3 Vital Things COVID-19 Long-haulers should know about LTD Claims | Disability Law Show TV – S4 E02

Episode Summary

3 VITAL THINGS COVI-19 LONG-HAULERS SHOULD KNOW ABOUT LTD CLAIMS on Season 4 Episode 02 of the Disability Law Show with disability lawyer and co-founding partner, Sivan Tumarkin.

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

Benefits cut off after an independent medical assessment

I’m a teacher and I suffer from anxiety and a disassociative disorder. I’ve been seeking treatment and been on medications while I was on LTD. I was sent to an independent medical assessment to see the insurer’s psychiatrist. The report disagrees with my treating doctors and so my benefits will be cut off. Can they do this?

• Independent medical examinations: Sivan explains that claimants who have had their benefits cut off due to an independent medical assessment should contact a disability lawyer and pursue legal action. Independent medical assessments are often used as justification to cut off benefits by insurers. Claimants should be proactive and pursue legal action as soon as possible. Claimants do have to attend a medical assessment that is requested by the insurer, however, they do not necessarily have to seek treatment from the suggested medical professionals.

Can you apply for LTD after losing an appeal?

I was cut off from long-term disability a few weeks ago. I’m thinking about using the insurance company’s appeals process to try to get my benefits back. If I ultimately lose my appeal, is it worth it to apply again?

• Applying for an appeal: Claimants should remember that the appeals process is an internal process within the insurance company and claims are not reviewed by an external arbitrator. Appeals are rarely effective despite how often they are suggested by insurance companies and typically waste time for claimants. Claimants should begin a legal claim as soon as possible in order to have it resolved as there is a limitation period of 2 years after the initial denial to pursue legal action.

3 Vital Things COVID-19 Long-haulers should know about LTD Claims:

• Can’t work due to the physical or psychological effects of COVID-19: The COVID-19 pandemic has resulted in many government programs and many insurance companies have pushed claimants to apply for support programs instead of long-term disability. Claimants who have physical or psychological symptoms as a result of COVID-19 and are unable to work and have coverage, should apply for disability benefits and not be dissuaded from doing so by insurers.
• Discriminate against you and deny your claim on the basis of a diagnosis: Sivan explains that despite the fact that the COVID-19 virus is relatively new, it should not matter whether or not a claimant is able to receive benefits. Most disability policies are not concerned with the diagnosis of a medical condition, but the symptoms which prevent an individual from working. Unlike travel insurance policies that were affected by COVID-19, most disability policies do not have COVID-19 exclusions.
• Denied LTD because of a COVID-19 exclusion: Claimants should not appeal the denial of their benefits if they are experiencing long-term COVID-19 symptoms. The relationship between the claimant and insurer is a contractual relationship in which both parties are obligated to behave in good faith. Claimants that have medical support detailing they are unable to work should be able to receive benefits. Appeals typically waste time and are not effective in procuring a person’s disability benefits.

Hiring an experienced disability lawyer when filing a claim

How important is the experience and reputation of the lawyer who is representing someone to get compensation after a disability claim denial?

• The legal process of a disability claim: It is very important that claimants do research before hiring a legal time to fight for their disability benefits. Hiring the right legal team ensures the legal process is quick and efficient and ultimately alleviates the burden and stress from a claimant so that they are able to focus on their health. Samfiru Tumarkin LLP provides free consultations for claimants pursuing their disability benefits and is known for its compassionate and communicative approach to clients. Insurance companies are also aware of the reputation of certain law firms and this can also help expedite the legal process.

Click Here For More Information About COVID-19 and Your Rights

Previous Episode: Disability Law Show S4 E01 – 3 Myths about “Total Disability” in LTD Claims