5 Things about LTD claims that everyone should know | Disability Law Show TV – S4 E08

Episode Summary

5 THINGS ABOUT LTD CLAIMS THAT EVERYONE SHOULD KNOW on Season 4 Episode 08 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

Told to work in another position by an insurer

I have a cardiac condition and used to operate heavy machinery. I was approved for LTD for 2 years. After 2 years I was cut off and told to do another job despite my doctor’s support that I am unable to work. What can I do?

• Returning to work in a new position: It is important for employees to heed their doctor’s advice and only return to work when their doctor advises them to do so. Employees are entitled to disability benefits if they have restrictions as well as functional limitations. Employees who are pressured to return to work before they can do so safely should speak to a disability as soon as possible.

Approved for CPPD but denied LTD

I was in a car accident a few years ago and since then I have had excruciating migraines. I’ve been approved for CPP Disability, but my insurance company says that I no longer meet the criteria for LTD, so they’re cutting me off. How is this possible?

• CPP Disability and chronic conditions: Claimants that are approved for CPPD have passed a more difficult test in order to be approved for CPP Disability. The test in order to be approved for CPPD asks that claimants who are unable to work have a prolonged and severe disability. The test in order to qualify for long-term disability asks that claimants are unable to do the tasks of their own occupation. It is illogical for a claimant to qualify for CPPD and not long-term disability benefits.

 5 Things about LTD claims that everyone should know

• Insurance companies routinely deny long-term disability claims: The majority of claimants who have been denied benefits but still have their doctor’s support do not pursue a legal claim. Many claimants feel intimidated by insurance companies but should pursue their rights if they are still unable to work.
  • LEARN MORE
    Doctor and treating medical team’s reports
• Denied claims on the basis that individuals are not “totally disabled”: Claimants are often told that they are not considered totally disabled by the insurance company in order to confuse them so they do not pursue legal action. Totally disabled in the insurance context means that claimants are unable to do the tasks of their own occupation due to a medical condition.
• Claimants who suffer from mental health issues and illnesses: Many claimants have either a primary or secondary mental health disability. There is unfortunately still a gap between how mental health claims and physical claims are managed by insurance companies. It is important for claimants who have a mental illness to still apply for long-term disability benefits as most policies include mental illnesses as possible disabilities.
  • LEARN MORE
    Depression and Long-term Disability Claims
    Anxiety Disorders and LTD
• The limitation period to pursue a legal claim: It is important for claimants to keep in mind the timeline as claimants have two years to pursue a legal claim from the initial date of denial. The insurer will not remind claimants of their deadline to pursue a claim and instead typically encourage claimants to appeal the denial.
• Contact a disability lawyer as soon as possible: Claimants who are denied benefits do not have any income coming in or benefits and are in difficult financial circumstances. The longer claimants take to begin a legal claim, the longer it will take to receive income and benefits. Claimants can begin pursuing legal action as soon as the insurance company informs them their benefits will end.

Can unionized employees seek advice from a disability lawyer

If someone is unionized and their union refuses to help them with their long-term disability claim, can they then get help from a disability lawyer?

• Union employees and disability claims: In most cases, a unionized employee can seek out legal counsel from a disability lawyer. It is not common for a union to have a dedicated team member to provide advice for union members regarding their disability. A disability lawyer will have to take a look at the union’s collective bargaining agreement to determine whether or not they are able to provide aid to the claimant.

Told to appeal by the insurance company

I am a tradesman and I’ve been on LTD for almost two years. I was cut off recently and was told that I can either appeal the denial or instead transition to office work. Should I appeal? What are my options?

• Appealing a denial: It is important for claimants to remember that if they have their doctor’s support, they should not return to work until they are cleared to do so. The decision to return to work is a medical decision and not a legal choice. Appealing a denial is generally a waste of time and is not effective. Starting a legal claim will force insurance companies to come to the table and correct the imbalance of power between the insurer and the claimant.

Uncooperative disability lawyer not keeping claimant updated

I have a mediation scheduled with my disability lawyer and the insurance company and I’m very nervous. I’ve asked my lawyer for information regarding the mediation, but he continues to be very uncooperative. I was on LTD for over a year due to a heart condition before my benefits were cut off.

• The legal process once a claim has been filed: It is important for disability lawyers to communicate with their clients and keep their claimants up to date and provide information so that they are able to understand the claim’s process. Claimants should and can ask their disability lawyers regarding what to expect from the mediation so that there are no surprises.

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

Previous Episode: Disability Law Show S4 E07 – 3 Ways the RIGHT disability lawyer can help when your claim is denied