Disability Law Show Bell Radio – S4 E07

Episode Summary

Discover your rights and the truth about insurance companies and long-term disability claims on Season 4 Episode 07 of the Disability Law Show on Newstalk 1010 in Toronto.

Listen below to James Fireman, a Toronto disability lawyer at Samfiru Tumarkin LLP, who guides 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

Do claims ever get resolved before mediation?

It is not common for disability lawyers to resolve a claim before mediation however occasionally it does happen. Claimants should not be deterred from filing a disability claim due to the assumption that it will be a long and arduous process. Claims typically do not lead to a trial and are resolved in mediation as insurance companies do not want to deal with further expenses.

I had a serious knee injury and have been on LTD as my job is very physical. The insurance company is attempting to push me back to work but my doctor says I’m not ready. What are my options?

The consequences of ignoring a doctor and the treating medical team’s advice can be significant for claimants. Claimants could be risking their own health and recovery if they return to work before they are cleared to do so. Claimants should listen to their doctor’s advice and ensure that all proper recommendations from their doctor are documented and sent to the insurer. Usually, a return to work plan is given in writing by the insurer. This plan should be given to the claimant’s doctor so that a doctor can comment on the plan and whether or not it is feasible.

I’ve been at my job for almost 20 years.  I have several health conditions that are slowing me down at work. Can I go on LTD, or will I have a fight on my hands?

For some employees, going on disability or medical leave might be their next step. Employees should not continue working to the point where their health is jeopardized. Claimants who are concerned about their ability to work should speak to their treating doctors and specialists and request their opinions on whether or not they are able to work and should pursue disability benefits. Claimants who have their doctor’s support are entitled to long-term disability benefits.

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Will an LTD claim be denied if the workplace triggered the health issue that put the person off work?

In some cases, insurance companies will deny long-term disability benefits if a mental illness is triggered by the workplace however this is not a justifiable reason. The trigger behind symptoms should not hold as much weight as the symptoms themselves that are preventing a claimant from working. Claimants should question whether or not they are able to go to their occupation in which those issues don’t exist. Claimants who are able to work for another employer in the same occupation would not be entitled to disability benefits.

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I’ve been getting my LTD payments tax-free as I paid for premiums through payroll. Would an eventual lump-sum payout be tax-free as well?

Some claimants do have a non-taxable disability group policy and are paying into premiums. Lump-sum payouts will be tax-free for claimants if their regular disability benefits were also exempt from taxes. Claimants who have taxable policies and are denied benefits and eventually negotiate a lump-sum settlement are required to pay taxes however the amount is typically not significant.