3 Important ways your doctor can help your LTD claim | Disability Law Show TV – S5 E05

Episode Summary

3 IMPORTANT WAYS YOUR DOCTOR CAN HELP YOUR LTD CLAIM on Season 5 Episode 05 of the Disability Law Show with disability lawyer and Partner Tamar Agopian.

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

Episode Notes

Offered settlement by the disability insurer

I was on LTD and received a settlement offer from my insurer in exchange for no longer being on the claim. Is this something I should accept?

• The settlement offered by the insurer: It is important when offered a lump sum settlement by an insurer to question several factors before accepting. It is important to consider the nature of the disability, what value is there to a monthly benefit, and fundamentally whether or not a return to work is in the near future. In many cases, the buy-out offered by an insurer is very risky and does not account for the amount of benefits a claimant will actually need.

Long-term disability benefits cut off due to addiction

My husband has been unable to work due to neurological issues and recently learned alcohol use could be the cause. Our insurance company has not stated that his long-term disability payments will end due to his addiction.

• Addiction and long-term disability claims: There are provisions in many disability policies that state that for disabilities that arise as a result of an addiction, disability benefits can be denied. This exclusion and denial can be considered a human rights issue. Individuals with the support of their doctor, regardless of addiction, should continue to receive long-term disability benefits. Substance abuse and addiction are considered to be an illness and disabilities.

3 Important ways your doctor can help your LTD claim

• Providing a detailed report: It is critical for claimants to have a detailed report from their doctor supporting their claim. Doctors’ reports should be detailed and offer specific information relating to a claimant’s symptoms and their inability to work as a result.
• Referrals to specialists: A family doctor is often the driver of an individual’s ability to access other specialists and treatment. Insurance companies often prefer specialist recommendations and opinions regarding a claimant’s disability. Psychologists and psychiatrists are often preferred in relation to a mental health claim.
• Following recommended treatments: In most disability policies, an appropriate treatment clause is included. Insurers will look to see if a claimant is making efforts to focus on their health and recovery. Claimants that do not seek out treatment risk having their disability benefits denied or cut off.

Repeated requests for an independent medical examination

I am being asked to attend another independent medical assessment. After the first, my insurer tried to force me to get treated by their doctor instead of my own. What can I do?

• Independent medical examinations: Most disabilty policies can include a provision requiring claimants to attend an independent medical assessment. Assessments are typically implemented in order to lead to an eventual cut-off of disability benefits. Claimants can ask questions regarding their examination to ensure they have complete clarity of what is expected of them and what the process will be like. It is important for claimants to ask for a copy of their assessment report in order to provide it to their own doctors.

Insurer implements a return to work program

I have been on disability due to severe depression. A new doctor has suggested there is a possibility I would be able to return to work in the future. As a result, I’ve been put on a return-to-work program even though I’m not ready.

• Returning to work after long-term disability: Claimants should try their best to coordinate between the medical team and what the insurer believes regarding a return to work. Limitations and accommodations can also be implemented in order to make a return to work more successful. Ultimately, claimants should ensure that their treating doctors approve they are ready to return to work and in what specific time frame.

PREVIOUS EPISODE: Disability Law Show S5 E04 – 3 Tips on communicating with your insurance adjuster