Disability Law Show Bell Radio – S4 E05

Episode Summary

Discover your rights and the truth about insurance companies and long-term disability claims on Season 4 Episode 05 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, who 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’ve been on LTD for 2 years before my benefits were cut off. I was told that my benefits ended due to a social media post proclaiming I was able to work. What can I do?

In many cases, insurance companies use surveillance and a claimant’s daily routine and habits to justify ending long-term disability benefits. Claimants should be careful what they choose to post online as insurance companies can argue that claimants are able to work due to what they choose to post online, particularly if they have a mental health claim. Individuals who have had their benefits cut off should speak to a disability lawyer in order to determine the reason the benefits have ended.

WATCH TO LEARN MORE
Disability Law Show Season 3 – Surveillance and LTD Claims

I was recently told by my insurance company they do not need my doctor to sign off on me being able to return to work. Is this true?

Insurance companies are within their rights to insist a claimant returns to work whether or not a family doctor agrees. It is important to remember that the insurance adjuster is correct in their analysis. Claimants that have the support of their family doctor and are instructed not to return to work should listen to medical advice. It is likely that a claimant’s case is heard in court, will take into account and place more emphasis on the prognosis of the claimant’s medical team.

What type of information the insurance company needs to approve someone’s disability claim?

An insurance company first and foremost needs to have up-to-date medical reports and supporting documentation to justify a disability claim. The symptoms a claimant has need to be connected to their inability to work and a doctor’s prognosis always ensures a stronger claim. Functional limitations are key however a doctor’s support that a claimant is unable to work can be more significant as limitations can lead an adjuster to suggest other occupations or accommodations.

My insurance company denied my LTD. They are asking for clinical notes from all doctors. Do I have to provide them?

While a claimant does not have to provide the insurance company with clinical notes however without the notes, the claim will be denied. All disability policies stipulate that claimants have to be able to prove they are disabled from working and the most effective way to do so is to provide medical documentation. Generally, it is better for claimants to provide all possible information to the insurance company so that there are no questions of the claimant hiding information or being dishonest.

When someone is getting treatment from the insurance company’s therapist, how is the progress tracked?

Progress in certain circumstances is only reported to the insurance company if the company is paying for the therapist themselves. At times a claimant’s own treating medical team might not be getting updates from the insurance company’s therapist. Claimants can ask for progress reports to be provided to them and their own treating medical team. Reports from a specialist that the insurance company has paid for typically focus on the improvements a claimant has made and do not emphasize the elements of a claimant’s disability that are still preventing them from working.