3 Ways to make an LTD claim stronger | Disability Law Show TV – S5 E01

Episode Summary

3 WAYS TO MAKE AN LTD CLAIM STRONGER on Season 5 Episode 01 of the Disability Law Show with disability lawyer and national co-managing Partner Sivan Tumarkin. and 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 provinces across Canada, excluding Quebec, on the only disability law show on TV and radio in Canada.

Episode Notes

Stigmas surrounding brain injuries and LTD benefits

I suffer from a mild brain injury and my insurance adjuster referred to my case as common; seemingly suggesting brain injuries were the new fibromyalgia. What will this mean for my disability benefits?

• Brain injuries and long-term disability benefits: Many insurance adjusters view common brain injuries, like concussions, in a skeptical manner due to the nature of the injury. Unlike a broken bone, brain injuries prove more difficult to have substantial physical evidence. Despite this, neurological conditions can be debilitating and prevent many claimants from working.
• Recovery from a traumatic brain injury: Many elements can affect the recovery of a brain injury, such as other mental illnesses like depression and anxiety. Due to the ever-changing nature of a brain injury, many insurance adjusters would stick to basic medical guidelines as proof a claimant should be ready to return to work.

Returned to work after pressure from an insurer

I was on LTD for over a year due to severe back pain. I returned to work as my employer and insurer were pressuring me to do so. return to work. I’m pretty sure I need more time off to heal.

• Returning to work from LTD: Claimants should remember that the decision on whether or not a return to work is possible is a medical decision. Insurance adjusters ultimately do not have the power to determine if a claimant is medically able to work and the accommodations or restrictions necessary. Individuals should be wary of returning to the workplace before they are ready as they can experience a regression in their recovery.
• Recurrence clause in a long-term disability policy: For those that have tried to return to work but have been unsuccessful, they are able to resume benefits due to a recurrence clause in their long-term disability policy. Despite this clause, many insurers will cut off benefits once a return to work has been attempted.

 3 Ways to make an LTD claim stronger

• Obtain the support of a treating doctor and have detailed medical reports: Many claimants mistakenly do not seek the support of a treating doctor to provide coherent and specific information stating they are unable to work. In some cases, medical reports from a medical team or doctor are not specific and relative to the claimant’s job and inability to work.
• Comply with all necessary treatment recommendations: From a legal standpoint, disability policies typically stipulate that in order to qualify for disabilty benefits claimants need to continue treatment. It is important that claimants reevaluate medications and treatment if it is no longer advised by their treating doctors. Claimants should always listen primarily to their own treating doctors even if the advice contradicts counsel from a treatment provider that the insurance company has recommended.
• Get all communication with the insurance adjuster in writing: Clients should ensure all manner of communications with an insurance adjuster are confirmed in writing, whether that is phone conversations or emails, etc. By keeping a record of communication, claimants protect their own interests and have a substantial amount of evidence if and when their benefits end.

 Benefits are potentially cut off due to a failure to comply

I am on LTD due to significant mental illness and undergoing treatment. My insurer is suggesting a new treatment which carries the risk of long-term side effects. Can my benefits be cut off if I don’t follow their recommendations?

• Cut off of long-term disability benefits: Insurance adjusters and companies cut off benefits for many reasons. Ultimately, claimants should continue to work on their recovery and if their benefits have been cut off, contact a disability lawyer as soon as possible. Claimants should not feel pressured by an insurance adjuster to follow treatment and advice that is contrary to that of their own treating doctors.
  

PREVIOUS EPISODE: Disability Law Show S4 E32 – 3 Things to know about surveillance and LTD claims