable to see my doctor, will I get cut off?

While we can’t make any guarantees that your insurer will not cut you off (as we commonly see insurers cut people off for invalid reasons), if your insurance company is telling you that you are not getting enough treatment during this coronavirus (COVID-19) saga, you will need to provide evidence that you have made reasonable efforts to see your doctors.  If, in spite of that, they still insist that they will be cutting you off, OR if they provide you with a letter which tells you that you are no longer going to be receiving benefits, you need to call a lawyer immediately. They should not be cutting you off.

My Insurer Says I Will Be Cut off if I don’t Get Treatment

The answer is the same as the last. You should be providing your insurer with all of your efforts to go see your doctors and make sure they are documented by way of email if you can.

I have other questions, who should I talk to?

Call us at 1-855-821-5900 for a 100% free consultation. Regardless of where you are in the LTD Insurance process, we are happy to talk with you and answer your questions, free of charge. You are not required to sign anything nor do you need to give a credit card number. Just ask questions and get answers from one of our disability lawyers in Ontario or BC.