Disability Law Show Bell Radio – S4 E10

Episode Summary

Discover your rights and the truth about insurance companies and long-term disability claims on Season 4 Episode 10 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

The thought of filing a legal claim to pursue disability benefits seems daunting to me. Is the process stressful and difficult?

It is an incorrect assumption that filing a legal claim to pursue disability benefits is an arduous and difficult process. Once a disability lawyer is retained, the communication between a disability insurer and a claimant is reduced dramatically and a disability lawyer assumes most of the contact and responsibility. Claimants incorrectly assume that appealing a denial of benefits will instead be effective and in most cases, actually creates further stress and wastes a claimant’s time. It is also important to note that legal claims rarely lead to court and litigation.

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I have been diagnosed with fibromyalgia. Is this condition enough to assert a long-term disability claim if I have my doctor’s support?

While at times it can strengthen a claim, a diagnosis is not necessary in order to pursue and receive long-term disability benefits. Claimants who have the support of their doctors that they are disabled from working are able to claim benefits. Fibromyalgia is a valid basis for long-term disability benefits as long as a doctor confirms the symptoms of the condition and prevents an individual from working. Unfortunately, insurance companies do resist claims regarding fibromyalgia as there are a lot of misunderstandings surrounding the illness.

I have been paying into a private disability insurance plan for over a decade. Is it worth it to continue payments? I’ve heard insurers rarely approve of LTD.

There are many cases in which a claimant is disabled and continues to receive disability benefits. While there are many situations in which disability insurers behave in a manner that they should, claimants should not be dissuaded from applying for disability benefits or paying into disability coverage. Private insurance policies can have many different provisions as opposed to group policies and claimants should look closely at the terms included.

I was diagnosed with cancer and had significant surgery. I’ve been receiving STD benefits. Physically, I’m able to return to work but emotionally I’m not. Can I apply for LTD?

It is important to determine the repercussions of a health condition on the impact of an individual’s essential duties at the workplace. Claimants should determine if they are functionally unable to perform the basic duties of their job and if they have their doctor’s support. In some situations, physical abilities are irrelevant as psychological symptoms and illnesses can also affect an individual’s ability to work

My husband was diagnosed with cancer and is on LTD and receives CPP.  Due to ongoing treatments, he is unable to work. The insurer informed us that we can take a lump sum or continue to receive payments. What should we do?

In some cases, if a claimant is close to the age of 65 and will likely have their benefits end soon, a lump sum offered by the insurance company could be a good choice. However, individuals with a long-term disability who have many years potentially left on disability leave should consider why they are being offered a large payment now. Insurance companies ultimately do not wish to continue paying claimants’ benefits, particularly if the payments will continue for a long period of time. Offering a lump sum to a claimant could be a disability insurer’s attempt to save money in the long run.

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After an unsuccessful attempt to return to work, my benefits were denied. I’ve been living off of a line of credit for a year now. Can I try to get a part-time job to help my situation?

Most long-term disability policies contain a recurrence clause. This clause ensures that individuals who attempt a return to work but are unsuccessful are able to resume their LTD benefits without a waiting or elimination period. Despite this clause, many disability insurers still deny claimants benefits and use the attempt to assert that claimants didn’t try hard enough or are actually able to work. Claimants are not under any obligation to abide by a policy that an insurer has breached. Individuals who are able to work on a part-time basis should do so but should also consider that this could affect the insurance company’s assertion that the claimant is able to work.