Chronic Pain and LTD Denials: What you should know | Disability Law Show TV – S7 E15

Episode Summary

CHRONIC PAIN AND LTD DENIALS: WHAT YOU NEED TO KNOW on Season 7 Episode 15 of the Disability Law Show with Disability Lawyer and Partner, Tamar Agopian.

Watch above to discover the steps you must take when the insurance company cuts off or denies your long-term disability claim anywhere in Canada, on the only disability law show on TV and radio in the country.

Episode Notes

An overlap of disability and employment issues

I had to take time off work due to depression and anxiety. My work environment was stressful, which aggravated my mental illness symptoms. I was denied LTD and so attempted a return to work, but my employer refused to permit my return. What can I do?

• Employment and disability benefits: It is vital to speak to a legal representative who is well-versed in both employment and disability law if the matters overlap. Employees must only return to work if they are cleared to do so by their doctor or given necessary accommodations. An unsuccessful return to work should lead to a resumption of disability benefits due to a recurrence provision.

Return to work stage of disability leave

I’m a single parent struggling with depression and PTSD after a bad car accident. I’ve been on LTD since, going to therapy regularly and taking medication. I just got a letter from my insurer saying I’m at the ‘return to work’ stage and will be cut off soon. Can I be forced back despite my therapist’s insistence that I’m not ready?

• Pushed to return to work: Insurers pressure claimants to return to work often before they are ready to do so as a pressure tactic. Some mental health conditions, such as PTSD, can be prolonged. Due to the nature of the disability, insurers can pre-emptively cut off benefits as they do not wish to continue paying them.

Chronic Pain and LTD Denials: What You Must Know

• Reason for denial: Insurers often deny chronic pain disability claims due to an insufficient lack of medical evidence. This is a common reason for the denial of benefits despite its lack of validity.
• Objective medical evidence: A lack of objective medical evidence is not a sufficient reason to deny long-term disability benefits. Claimants do not have to provide a diagnosis of their medical condition, just their doctor’s support and a record of ongoing symptoms. Detailed doctors’ reports, as well as journals, can strengthen a claim.
  
• Challenging a denial of benefits: Claimants do not have to accept a denial of benefits if they are unable to work, and instead can pursue legal action.

Claimant was worried about CPPD denial

My wife’s been on LTD for almost two years now, but her benefits are supposed to end soon. Her insurer sent her a letter telling her to apply for CPP Disability. The thing is, she’s not sure what to do. What if her CPPD application doesn’t get approved? Can she resume LTD benefits? She’s not able to go back to work.

• CPP disability benefits: CPP Disability is a government-sponsored disability program that offers benefits to individuals. The test to qualify for CPP Disability is more difficult than the long-term disability benefits. While approval for CPP Disability can strengthen an LTD claim, it is not required to continue to receive disability benefits.

PREVIOUS EPISODE: Disability Law Show S7 E14 – Two-year mark on Long-Term Disability: What you need to know