Disability Law Show Bell Radio – S3 E37

Episode Summary

Discover your rights and the truth about insurance companies and long-term disability claims on Season 3 Episode 37 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 have physical as well as some cognitive ailments that prevent me from doing my job. I can only look at a screen for about 10 minutes. My doctors say I cannot return to work just yet. My insurance adjuster has said my benefits will be cut off soon. What can I do?

It is important for claimants to remember is that only their treating doctor and medical team can determine when they are ready to return to work and what if any accommodations are required. While it is important to be mindful of the doctor’s prognosis. it is likely that claimants will be cut off of benefits if the insurance adjuster forewarns them. Once a claimant is given a warning that their benefits will end, they should contact a disability lawyer as soon as possible to determine their next steps.

I’m on LTD and am contemplating moving to a different province with more affordable living expenses. What are my obligations to the insurance company?

Claimants should be open and honest with their disability insurer and err on the side of caution. Claimants who are unsure of their situation should ask their adjuster questions regarding their rights and benefits. Insurance adjusters owe their claimants good faith as well as the claimants themselves. Some insurance policies could have terms that cut off benefits if a claimant relocates.

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• Dealing with a difficult insurance adjuster

A few months ago, my insurance company told me I had to go to a neuropsychologist for an assessment.  Weeks later, the claims manager called me to tell me that they were ending my benefits. I looked up the psychologist, and he has a previous finding of professional misconduct and being non-objective. How is this fair?

Insurance companies tend to prefer certain medical professions over general practitioners’ opinions on the claimant’s prognosis and condition as well as their ability to return to work. Once a claim has begun and if the claim eventually does proceed to court, the courts generally prefer the claimant’s treating doctors as opposed to an insurance adjuster’s preferred assessors. Findings in which an expert is illuminated as non-objective and unprofessional will not help the insurance adjusters’ decision to end benefits. Claimants are able to research the reputations of the experts that are reporting on their conditions and reporting to the disability insurer.

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Invisible Illness and Long-term Disability

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?

Disability insurers receive a credit from the compensation that a claimant receives from CPP Disability. While it should not influence long-term disability benefits, denial of CPPD can affect LTD. The test in order to qualify for CPPD is typically more difficult than the test to qualify for long-term disability benefits. Despite this, claimants should still apply for CPPD and not be dissuaded from doing so or beginning a legal claim if their LTD benefits have been cut off as a result of CPPD denial.

My daughter works in a unionized environment and has just been told she is being terminated from LTD. What options does she have?

Unionized employees have a collective bargaining agreement that applies to their employment situation that details all of their rights. There are typically some references to LTD benefits and depending on the collective bargaining agreement, external disability lawyers can represent union employees or not. In some situations, the agreement could prevent external legal counsel and union employees will have to speak to union representatives. Appeals are rarely effective for non-union employees however in some cases it can be a necessary part of the process for unionized employees.

With the holidays around the corner, many people are starting to make plans to visit family.  If you are receiving LTD benefits, are you able to travel?

In some instances, travelling could pose problems for claimants on long-term disability. Claimants should be as transparent as possible with the insurance adjusters and if there are physical restrictions, receive clearance from their treating doctors.