Disability Law Show

Disability Law Show Bell Radio – S3 E39

A headshot of Disability Lawyer James Fireman, Partner at Samfiru Tumarkin LLP, to the right of the Disability Law Show logo. He hosts the show on radio stations Newstalk 1010 in Toronto and Newstalk 580 CFRA in Ottawa, Ontario.

Episode Summary

Discover your rights and the truth about insurance companies and long-term disability claims on Season 3 Episode 39 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 a permanent wrist injury that prevents me from working adequately after routine surgery. I have chronic pain despite various treatments and rehabilitation through my insurer. I was cut off after 3 years and told to do another job. What can I do?

It is important in these situations for claimants to look closely at their long-term disability policies. After two years the test in order to qualify for long-term disability benefits changes from the ability to work in their own occupation as opposed to any position. In order to be able to work in comparable positions. some claimants will need support and further training in order to pursue other employment that they are suited for.

I have significant osteoarthritis and was on LTD for two years and halfway through my third year, I was told I could do another occupation. What are my options?

Insurance adjusters often use a transferable skills assessment for claimants after the two-year mark. These reports are often sent off to a third-party assessor and the positions that are suggested for claimants are rarely adequate and comparable. Comparable positions not only have to be financially viable for claimants but also positions in which a claimant has the suitable training and skillset.

Arthritis and Long-term Disability

I was diagnosed with MS around the same time I started a new job. Fast forward two years and the symptoms have flared and made my current duties impossible. Can they deny my application?

The core test of disability is whether or not the symptoms prevent a claimant from doing the basic duties of their job. Insurance adjusters can deny claimants applications, however, it will be important for claimants to apply if they are unable to work and have their doctor’s support. Certain conditions, like MS, can worsen over time. Doctors can report and document conditions that have worsened over time as the progression will be important as evidence for insurance adjusters.

I am on long-term disability and am going to be applying for CPP disability. Do I need to let the insurance company know that I am applying?

CPP disability is a federally run program and claimants are able to apply for it if they have been paying into it. Claimants who meet the test and are approved for CPPD are a more significant test to pass than the test in order to qualify for long-term disability. Claimants who are approved for CPPD in most cases are also approved for LTD. Despite the approval or denial of CPPD, claimants should still apply as most disability policies stipulate claimants have to do so. If asked by the insurance adjuster, claimants will have to respond honestly about whether or not they have applied or been approved or denied for CPPD.

When someone’s insurance adjuster is changed suddenly, is this a worry that the LTD benefits will be cut off?

Insurance adjusters typically have a high volume of files and can at times be overwhelmed and do not have the time to invest properly for each file. Claimants should note that a new adjuster does not necessarily mean their claims will be cut off, however, it can lead to a denial or end of benefits. Claimants who feel their correspondence with their adjuster has led to further stress should ensure all communication is in writing and if possible request a change of adjusters.

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