Disability Law Show Bell Radio – S3 E42

Episode Summary

Discover your rights and the truth about insurance companies and long-term disability claims on Season 3 Episode 42 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 cerebral palsy and have worked on my feet for years. I was injured and the condition worsened. Eventually, I could no longer do my job and applied for LTD. I was denied as my insurer says I was able to work. What can I do?

Insurers often rely on the distinction between occupation and job in disability policy language. Claimants who have an issue in their own work environment are often told they are not disabled as they can work in another environment. Claimants who are unsure of their rights and do have their doctor’s support should contact a disability lawyer in order to determine their rights and what they are owed.

I have been approved for LTD benefits about 8 months ago.  I’m being treated for depression and anxiety. Am I obligated to provide my employer updates about my health?

Employers are permitted to inquire about an employee’s prognosis but not their diagnosis and specifics about their medical condition. It is in an employee’s best interest to keep their employers updated on when they are able to return to work and the necessary accommodations and restrictions in order to return effectively. Typically there is communication between the insurance adjuster and the employer.

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Depression and Long-term Disability Claims
Anxiety Disorders and Disability Benefits

If someone is declined for short-term disability benefits, are they automatically not eligible for long-term disability benefits?

Claimants should err on the side of caution but if unsure of whether or not they should apply for LTD benefits, should do so as soon as possible. Claimants can be declined LTD benefits on small technicalities like getting an application submitted on time. By applying for LTD, claimants have effectively put the insurance company on notice that the benefits will be continuing.

I’ve been on LTD for a year due to a traumatic brain injury. I’m in an executive role and it seems that I might not be able to deal with the pressures of my job. Could I ask for training for a different role or should I wait the full two years?

It is reasonable for claimants in this situation to ask their employer and insurance company for possible training. Before a claimant reaches out to the insurance company, they should speak to their treating doctors about their concerns and what they will be able to do in terms of training and a career path. Claimants should not act in conflict with their doctor’s advice and return to work before they are permitted to do so successfully.

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Brain injuries and LTD claims

I’ve been told to apply for CPP Disability by my insurer. Should I wait to be cut off or contact a disability lawyer now?

CPP disability is paid into by most people and the test in order to qualify for CPP benefits is more difficult than long-term disability. Claimants who are approved for LTD might not necessarily be approved of CPP disability. Most insurance policies do require claimants to apply for CPPD. Insurance companies are entitled to take a credit if claimants are approved for CPP disability benefits. Insurance adjusters will have more difficulty denying or cutting off benefits for claimants who are approved for CPP disability.

I’ve been off work for months because of depression. I’m not ready to go back to work but what happens if my benefits get denied?  What do I say to my employer if they ask me about coming back?

Employees who are denied disability benefits but are still unable to work and have their doctor’s support should not return to work before they are ready to do so. Employees who have been denied LTD but are unable to work can inform their employer of their current prognosis. Claimants who are currently on short-term disability benefits and are unlikely to be able to return to work soon should apply for long-term disability benefits as soon as possible.

My friend and I both have MS and have been on LTD for 13 years with the same employer. Every year the insurance company asks if our condition has improved. Can they do this?

The insurance company is able to request an annual update to claimants on long-term disability benefits. Adjusters have the right to know the prognosis of claimants even if the disability benefits have been approved for a long duration. Updates from claimants are not necessarily regarding updated medical information but also location and financial information.