An epilepsy disability lawyer can help if your short-term or long-term disability benefits have been denied, delayed or cut off.
An insurance company may accept that you have epilepsy but argue that your seizures are controlled, happen too infrequently or do not prevent you from performing another job.
The insurer should consider more than the number of seizures you experience. It must also consider their unpredictability, your recovery time, medication side effects and the safety requirements of your occupation.
Samfiru Tumarkin LLP represents people with denied and terminated disability claims throughout Canada, excluding Quebec.
On This Page:
- How a Lawyer Can Help
- When to Contact a Lawyer
- Why Epilepsy Claims Are Denied
- Evidence for Your Claim
- What Happens Next?
- Frequently Asked Questions
How Can an Epilepsy Disability Lawyer Help?
A disability lawyer can review your insurance policy, denial letter and medical evidence to determine why the insurer refused or terminated your benefits.
A lawyer may help by:
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Explaining the definition of disability in your policy
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Identifying problems with the insurer’s decision
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Determining what medical or functional evidence is missing
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Showing how seizures affect your actual occupation
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Addressing safety restrictions and medication side effects
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Communicating and negotiating directly with the insurer
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Starting legal action when appropriate
Connecting Epilepsy to Your Job Duties
The effect of epilepsy depends partly on the work you perform.
A sudden loss of awareness or physical control may make driving, operating equipment, working at heights or performing emergency duties unsafe.
Office and professional work may also become unsustainable when seizures, recovery periods or medication interfere with memory, concentration, communication and attendance.
When Should You Contact an Epilepsy Disability Lawyer?
Speak with a disability lawyer promptly if:
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Your short-term or long-term disability claim was denied
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Your approved benefits were later cut off
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The insurer says your seizures are controlled or too infrequent
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You are told that you can perform safer, sedentary or remote work
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Medication side effects or recovery periods are being overlooked
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You are being pressured to return to work before your doctor believes it is safe
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You are considering an internal appeal
You do not have to wait until your seizures become more frequent or cause a workplace accident. Getting advice early can help you understand your policy, legal options and important deadlines.
Do You Have to Appeal to the Insurance Company?
An insurer may invite you to submit an internal appeal after denying your epilepsy disability claim.
An appeal is not always the best option. The same insurer that denied the claim will review it, and submitting similar evidence may produce the same result.
You may not need to complete the insurer’s appeal process before pursuing legal action. Speak with a disability lawyer before deciding how to respond.
Why Are Epilepsy Disability Claims Denied?
An epilepsy disability insurance claim denial may occur even when your neurologist supports you being off work.
Common reasons include:
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The insurer says your seizures are controlled by medication
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Your seizures are described as too infrequent to prevent work
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Testing does not capture frequent seizure activity
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Your medical records do not clearly explain your restrictions
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The insurer says you can perform a safer or sedentary occupation
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Recovery time and medication side effects are overlooked
The Insurer Says Your Seizures Are Controlled
Medication may reduce seizure frequency without eliminating the risk of another episode.
The insurer should also consider whether medication causes fatigue, dizziness, memory problems, slowed thinking or difficulty concentrating.
A person may follow every reasonable treatment recommendation and still remain unable to work safely or reliably.
The Insurer Says Your Seizures Are Infrequent
The number of seizures is only one part of the claim.
A relatively infrequent seizure may still prevent driving or safety-sensitive work. You may also experience warning symptoms, anxiety, poor sleep or lengthy recovery periods between episodes.
The Insurer Says You Can Perform Another Job
An insurer may accept that you can’t return to a safety-sensitive occupation but argue that you can perform office or remote work.
It should consider whether you have the education and experience required for the proposed occupation and whether you can meet its attendance, concentration and productivity demands.
The ability to remain seated does not automatically establish that you can sustain sedentary work.
Your Benefits Are Cut Off After Two Years
Many LTD policies change their definition of disability after approximately two years.
The insurer may accept that you can’t perform your previous occupation but argue that you can work elsewhere.
It should consider your seizure-related restrictions, medication side effects, transferable skills, education and work experience before identifying another occupation as suitable.
What Evidence Supports an Epilepsy Disability Claim?
A diagnosis alone may not explain everything the insurer needs to know. Your evidence should show how epilepsy affects your ability to perform your actual job.
Helpful evidence may include:
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Medical records from your family doctor and neurologist
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The type, frequency and duration of your seizures
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EEG, imaging and other relevant test results
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Your symptoms and recovery time after a seizure
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Your medication history and side effects
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A detailed description of your job and its safety requirements
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Failed accommodation or return-to-work attempts
Document Seizures That Other People Witness
You may not remember everything that occurs during a seizure. Information from a family member, coworker or another witness may help your doctors understand what happened.
A seizure diary may also document the date, duration, possible triggers, warning symptoms and recovery time associated with each episode.
Explain the Recovery Period
The insurer may focus on the duration of the seizure while overlooking what happens afterward.
Explain whether you experience confusion, exhaustion, headache, muscle pain, memory problems or the need to sleep for several hours.
What Happens After You Contact an Epilepsy Disability Lawyer?
During an initial consultation, a disability lawyer may ask about your seizures, occupation, treatment and the insurer’s reason for denying or ending your benefits.
The lawyer may review:
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Your denial or termination letter
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The definition of disability in your policy
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Your medical evidence and seizure history
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Your job duties and safety restrictions
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Important dates and possible legal deadlines
The lawyer can then explain whether the insurer’s decision may be challenged and what evidence could strengthen your case.
How Can an Epilepsy Disability Claim Be Resolved?
Depending on the circumstances, a denied claim may be resolved through reinstatement of monthly benefits, payment of benefits previously withheld or a negotiated settlement.
There is no standard epilepsy disability settlement. The outcome depends on the insurance policy, monthly benefit, medical evidence, age, prognosis and other circumstances.
Is There a Fee to Speak With a Disability Lawyer?
Samfiru Tumarkin LLP offers a free initial consultation for denied short-term and long-term disability claims.
There are no upfront legal fees. You only pay if we successfully resolve your disability claim.
Frequently Asked Questions About Epilepsy Disability Lawyers
What does an epilepsy disability lawyer do?
A disability lawyer reviews your insurance policy, medical evidence and denial letter and helps challenge the insurer’s refusal to pay benefits.
When should you contact an epilepsy disability lawyer?
Speak with a lawyer after your claim is denied or cut off, before filing an internal appeal, or if you are being pressured to return to unsafe work.
Can a lawyer help before your benefits are terminated?
A lawyer may provide advice when the insurer requests additional information, schedules an assessment or warns that benefits may end.
Can controlled epilepsy qualify for long-term disability?
Potentially. Less frequent seizures may still create serious safety restrictions, and medication side effects may prevent reliable work.
Do you have to appeal to the insurer first?
Not necessarily. An internal appeal is only one possible option. Speak with a disability lawyer before deciding how to challenge the denial.
How long do you have to challenge an epilepsy claim denial?
Legal deadlines apply and may vary based on the province, policy and circumstances. Get legal advice promptly to protect your options.
Speak With an Epilepsy Disability Lawyer
Living with unpredictable seizures is difficult enough. You should not have to fight an insurance company alone while managing safety restrictions, medication side effects and financial uncertainty.
Samfiru Tumarkin LLP represents people with denied and terminated disability claims throughout Canada, excluding Quebec.
Some members of our legal team previously worked for insurance companies. We understand why epilepsy claims are challenged and what evidence may be needed to dispute a denial.
For more information about eligibility and available benefits, read our guide to epilepsy disability claims in Canada.
Contact us for a free consultation if your short-term or long-term disability claim has been denied or cut off.