Disability Law Show Bell Radio – S3 E40

Episode Summary

Discover your rights and the truth about insurance companies and long-term disability claims on Season 3 Episode 40 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.

Listen to the Episode

Episode Notes

I’m a teacher and was denied my benefits a year ago. My appeal was denied and I asked my union for help. Can union members who are denied disability benefits hire a disability lawyer?

In most cases, disability lawyers are able to help union members who are denied LTD. Many unions are not equipped to help their members with disability benefit disputes and do not have the expertise and experience in dealing with insurance companies. External disability lawyers can expedite the process to ensure that claimants are able to receive their benefits. It is important for claimants to remember that there is a two-year limitation period after the initial denial of disability benefits.

I have been approved LTD over the 2-year mark. Now insurance company constantly requests constant updates which cause more anxiety for me. Can the insurance company give me a buy-out?

While it is possible for the insurance company to offer a buy-out it is not in the claimant’s best interest. It is a good sign if a claimant has been approved to continue their disability benefits over the two-year mark however, the frequent request for updates does indicate a possible future denial. Claimants in this situation do not have any leverage to encourage the insurer to offer a lump-sum payment or a buy-out that is adequate.

When you settle your client’s case for disability benefits, does it impact the other types of benefits your client might have like health and dental coverage?

A claimant’s other health benefits and coverage should not be affected by the approval of disability benefits. Group disability policies can include coverage for other health benefits. A disability lawyer will seek to limit the claim settlement to only be concerned with disability benefits. Health benefits are often tied to employment and not specifically the insurer.

My sister’s LTD was recently cut off.  Three years ago she had surgery that resulted in chronic pain in her wrist.  She’s right-handed and used to work in a call centre.  All her doctors said she could no longer do this work. The insurance company sent her to rehab but none of the therapies or medication have worked.

Claimants under typical disability policies are offered coverage up until the age of 65. In some cases, the age of a claimant can factor into denial as young claimants who are unable to work could be on long-term disability benefits for a long time. After two years of disability benefits, insurers who have denied benefits have to justify the denial by offering a comparable position for claimants. Claims are often denied after two years of disability benefits as the test in order to qualify for benefits becomes much more difficult.

An insurance company may offer some job search training to help a claimant look for another job.  What happens to the LTD benefits if this aid is offered?

In most situations, a return to the workplace should be planned with the claimant’s doctors. It is important for claimants to proceed with caution to return to work as it is often in the insurer’s best interest for claimants to be off of disability benefits. Claimants should only attempt to return to work with their doctor’s approval. Claimants who return to work before they are ready are risking a regression in their recovery.