3 Key questions about surveillance and LTD | Disability Law Show TV – S5 E13

Episode Summary

3 KEY QUESTIONS ABOUT SURVEILLANCE AND LTD on Season 5 Episode 13 of the Disability Law Show with disability lawyer and co-founding Partner, Sivan Tumarkin and national practice leader, James Fireman.

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

Approved for short-term disability but denied LTD

I’ve been struggling for the past few years with my mental health. I was on short-term disability for a few months. Unfortunately my LTD claim with the same insurer I was denied.

• Transitioning from short to long-term disability: Claimants who are approved for short-term disability and long-term disability with the same insurer are often confused when denied LTD. The test in order to qualify for STD and the first two years for LTD are inherently the same. Claimants should remember that approval for STD does not mean automatic approval for long-term disability. Individuals unsure of their rights and the provisions outlined in their disability policy should seek legal advice from a disability lawyer.

Disability benefits after 2 years

After a failed return to work from LTD, my benefits resumed but only up until the two-year mark. My doctors have indicated that I have a long road to recovery. What happens if I’m still not well enough to return?

• Change in definition period: In most disability policies, in order to qualify for long-term disability, claimants have to prove they are disabled from working in their own occupation. After two years,  a change in the definition of what is considered disabled from working occurs. After the initial period, claimants have to be able to prove they are unable to work in any occupation in which they have the training and skillset.
• Returning to work: Individuals should not be pressured into returning to work before they are cleared to do so by their treating doctors. While an unsuccessful return to work can result in a recurrence claim being triggered, claimants could experience a regression in recovery.

3 Key questions about surveillance and LTD

• Legality behind surveillance: While insurance companies are legally entitled to conduct surveillance there are limitations. Surveillance cannot infringe upon the health and safety of claimants. It is also a measure that is very expensive and insurers do not conduct surveillance for an extended period of time.
• Preventing surveillance from occurring: Claimants have to be aware of the surveillance being conducted in order to be able to stop it from being conducted. Investigators will typically do what they can to ensure their presence is unknown. Claimants who feel they are being surveilled or are being watched can contact the police and their treating doctors.
• A cut-off from LTD benefits: Insurers will and can use surveillance footage in order to justify denial or cut-off from benefits. Often, despite the justification from insurers, surveillance footage rarely confirms a claimant is not disabled from working. Surveillance footage is often used out of context by insurance companies. Insurers now typically use the claimant’s social media accounts to create a narrative to cut off disability benefits.

Beneficiary money and LTD benefits

I have been on LTD for almost three years due to severe back pain and arthritis. After a close relative passed away, I was given money as a beneficiary. Is this considered income that would affect my benefits?

• Other sources of income: Inheritance is not generally considered income and cannot affect a long-term disability claim. There are other elements that can affect an LTD claim. Passive income, such as investments, should not affect what is considered income. In some cases, severance pay will have to be offset and claimants should ensure they are aware of the provisions outlined in their disability policies.

PREVIOUS EPISODE: Disability Law Show S5 E12 – Preparing for an Independent Medical Examination