Chronic Pain and Disability Claims | Disability Law Show TV – S3 E34

Episode Summary

CHRONIC PAIN AND DISABILITY CLAIMS on Season 3 Episode 34 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

Denied LTD despite mental illness and chronic pain

I suffer from depression and anxiety as well as chronic pain. I was a dental hygienist and applied for long-term disability and denied three times. What are my options?

• Mental health and chronic pain: Sivan explains that it is important to contact a disability lawyer as soon as long-term disability benefits were denied. Appeals are rarely effective and are purely a process created by the insurance company to prolong the process for claimants.

“Coronaphobia” leads to denial of disability benefits

I have been suffering from depression and anxiety after contracting COVID-19 at work. The insurance company denied my long-term disability claim and said I had to appeal. I’m not sure what to do. Just the thought of going back to work makes me more anxious and nervous.

• Appeals process after LTD denial: Appealing a long-term disability denial rarely leads to a reversal by the insurance company. Appeals are an internal process and are not evaluated by an external adjuster. By beginning a legal claim, the process changes and the insurance company is aware they will be forced to pay legal fees which could eventually lead to a case in court.
  • Learn More
    Depression and Long-term Disability Claims
    Coronaphobia and LTD Claims: 3 Things you need to know

Chronic Pain and Disability Claims

• What is chronic pain: Chronic pain is continuous and goes on for a prolonged period of time that can last for months or years. Chronic pain is a label and the symptoms can prevent an individual from working.
• Why do insurers deny LTD claims for chronic pain: Sivan explains that insurance adjusters do not want to continue paying a claimant for a longer period of time. Adjusters often cast doubt early on after a claimant files for benefits and try to determine when the pain should be resolved.
• What should you do to make a successful claim: Claimants should keep in touch with their doctor and ensure all medical records are up to date as well as undergoing recommended treatment. It is important to ensure the insurance adjuster is kept up to date.
• What should you do if your claim for chronic pain is denied: Upon denial of disability benefits, it is important to contact a disability lawyer as soon as possible. Appeals are typically not effective and ensure more time is wasted awaiting benefits.
  • Watch to Learn More
    Disability Law Show Season 3 Episode 20 – 3 Reasons to Avoid an LTD Appeal

Benefits cut off as insurer says a sedentary job is possible

I was on long-term disability after multiple surgeries on my kidneys, which left me with residual pain in my back. My doctors confirmed that I wasn’t able to sustain a full-time job. After numerous calls from my adjuster, they decided to cut off my LTD, saying I could do sedentary work. Can they do this?

• Told to do another job by the insurer: Sivan explains that in order to qualify for long-term disability benefits, claimants have to prove they are unable to perform the basic tasks for their own occupation in the first two years. After two years, the test to qualify for disability benefits changes to an inability to work at any occupation. It is important to look closely at the insurance policy in question. and remember that only a doctor can determine when a claimant is ready to return to work or able to work in any capacity.

Insurance adjuster hounding claimant for more medical information

I stopped working after receiving a cancer diagnosis. I received a letter from my insurer after 9 months on LTD and CPP, stating that my benefits will be cut off as my doctor refuses to provide a report on my health issues. My physician has provided a letter with relevant medical information. Despite this, the adjuster keeps hounding me for more information. Is this normal?

• Updated medical reports: Medical information for Insurance companies are entitled to updated medical information but there are limits to the number of updates that are deemed necessary. Insurance adjusters are obligated to operate in good faith with claimants and a violation to do so, such as harassment or bullying, can lead to potential damages and a bad faith claim.
  • Watch to Learn More
    Disability Law Show Season 3 Episode 28 – 3 Things in your doctor’s report that strengthens your LTD claim

What is the “Any Occupation” period?

“What is the “Any Occupation” period? Does that mean that if you can do any occupation you don’t qualify for benefits anymore?”

• Any occupation period: The “any occupation” period occurs after an individual has received long-term disability benefits after two years. Claimants who are unable to work in any occupation after two years, not just their previous position due to ongoing medical reasons, are able to claim disability benefits. Any occupation refers to any position that a claimant is suitable for and earns comparable income.

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

Previous Episode: Disability Law Show S3 E33 – If denied LTD, what to expect when you hire Samfiru Tumarkin LLP