3 Important facts about your medical reports | Disability Law Show TV – S6 E04

Episode Summary

3 IMPORTANT FACTS ABOUT YOUR MEDICAL REPORTS on Season 6 Episode 04 of the Disability Law Show with disability lawyer and Partner James K. Fireman.

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

Episode Notes

Disability benefits and returning to work

If I file a legal claim for disability benefits, does this prevent me from eventually returning to work if I have recovered?

• Importance of disability benefits and recovery: Many individuals mistakenly assume that filing a legal claim to ensure disability benefits are approved will become an obstacle to recovery. Returning to work and recovery remains the ultimate goal of disability leave, regardless of any legal action taken. Most disability policies contain a recurrence clause that allows claimants to resume benefits if their return to work was unsuccessful.
  

Informing the insurer of the inability to work

My wife is on LTD and has been approved for CPPD for a little over two years. Her LTD is supposed to end in a few months. After seeing her family doctor recently, she was told she wasn’t ready to return to work. Should we inform the insurer?

• Ready to return to work: Many insurance adjusters will pressure claimants to return to work preemptively, especially around the two-year mark of disability benefits. Claimants who have the support of their treating doctors should inform their insurers as soon as possible of their prognosis and continued inability to work.

3 Important facts about your medical reports

•  A doctor’s report: Claimants should ensure their doctor’s medical reports and files are as detailed as possible and relevant to a claimant’s position in their workplace. Treating medical teams are often unaware of what is required in order to strengthen a disability claim.
• What your job entails: Claimants should not assume that their treating doctors are aware of what their occupation entails. It is vital for doctors to detail why a claimant’s condition prevents them from fulfilling the basic tasks of their position. Claimants can provide their doctors with a job description to ensure their doctors are adequately informed.
• Able to seek legal advice: Doctors are able to seek legal advice from disability lawyers if unsure of their next steps and how best to advise their patients.

Effect on mental health due to insurer communications

Lately, my insurance adjuster has been constantly requesting updates. This has led to increased anxiety and seems to be detracting from any progress I’ve made with my mental health. Can I refuse to answer these calls?

• Communicating with an insurance adjuster: Claimants have an obligation to provide their insurer with updated medical information regarding their claim. Despite possible stress, claimants should never refuse to speak to an adjuster. Individuals who feel their case adjuster is difficult and aggressive can request another handler for their file. It is vital for claimants to document all communications with their adjuster in writing.

Repeated appeal attempts for LTD

I just learned that my second appeal of an LTD denial was rejected by the insurance company. When I told my manager about it, he said that I should appeal again. He added that, if that appeal fails, too, he will likely need to lay me off.

• Appeals after a denial of disability benefits:  The appeals process is generally considered to be a waste of a claimant’s valuable time after a denial occurs. Appeals were created by the insurance company as a means to ensure they remain in control throughout the claims process. Appeals are rarely successful and rarely conducted by an objective third party.

PREVIOUS EPISODE: Disability Law Show S6 E03 – How to protect yourself from harassment from an adjuster