Disability Law Show Bell Radio – S3 E36

Episode Summary

Delayed surgeries leading to a denial of benefits. workers compensation benefits, and more on Season 3 Episode 36 of the Disability Law Show on Newstalk 580 CFRA in Ottawa.

Listen below as Tamar Agopian, Senior Associate at Samfiru Tumarkin LLP and Ottawa disability lawyer guides you through the proper steps to take when the insurance company cuts off or denies your long-term disability claim. Get the advice you need and the compensation you deserve from a disability lawyer in Ontario.

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Episode Notes

Due to COVID restrictions, I’ve been waiting to get surgery for over a year now.  My doctor and surgeon say I should not work until I get the surgery I need. Insurance is threatening to cut off my benefits because their doctor thinks I don’t need the surgery.

Insurance companies often encourage claimants to try another job to claimants who have been on disability benefits for two years. Claimants cannot be forced to return to work or another job by the insurance adjuster and must listen to the advice of their treating medical team. Claimants also have to be given realistic and comparable employment. In many cases, the options for employment can be difficult for employees who have necessary accommodations or further training and skillsets.

You talk a lot about how CPP Disability benefits work with LTD benefits.  Is it the same for workers’ compensation benefits?

Workers’ Compensation Benefits are tied to workplace injuries however it is also available for claimants with mental health needs. Workers Compensation does not operate in the same manner as CPP Disability (CPPD) however insurance companies likely would view it as the same. Workers’ Compensation is a wage loss and is typically more compensation than CPPD.

LEARN MORE
• Invisible Illnesses and LTD
• Interplay between LTD and CPPD

Are there any issues with earning money from my online business while I’m on LTD?

Most disability policies have provisions that include language surrounding eligibility. Claimants that are earning income can potentially void their eligibility for long-term disability benefits. Active income however differs from compensation from a passive income such as an unchanged source of income, there could be an argument that a claimant should not be entitled to LTD benefits.

LEARN MORE
Termination of Employment While on LTD

Will you speak to people about their disability claims even if they haven’t been cut off by the insurance company?

Disability lawyers at Samfiru Tumarkin LLP will speak to claimants for various reasons and not just because their benefits have been cut off or denied. It is helpful for claimants to seek counsel at various stages of their claim process. Claimants have two years to file a legal claim after the initial date of denial of benefits. In many cases, claimants should be proactive and begin a claim when they are given forewarning that their benefits will be cut off.

I’ve been on LTD for the last year.  My doctor informed me recently that I would be able to begin working again on a part-time basis. Would I still be covered under LTD?

Most disability policies have similar terms and provisions for how a claimant is able to be eligible for LTD however there is a variety for partial work capacity limits. Claimants who have their doctor’s support in returning to work should outline the specifics of their ability to work and their limitations. Insurance adjusters will deduct compensation from benefits if a claimant is earning income. It is important for claimants to have their doctor’s approval before attempting a return to work in any capacity.

If you are receiving long-term disability benefits, what happens if you apply for CPPD benefits? If they turn you down, will your LTD insurer stop paying?

CPPD is available through the federal government and is available to claimants who have a severe and long-term disability. The test in order to qualify for CPPD is often more difficult than the test in order to qualify for LTD. Approval of CPPD is often used as proof of evidence that a claimant is already considered disabled. While it shouldn’t, the approval or disapproval of CPPD can impact the approval or continuation of LTD. Claimants should still apply for LTD if they have been denied CPPD, as it is not enough of a justification to be denied.