Disability Law Show Bell Radio – S3 E32

Episode Summary

Discover your rights and the truth about insurance companies and long-term disability claims on Season 3 Episode 32 of the Disability Law Show on Newstalk 1010 in Toronto.

Listen below to James Fireman and  Tamar Agopian, Disability lawyers at Samfiru Tumarkin LLP, as they guide you through the proper steps to take when your insurance provider cuts off your long-term disability or denies your insurance claim.

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Episode Notes

What is a transferable skills analysis and what purpose do they serve?

Many insurance companies send claimants for a transferable skills analysis. Insurers hire an expert to write a report and list options for possible new positions a claimant will be able to do based on their skill set and their medical restrictions. Typically this analysis is done around the two-year mark of a claimant’s long-term disability benefits as the test to qualify for benefits at this point becomes more difficult.

I worked in a factory for years and am a supervisor. I’ve developed anxiety and depression and I could no longer work. I received benefits for 2 years but my condition has become severe. Despite this, my benefits were cut off. What do I do?

Claimants are often denied or had their benefits cut off after two years. Insurers will typically try and send claimants for a skills analysis in order to justify ending benefits, as they try and find other positions they would be able to perform. It is important to remember however that skills analysis often ignores key necessary accommodations and restrictions required for a claimant to return to work.

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Anxiety Disorders and Long-term Disability Claims
Depression and Disability Benefits

My insurer cut me off but they are giving me time to appeal the denial and says that they think I could do office work. I have been a tradesman my whole life. My situation hasn’t changed and it’s still difficult to get an appointment with my doctor.  Should I try to get my doctor to provide a letter stating my current condition?

The appeal process was created by insurance companies in order to deter claimants from pursuing legal action and typically is not effective as it is an internal process. While it is important to provide updates to the insurer from a treating doctor, sending in the same information and reports from a physician will be ineffective and will only waste time. It would be more worthwhile to contact a disability lawyer to determine what other options are open to pursuing disability benefits.

What do I do when my insurance company won’t approve my claim? I’ve gone through the steps to get approved but they say I need more information and can’t approve me.

It is important to contact a disability lawyer as soon as possible in order to pursue disability benefits. Insurers that are asking for more information are delaying an outright refusal or denial. Insurers are obligated to be open and honest about why a denial of benefits has occurred and provided a claimant with the next steps and options. Claimants can contact a disability lawyer before a denial occurs simply to inquire about their rights to benefits.

I’ve been on LTD  due to cancer in the breast, thyroid as well as lymph nodes. Although surgeries are now over, I’m not well. Can they force me back to work if I don’t feel well enough?

Insurance companies cannot force claimants to return to work before they are ready to do so. A treating doctor or physician are the only individuals who can determine whether or not a claimant is ready to return to work and the possible accommodations required in order to return effectively. Claimants who return to work before they are able can regress in their condition and could have significant consequences for their health.

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Cancer and Long-term Disability Claims

I suffered a breakdown this year due to the sudden death of my mom. I have a history of depression and anxiety, and my doctor advised that I take some time off. I haven’t been able to access the therapy I need and my insurer and employer are constantly asking me to provide more medical information. Should I just keep appealing?

Mental illnesses are at times difficult to prove and because of the nature of the illness, can cause difficulties in claiming disability benefits. A claimant’s health should be their first priority and all steps should be taken to have the most effective treatment. Appeals are not an effective process and generally a waste of time for claimants and can often add to the stress and anxiety a claimant is already feeling. In order to alleviate pressure, contacting a disability lawyer is important and efficient. In some cases, if an insurer has cause additional stress, they can potentially be liable to damages against the claimant.