A concussion disability lawyer can help if your short-term or long-term disability claim has been denied, delayed or cut off by the insurance company.
Insurers often argue that a normal brain scan, an expected recovery timeline or your ability to complete basic daily activities proves that you can return to work.
A lawyer can review your policy, denial letter and medical evidence, take over communication with the insurer and determine the best way to challenge its decision.
Samfiru Tumarkin LLP provides free consultations to people whose concussion disability benefits have been denied or terminated across Canada, excluding Quebec.
On This Page:
- When to Contact a Lawyer
- Why Concussion Claims Are Denied
- How a Lawyer Can Help
- Evidence for Your Claim
- Appeal or Legal Claim?
- Frequently Asked Questions
When Should You Contact a Concussion Disability Lawyer?
Speak with a disability lawyer as soon as the insurer denies your claim, stops your payments or tells you that your benefits will end.
Legal advice may be particularly important when:
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Your initial short-term or long-term disability application was denied
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Your benefits were approved and later cut off
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The insurer says you should have recovered by now
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A normal CT scan or MRI is being used against you
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Your headaches, dizziness or cognitive symptoms are described as subjective
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You are being pressured to return to work before you are medically ready
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A gradual return-to-work attempt failed or worsened your symptoms
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The insurer says you can perform remote, sedentary or alternative work
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The denial letter invites you to submit an internal appeal
Benefits Approved and Then Cut Off
An approval does not guarantee that the insurer will continue paying benefits. The company may reassess your claim based on updated records, a paper review, surveillance or an expected recovery timeline.
A lawyer can examine whether the insurer fairly considered your continuing symptoms and actual ability to sustain work.
Denied During the Transition From STD to LTD
Your insurer may approve short-term disability benefits but refuse your long-term disability claim.
This does not necessarily mean that you recovered. LTD may use different policy wording or require updated evidence explaining why your concussion symptoms continue to prevent work.
Why Do Insurers Deny Concussion Disability Claims?
An insurer may accept that you experienced a concussion but dispute whether your continuing symptoms prevent you from working.
Common denial reasons include:
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Your CT scan or MRI is described as normal
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Your symptoms are described as subjective or self-reported
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The insurer says most people recover within a short period
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Your medical records do not clearly explain your work restrictions
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Cognitive testing is interpreted as showing adequate function
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The insurer says you can perform sedentary or remote work
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Daily activities are treated as proof that you can maintain employment
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An unsuccessful return-to-work attempt is treated as evidence that you are capable
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Anxiety or depression is blamed for all your continuing symptoms
The Insurer Says Your Brain Scan Is Normal
Routine imaging may be normal after a concussion. A CT scan or MRI is often used to identify bleeding, fractures or other serious injuries rather than measure the severity of concussion symptoms.
A lawyer can help ensure that the insurer considers your complete clinical history, examinations, treatment and functional restrictions.
The Insurer Says You Should Have Recovered
General recovery timelines do not determine your individual capacity to work. Some people experience headaches, dizziness, cognitive fatigue and sensory sensitivity long after the initial injury.
The relevant question is whether your continuing symptoms prevent you from performing your occupation—not whether your recovery has taken longer than average.
The Insurer Says You Can Work From Home
Remote work still requires screen use, concentration, communication, memory and dependable productivity.
Working from home does not eliminate headaches, light sensitivity, cognitive fatigue, dizziness or the need to rest after mental activity.
How Can a Concussion Disability Lawyer Help?
A disability lawyer can identify weaknesses in the insurer’s decision and build a claim around your policy, medical evidence and actual occupational demands.
Depending on your situation, a lawyer may:
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Review your disability policy and denial letter
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Identify the definition of disability that applies to your claim
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Determine the legal deadlines affecting your rights
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Obtain and review the insurer’s claim file
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Identify gaps in the medical and occupational evidence
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Communicate directly with the insurance company
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Challenge insurer medical reviews, surveillance or inaccurate assumptions
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Negotiate for payment of benefits or compensation
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Start a legal claim when appropriate
Focus the Claim on Sustainable Function
An insurer may focus on whether you can complete a short conversation, drive occasionally, attend an appointment or use a computer briefly.
