3 Myths about Disability Claims | Disability Law Show TV – S6 E11

Episode Summary

3 Myths about Disability Claims on Season 6 Episode 11 of the Disability Law Show with disability lawyer, and Partner Tamar Agopian.

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

Benefits cut off and forced to work

I am still unable to work due to my medical condition, and have the support of my doctor who believes I have long-term COVID-19. Despite this, the insurer is pressuring me to return to work. What can I do?

• Long-term disability claim process: Claimants unsure why they have been denied long-term disability should remember that it is not uncommon. Insurance companies prefer to maintain the power imbalance between the adjuster and the claimant. A common reason for denial is often that there is a lack of objective medical evidence. Claimants do not have to accept a denial and can pursue legal action.
  

Complying with recommended treatment for LTD

I am a heart attack survivor currently undergoing medical treatment. I’ve been on LTD for close to 2 years now. My family doctor has not cleared me to begin a rehab program and believes it is too aggressive, yet the insurer insists that I attend. Do I have to follow the recommended treatments?

• Terms of disability policies: Claimants should ensure they are following the advice given by their own treating doctors and medical team. Insurers often rely, however, on certain provisions outlined in a disability policy. Most disability policies will include terms that require claimants to comply and a perceived refusal to do so, can lead to a cut-off from benefits. Claimants should look closely at the terms of their disability policy and seek legal advice if necessary.

3 Myths About Disability Claims

• Determine whether you are disabled: It is a common misconception or myth that only insurance companies can determine whether or not an individual is disabled. In reality, claimants should look first to their treating doctors to determine if they can work.
• Accepting a denial of disability benefits: A denial of disability benefits does not have to be accepted by claimants. Filing a legal claim with the help of a disability lawyer can result in approval for benefits.
• Appealing a denied claim: The appeals process was created by insurers and is meant to frustrate claimants. Appeals are rarely successful and are not typically conducted by an external third party. Appeals waste valuable time as a claimant has up to two years after the initial denial to file a legal claim.

A failed attempt to return to work after LTD

I was on long-term disability for over a year before I attempted to return to work at my office. I was successful for 2 weeks but then began having debilitating panic and anxiety attacks. My doctor wants me to return on leave, but my insurance says I can now work and won’t resume benefits. What do I do now?

• Recurrence clauses in LTD policies: A recurrence provision is often included in a long-term disability policy. Recurrence clauses ensure that a claimant can resume benefits without a waiting period if a return to work attempt was unsuccessful. Claimants need to have a detailed report from their treating doctor supporting the inability to work.

Change in definition of disability policy

I am on LTD for ongoing chronic pain. My group policy has a one-year change in definition provision, which will be coming up in a few months. I was told by the insurer that my LTD was approved past the change in definition date but was not specific. Is there anything I need to do now to protect myself?

• Change in the definition of disability: The “change in definition” period is a critical time for insurers. Claimants wishing to protect themselves from further should ensure all communications with the insurance adjuster are documented in writing.

PREVIOUS EPISODE: Disability Law Show S6 E10 – What to know about addiction and disability claims