Diabetes and Long-term Disability Claims

Diabetes can affect an individual’s ability to function, and complications leading from diabetes can be disruptive to one’s daily life. If your diabetes is disrupting your ability to work, and you have an insurance plan that covers this condition, you can file a long-term disability claim for benefits.

Read on to learn more about this disease, and how you can get the help you need if your long-term disability claim for diabetes is denied in Canada.

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Understanding Diabetes

Diabetes is a chronic condition that occurs when the body cannot produce or manage its own insulin, which is the hormone that controls blood sugar levels. If untreated, it can lead to serious health complications. However, it is possible to manage diabetes and remain healthy.

Diabetes Facts:

• It is estimated that 10% of the population in Canada are living with diabetes.
• Approximately 90% of those living with diabetes have type 2 diabetes.
• Around 29% of Canadians are living with diabetes or prediabetes.
• 1 in 10 women who get pregnant will experience gestational diabetes.

Diabetes can lead to other complications, including:

• Diabetic retinopathy (vision loss)
• Foot ulceration (and amputation)
• Depression (around 30% of people with diabetes experience depression)
• Anxiety
• Celiac disease
• Cardiovascular disease
• Kidney failure
• Stroke
• Erectile dysfunction

Types of Diabetes

There are three main types of diabetes:

• Type 1 Diabetes
• Type 2 Diabetes
• Gestation Diabetes

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease, whereby the immune system destroys insulin produced by the pancreas. Individuals with type 1 diabetes need to rely on an external source of insulin to live. It typically develops in children and youth but can also develop in adults.

Type 2 Diabetes

Type 2 diabetes is a metabolic disorder, where the pancreas does not produce enough insulin for the body to even out blood sugar levels. It is more common in individuals with a family history of diabetes, individuals who are overweight, or who are physically inactive. It is most common in individuals over 40 but can occur among younger individuals.

Gestational Diabetes

Can occur in pregnant women, but usually disappears after the birth of the child. Developing gestational diabetes while pregnant increases the probability of the mother developing type 2 diabetes later in life.

Common reasons for denial of disability claims for Diabetes

The applicant has not sought the appropriate medical attention

A diagnosis of type 1 or type 2 diabetes may not be enough to establish disability due to the disease. Your insurer may say that you are not seeking appropriate treatment. This could be related to the frequency or your medical visits, or due to not seeing a specialist.

If you are referred to a specialist, regular visits are important. These will help you to address any complications from diabetes. It is also important that you address the functional limitations that are affecting your ability to work, so that your doctor can describe these in a statement that you will submit with your claim. Attendance at medical appointments is mandatory in order to maintain a consistent record of the progression of your disability.

You are not yet receiving the appropriate treatment

If you were recently diagnosed by your family physician, and are awaiting an appointment with the correct specialist, your insurance company may deny your claim on the basis that you are not yet receiving the appropriate treatment. But referrals to specialists can mean long wait times, and this should not prevent you from receiving your benefits while you wait.

Not enough medical evidence or documentation to confirm your diagnoses

One reason medical claims are often denied is a lack of objective medical testing or evidence to provide support to your claims of functional limitation. If you are receiving regular medical attention, discuss with your doctor the difficulty you are having functioning.  Your doctor will help you develop a treatment plan, and you can demonstrate that you are trying to resume your work.

What you can do to improve your chances of getting your benefits approved

Keep records of your treatment

Appropriate medical attention will help you manage your diabetes and address any new or developing complications. Record the frequency of your medical visits in a journal or diary, noting any progress or regression you experience with respect to complications. Keep records of the medications attempted, prescriptions taken, and any specialists you see in the process of managing complications from your diabetes. It is the documentation that the insurance company will be using to determine whether you are experiencing limits to your functioning at work, so you want to make sure they have as much of it as possible.

Present a narrative of your illness

You can also obtain witness statements from co-workers with respect to your difficulties maintaining your duties at work. Your insurance provider needs to be presented with the entire story. You can present a narrative of your diagnosis, symptoms, complications, and your full treatment plan and the steps you are taking to improve functionality.

Was your LTD claim for diabetes denied?

If your long-term disability claim for diabetes has been denied or cut off, don’t deal with the insurance company on your own, at a time when you are already feeling overwhelmed living with a disability. If complications from diabetes is legitimately preventing you from functioning to the extent that you cannot work, our experienced team of disability lawyers can directly handle your insurer on your behalf when your claim is rejected.

Don’t walk way from your rights. That is what the insurance company wants you to do. They may also encourage you to appeal the denial. Do not go through the insurance company’s appeals process! In most cases, your appeal will be unsuccessful, and your insurer will use this tactic to run out the clock on your time limit to file a claim for full compensation.

If your disability claim is denied in Canada, you need to contact the experienced long-term disability lawyers at Samfiru Tumarkin LLP immediately at 1-855-821-5900 for a FREE CONSULTATION. We will review the facts of your situation, tell you if you have a case, and take the fight to the insurance company on your behalf. Don’t let them walk away with the money that they owe you in your time of need.

Get the advice you need, the compensation you deserve.

Additional Resources

• Diabetes Canada
• Diabetes Canada – Tools and Resources
• Government of Canada – Resources
• Government of Canada – Tips for Healthy Eating
• Canada’s Food Guide
• American Diabetes Associate – Healthy Eating
• National Institute of Diabetes and Digestive and Kidney Diseases – Changing Habits