Disability Law Show Bell Radio – S3 E35

Episode Summary

Discover your rights and the truth about insurance companies and long-term disability claims on Season 3 Episode 35 of the Disability Law Show on Newstalk 1010 in Toronto.

Listen below to James Fireman and Tamar Agopian, Toronto 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. Find out how a disability lawyer in Ontario can help you secure proper compensation.

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Episode Notes

I’d suffered a stroke and had a rare underlying condition. My rehabilitation was very difficult but I did improve although I still experience extreme fatigue. My condition is chronic but despite this, I was cut off of LTD after two years. What do I do?

Insurance adjusters often at the two-year mark in order to save money, send their claimants’ files to be sent to a doctor to be assessed. Often the doctor that assesses these files is not specialized in the condition that the claimant has, and typically is a family physician, and does not ever meet the claimant. By not sending the claimant to be assessed to the appropriate professional, a report is generated that is inaccurate but leads to the belief that the claimant can return to work. Adjusters will use this opinion in order to justify cutting off long-term disability benefits. Claimants should remember that this opinion does not have much merit.

Do insurance companies treat claims for physical disabilities any differently than those for mental health conditions?

Insurance companies view mental health conditions are often treated and can be treated as if they were physical conditions. Insurance adjusters are regimented and want to be able to put disabilities in easy-to-determine categories and often mental illnesses complicate claims. Conditions like depression and anxiety are often combined and misrepresented by adjusters and there is less time spent on the nuances of each condition.  Claimants with physical conditions are much more likely to have their claims and benefits approved.

LEARN MORE
Anxiety Disorders and LTD
Depression and LTD Claims

I’m on LTD and have been for a few years.  I recently withdrew an RRSP.  My insurance adjuster is now saying I need to pay back some of this RRSP money because it is income. Is it right that the insurance company is counting this as retirement money?

It is important for claimants and a disability lawyer to look closely at the terms of the disability policy. Some policies could include an RRSP and have certain provisions and a court might agree with the insurance company. Disability provisions in insurance policies however are usually concerned with active income, not passive means of income such as an RRSP. If in this situation, claimants should be very careful before withdrawing an RRSP if on disability coverage.

I have an online business as well as a full-time job. I recently had an injury and my doctor recommended that I go on LTD. Are there any issues with earning money from my online business while I collect benefits?

There could be certain terms and conditions in an insurance policy that stipulates claimants cannot receive LTD benefits if they are earning income or compensation by way of profit. There are many determining factors that could determine whether or not a claimant could continue to receive LTD, such as the nature of the condition and the full-time position the claimant is employed in. Claimants should inspect their policies closely and possibly reach out for counsel from a disability lawyer.

I have been on long-term disability for the last year. My doctor informed me last week that I would be able to begin working again on a part-time basis. Would I still be covered for LTD benefits?

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Returning to work and LTD

Most disability policies have the same definition of what qualifies as unable to work however there are other terms that differ from policy to policy. While claimants on some disability policies would not be able to receive benefits if employed, others could have other more complicated formulas that are more specific to the amount of income earned while still on LTD.