A lawyer can redirect the analysis toward whether you can repeat work activities throughout a full day and maintain them over a normal workweek.
Address Your Complete Medical Condition
A concussion may exist alongside neck injuries, migraines, vestibular problems, sleep disruption, chronic pain, anxiety or depression.
The insurer should consider the combined effect of every condition rather than dismissing each limitation in isolation.
Learn more about concussion disability benefits and post-concussion syndrome disability claims.
What Evidence Can Support a Concussion Disability Claim?
A concussion disability claim should include evidence explaining both your continuing symptoms and the work you are expected to perform.
Medical Evidence
Helpful medical evidence may include:
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Emergency-room and family-doctor records
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Records from neurologists, physiatrists or concussion specialists
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Vestibular, vision, neurological or cognitive assessments
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The frequency and severity of headaches, dizziness and sensory sensitivity
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Problems with memory, concentration, processing speed and mental stamina
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Restrictions involving screens, reading, driving, movement or busy environments
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Your treatment history and medication side effects
Occupational Evidence
Your claim should also explain:
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Your essential job duties
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The amount of reading, screen use and concentration required
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Exposure to noise, bright lighting, movement or crowded environments
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Whether you drive, work at heights or operate equipment
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Workplace accommodations that were attempted
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Any unsuccessful gradual return-to-work plan
Document What Happens After Activity
Your records should explain whether reading, computer use, meetings, driving or physical activity worsen your symptoms and how long recovery takes.
Being able to complete an activity once does not necessarily mean that you can repeat it throughout a normal workday.
Should You Appeal a Denied Concussion Disability Claim?
Do not assume that an internal appeal is automatically the best way to challenge a denial.
During an internal appeal:
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The insurance company reviews its own decision
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There is no independent decision-maker
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The insurer controls the review process
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Important legal deadlines may continue to run
An appeal may be appropriate in some situations. In others, a legal claim may provide a more effective way to obtain the insurer’s file, challenge its evidence and pursue compensation.
A disability lawyer can review the denial and explain which approach makes sense for your circumstances.
Denial at the Change of Definition
Many LTD policies initially assess whether you can perform your own occupation. After a set period—often two years—the insurer may consider whether you can perform another suitable occupation.
An insurer may argue that you can perform quieter, less physical, sedentary or remote work even when cognitive and sensory symptoms prevent reliable employment.
Learn more about the change of definition in long-term disability claims.
Frequently Asked Questions About Concussion Disability Lawyers
When should I contact a concussion disability lawyer?
Speak with a lawyer as soon as your disability claim is denied, your benefits are cut off or the insurer tells you that payments will end.
Can a lawyer help if my CT scan or MRI is normal?
Yes. A lawyer can help build the claim around your symptoms, examinations, treatment, functional restrictions and occupational demands rather than relying solely on routine imaging.
Can the insurer deny my claim because I should have recovered?
The insurer may make that argument, but general recovery timelines do not determine your individual ability to work. Continuing symptoms and limitations must be assessed based on your evidence.
Should I complete the insurer’s internal appeal first?
Not necessarily. Speak with a disability lawyer before appealing. The same insurer reviews the appeal, and legal deadlines may continue to run.
How much does a concussion disability lawyer cost?
Samfiru Tumarkin LLP offers a free initial consultation. Contingency-fee arrangements may be available where appropriate, meaning legal fees are paid from money recovered for you rather than upfront.
Speak With a Concussion Disability Lawyer
Managing headaches, cognitive problems and sensory sensitivity is difficult enough. You should not have to fight the insurance company alone.
Samfiru Tumarkin LLP represents people with denied and terminated short-term and long-term disability claims throughout Canada, excluding Quebec.
Our disability lawyers can review your insurance policy, medical evidence and denial letter and explain your options clearly.
Contact us for a free consultation if your concussion disability claim has been denied, delayed or cut off.