How to fight a long-term disability claim denial when you’re in a union

When someone is denied short-term disability (STD) or long-term disability (LTD) coverage by their insurer, their best option in most cases is to start a legal claim against the insurance company for the money they are owed. However, unionized employees are sometimes not allowed to start legal claims and instead must have their union file a grievance.

Your options as a unionized employee

It is very important for a unionized employee to know, from the outset, if they should go the legal claim route, or the grievance route. A disability lawyer can help make this decision and explain your options. If you make the wrong choice, that could lead to negative implications such as a cost-award against you. It may also result in missing key deadlines such as the limitation period for starting a legal action. Even if you are lucky enough to avoid both of these pitfalls, the initial error of how to fight for your benefits would still, at the very, least cause fairly significant delays in resolving your claim.

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Arbitrable vs. inarbitrable: how to determine the best option

If you are a unionized employee  and your LTD coverage has been denied, determining which option is appropriate for your claim can be tricky, and you should contact a disability lawyer right away to assist in this analysis. We often assist unionized employees choose the right option and resolve these kinds of claims efficiently and relatively quickly.

When I advise clients about whether they should pursue a legal claim against the insurer, or file a grievance through their union, the question to be answered is whether the claim is “arbitrable” (meaning that it can be decided at Arbitration), or “inarbitrable” (meaning that it cannot). Essentially, that question is answered by looking at the terms of your union’s Collective Agreement. It would be nice if these Collective Agreements simply stated whether your LTD claim is arbitrable or inarbitrable, but they very rarely do. However, we have guidance from prior court decisions where judges have provided guidelines that help decide if a disability claim is arbitrable or not.

Arbitrable

If the entire LTD policy is included in the employee’s Collective Agreement, the claim is considered arbitrable. In this case, the individual will have to file a grievance through their union if their LTD claim is denied or cut off.

Inarbitrable

If the LTD policy is not mentioned in the employee’s Collective Agreement at all, the claim is considered inarbitrable, and the individual can enlist help from a disability lawyer at Samfiru Tumarkin LLP.

No cost to discover your rights

Unfortunately, most Collective Agreements are not clear and the answer requires some legal analysis. We advise clients daily on these issues, at no cost. We do not charge clients anything for consulting and providing guidance on this issue. Unionized employees have nothing to lose and everything to gain by contacting us to discuss their LTD matters and any questions they have regarding their claims.

Ultimately it is your choice on how to proceed (through a grievance with a union or a legal claim), but this decision must be made carefully and with full consideration of what is at stake. We can help you make that decision and empower you to understand your rights under your Collective Agreement and LTD policy.