3 Ways the RIGHT disability lawyer can help when your claim is denied | Disability Law Show TV – S4 E07

Episode Summary

3 WAYS THE RIGHT DISABILITY LAWYER CAN HELP WHEN YOUR CLAIM IS DENIED on Season 4 Episode 07 of the Disability Law Show with disability lawyer 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

Long-term Disability benefits and being diagnosed

I suffered from an unknown illness last year with extreme fatigue. It could have been COVID-19 but it was too early on for me to be tested. I applied for LTD but was denied as there was no known diagnosis. What can I do?

• No diagnosis for the medical condition: It is important for claimants to remember that most long-term disability policies are not concerned with a medical diagnosis but instead with a claimant’s symptoms and inability to work. A specific diagnosis is not required in order to be entitled to disability benefits. A claimant will have to have the support of their doctor to qualify and show a willingness to seek treatment. Insurance adjusters that are concerned primarily with the diagnosis of a claimant are opening themselves up to possible punitive damages.
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    COVID-19 Long-Haulers

Denial of benefits due to the definition of “total disability”

After a review of my medical information on file, the insurance company determined that I don’t meet the definition of total disability according to my policy. I am being treated by a physician and my doctor says I can’t complete the daily tasks of my job. Should I appeal their decision?

• Terminology in disability claims: Claimants that have their doctor’s support should be eligible to receive long-term disability benefits. Claimants who have been denied benefits despite medical support should contact a disability lawyer as soon as possible to begin a claim. The term “total disability” is often misunderstood and simply means a claimant is disabled from performing the necessary tasks in order to work. Appealing a denial of benefits is rarely effective and typically a waste of time.

3 Ways the RIGHT Disability Lawyer can help when your Disability Claim is Denied

• The right disability lawyer will take over all communications: Speaking with a disability adjuster can often cause a lot of stress and anxiety for claimants. Hiring a disability lawyer ensures that claimants no longer have to communicate with the insurance company as the lawyer takes over communication.
• The right disability lawyer will demand a copy of your entire file: Claimants are able to ask for their file from their disability insurer but are often denied. Once a legal claim has begun, the disability adjuster has to give the retained lawyer all necessary documentation, which includes all memos and medical reports, as well as possible surveillance.
• Tremendous pressure on the insurance company: Insurance companies often cut corners and ignore medical advice. An efficient disability lawyer can comb through all possible errors in an adjuster’s file and force the insurance adjuster to account for their behaviour. Hiring a disability lawyer forces the insurance company to account for their mistakes.
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    Communicating with difficult disability adjusters

Told to try a new position as an insurance adjuster

After being on LTD for almost 2 years, my insurer has informed me that I will be cut off. The adjuster believes I can do office work, but my doctor doesn’t. I have been a tradesman my whole life. What can I do?

• Change in definition period: After a claimant is approved for LTD benefits, there is a period of two years after the approval that is called the own occupation period. At the two-year mark, the test changes for claimants to qualify for LTD benefits and it is now more difficult as claimants will have to prove they are unable to work in any occupation. Claimants are often cut off from their benefits at the two-year mark by insurance companies. Claimants, however, must be given a comparable occupation that they are qualified to do. Many insurance companies do not consider the comparable element of a new position for claimants.

The claimant asked for the insurance adjuster to change the behaviour

I suffer from severe anxiety and panic attacks and am currently on LTD. My doctor has advised my insurer that their verbal interviews are triggering. I have asked that the interviews be done in writing. This is extremely stressful and makes my condition worse. What can I do?

• Communicating with the insurer: It is important for claimants to put all requests from the insurance company in writing and accommodate the insurance adjuster as much as possible. Claimants who feel that they are not receiving appropriate behaviour from their adjuster should try and communicate their concerns in writing. Complaints that do not communicate with their adjuster risk having their disability benefits cut off.
  • WATCH TO LEARN MORE
    Disability Law Show – Top 3 reasons not to fear your LTD adjuster

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

Previous Episode: Disability Law Show S4 E06 – What you need to know about cancer and LTD claims