Invisible Illness and Long-term Disability Claims

We believe that invisible illnesses are real, common, and debilitating, and they require medical attention, support, and treatment. Despite the challenges they present, we have helped many clients who suffer from this illness understand their rights surrounding disability insurance benefits.

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

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What is an Invisible Illness?

Invisible illnesses are any condition that exists yet lacks visible or quantifiable medical evidence to prove its existence. You may be suffering from a disease that your doctor cannot run a test for, and is unable to prove with concrete evidence (e.g. an x-ray provides proof of a broken bone). Nevertheless, disabilities that arise from invisible illnesses do exist, and you have a right to access medical benefits and coverage through your long-term disability plan for your illness.

A medical condition could be severely impacting your quality of life and your ability to work, despite the fact symptoms are invisible. Because invisible illnesses are conditions or illnesses that cannot be seen, and are not easily diagnosed by the medical profession, insurance companies often deny disability claims that fall within this category. Their excuse is that there is not enough evidence to support the individual’s claim.

According to Canadian Surveys on Disabilities (CSD), roughly 17% of Canadians are affected in their daily lives by a disability. Among those who had a disability, roughly 14% of those affected were afflicted with some form of physical pain daily, and 8% of those who suffered pain also suffered from a mental health-related disability.

What are the types of Invisible Illnesses?

Invisible illnesses can include the following conditions:

• Anxiety disorders

• Brain injuries

• Chronic pain

• Fibromyalgia

• Lyme disease

• Depression

• Psychiatric disorders

• Rheumatoid arthritis

Why are claims for Invisible Illness denied?

They Claim You Have Insufficient Medical Documentation

Many insurance companies will claim that you do not have sufficient medical evidence to justify your claim. If you have been seeking medical attention for your treatment, your doctor will have documented the various stages of your illness and provide you with adequate evidence. If your insurance company has denied your claim and have told you that they believe your medical documents don’t support your claim, seek the help of a professional. An experienced long-term disability lawyer at Samfiru Tumarkin LLP can help present your case in a holistic way, and explain to your insurance provider why you cannot work.

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.

They Tell You That You Are Not “Totally Disabled”

Insurance companies have invented the term “totally disabled” to mislead clients into believing that there is some catastrophic injury or disability required for you to get benefits from your provider. This is not true. You do not need to be incapacitated to receive the benefits you are entitled to. If your disability is preventing you from performing substantial aspects of your occupation, or any other occupation for which you are suited for by training, education, or experience, then you qualify for long-term disability.

They Say You Can Do Similar Work

Your insurer may take the position that you can move into another occupation, when that is in fact not the case and against medical advice from your doctor. Your insurance company may request a skills assessment, and use the result to insist you can do similar work. If the results of the skills assessment performed by the insurance company goes against your doctor’s advice, you need to contact us.

Was your LTD Claim Denied?

Insurance companies make money by selling you “peace of mind” and then refusing to pay when you claim compensation through your long-term disability benefits. When you are suffering from the stress and pain of an invisible disability, the last thing you is expect is for your insurer to deny your LTD claim, especially when you have legitimate support from your doctor or psychologist. It can be a devastating experience.

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 anywhere in Canada (excluding Quebec), 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

• Anxiety Canada
• Centre for Addiction and Mental Health (CAMH)
• Government of Canada – Mental Health – Anxiety Disorders
• Canadian Mental Health Association (CMHA)
• Centre for Addiction and Mental Health (CAMH)
• The Lifeline Canada Foundation
• Arthritis Society (Canada)
• The Arthritis Foundation
• Canadian Women’s Health Network
• Chronic Pain Association of Canada
• Practical Pain Management