Disability Law Show

3 Things LTD claimants must know before a return to work | Disability Law Show TV – S3 E27

Episode Summary

3 THINGS LTD CLAIMANTS MUST KNOW AND DO BEFORE A RETURN TO WORK on Season 3 Episode 27 of the Disability Law Show with disability lawyer and partner, 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 Ontario, British Columbia, or Alberta, on the only disability law show on TV and radio in Canada.

Episode Notes

After an LTD claim is settled

What happens after a legal claim has been settled? Can you return to work?

  • Legal process of an LTD claim: James explains that after a case has been resolved there is a lump sum given to claimants as well as benefits for the future for the claimant. If a claimant is able to return to work they should do so with their doctor’s approval.

Long-term disability denied as my condition is “not bad enough”

I have osteoarthritis in my spine and my back pain was getting so bad my doctor told me to take time away from my job. I was denied LTD because my pain was not “bad enough,” according to the insurer. In light of this, my doctor says he can clear me to return to work, but only with extreme limitations. My boss is refusing to accommodate me.

  • Insurer judges claimant’s medical condition: James explains that extreme accommodations suggest that a claimant has a disability and might not actually be able to work and perform the basic functions of their job. Some insurance policies will have specific requirements and should be closely looked at by a disability lawyer.

3 Things LTD claimants MUST know and do before attempting a return to work

  • Confirm that there is a recurrence clause in your LTD policy: A recurrence clause states that if a claimant is receiving benefits and is approved to return to work and the return is unsuccessful, the claimant will be entitled to receive benefits again without a waiting period. Insurance companies typically encourage claimants to return to work however a claimant should only do so with their doctor’s approval.
  • Make sure that your doctor confirms that you’re ready to return to work: James explains that medical approval is vital in order to receive disability benefits from an insurer as the responsibility will fall on the claimant for not listening to professional advice.
  • Confirm with your adjuster in writing: Insurance adjusters likely will cite the recurrence clause in the insurance policy. By communicating with an adjuster, a claimant will ensure that they want to be able to return to work but it might not be successful.

Missed the deadline to appeal an LTD denial

What happens if I miss the insurance company’s deadline to appeal the denial of my long-term disability claim?

  • Disability claim deadlines: James explains that insurance companies want claimants to appeal the denial and unfortunately they are rarely successful. The appeal process is internal within the insurance company and is likely inspected by the insurer who denied the benefits.

Disability benefits are cut off while awaiting treatment

I’m getting LTD benefits for a torn left shoulder. My doctor is telling me I need surgery for my shoulder and possibly my elbow, but COVID is making it nearly impossible for me to see the surgeon and get scheduled for surgery. Will my benefits be cut off while I await treatment?

  • Awaiting treatment and on LTD: Claimants have a duty to make all reasonable attempts to seek treatment for their disability. However if a claimant is unable to receive treatment, there is no justification for the insurer to deny or cut off benefits. Insurance adjusters could potentially be open to punitive damages if a legal claim is filed.

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Next Episode: Disability Law Show S3 E28 – 3 Things in your doctor’s report that strengthens your LTD claim

Previous Episode: Disability Law Show S3 E26 – 3 Things our lawyers do after you hire us to fight your LTD insurer

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