3 Common misconceptions about LTD claims | Disability Law Show TV – S4 E31

Episode Summary

3 COMMON MISCONCEPTIONS ABOUT LTD on Season 4 Episode 31 of the Disability Law Show with disability lawyer and national co-managing Partner Sivan Tumarkin.

Watch above to discover the steps you need to take when the insurance company cuts off or denies your long-term disability claim in Ontario, British Columbia, or Alberta, on the only disability law show on TV and radio in Canada.

Episode Notes

Cost of living increases and LTD benefits

With an ever-increasing rise in the cost of living, am I entitled to an increase in my long-term disability benefits from the insurer?

• Long-term disability policy and contract: It is important for claimants to look closely at the provisions outlined in their disability policy. At times, claimants are entitled to a cost of increasing living benefits but have not received increased payments. Claimants who believe they are entitled to something and do not have access to their policy are within their rights to ask their insurer for a copy of their policy.

Disability benefits cut off after a medical assessment

After I underwent a medical assessment requested by my insurer my LTD benefits were cut off. It’s been 2 years but my doctor says I’m not ready to return to work.

• Two-year mark of long-term disability benefits: It is very common for insurance companies to push claimants to return to work or cut off long-term disability benefits around the two-year mark. In most standard policies, in order to receive LTD benefits after two years, claimants have to prove they are disabled from working in any occupation.
• Independent medical assessments: The insurance company selects certain experts and professionals to conduct evaluations that will aid them in cutting off a claimant’s benefits. Claimants are expected to attend an independent medical assessment. Ultimately, a claimant’s own medical team’s opinion will hold more weight than a consultant that the insurer has recommended. Treating doctors of a claimant are held in more esteem in court by judges.

3 Common misconceptions about long-term disability claims

• Total disability does not, in fact, mean “total” disability: Insurance companies control the language implemented throughout the claims process and within the disability policies themselves. The term “total disability” in a long-term disability context is very different from the term used in practical terms. To be totally disabled, a claimant has to prove they are totally disabled from their own job and cannot perform the essential tasks.
  
• Insurers can’t ignore what your doctors say: Insurers often cherry-pick information from reports provided by a claimant’s doctors and treating medical team. Claimants should continue to provide up-to-date and detailed doctor’s reports to their insurance company despite this behaviour from the insurer.
• Insurers can’t force you back to work before you are ready: It is common for insurance companies to force claimants back to work despite the advice from doctors. Only a treating doctor can advise a claimant when they are ready to return to work and the restrictions or accommodations required once the claimant is ready.

Long-term disability benefits if employment ends

I’ve been on disability for three years but my employer might be going out of business soon. What will happen to my LTD benefits if that happens?

• Employment issues and Long-term disability: Ultimately once a claimant is on long-term disability it does not matter if their employer is still in business unless an employer is providing the benefits itself.

Applying for CPPD while on LTD due to a car accident

I’ve been on LTD for two years after sustaining a serious back injury in a car accident. My insurer has told me to apply for CPP Disability. What should I do?

• Applying for CPP Disability: Most long-term disability policies have a provision that requires claimants to apply for CPP Disability. Claimants should remember that if they do not apply for CPPD, the insurers will assume the amount of benefits a claimant would receive from CPPD and reduce the compensation from LTD accordingly. It is much harder for claimants to have their LTD benefits cut off after receiving approval for CPPD as the test in order to qualify for CPP Disability is much more difficult than that of LTD.

PREVIOUS EPISODE: Disability Law Show S4 E30 – 5 things to remember for clients unsure about legal claims