Disability Law Show Global News Radio – S8 E23

Episode Summary

COVID-19 long-haulers, disability denials in a union, bad legal advice, and more on S8 E23 of the Disability Law Show on Global News Radio in Toronto and Vancouver.

Listen below to Sivan Tumarkin co-founding Partner and Albert Klein, disability lawyers at Samfiru Tumarkin LLP as they join co-host John Scholes and guide you through the proper steps to take when your insurance provider cuts off your long-term disability or denies your insurance claim.

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Episode Notes

Many Canadians are feeling the psychological impact of COVID-19. Despite this, insurance companies again are refusing to pay disability benefits to claimants.

Many people are suffering from long-haul COVID-19 symptoms. Physical as well as physiological symptoms. Insurance companies are denying many of these claims. It is important for claimants to remember when they are denied by the insurance company, they have other options. It is also generally a waste of time to file an appeal as when an appeal is investigated, claimants are asking the exact same people who initially denied them. Insurance companies need to remember that they collected premiums for years from both employers and individuals.

I’ve been verbally abused by my insurance adjuster and he is refusing to put anything in writing and insists only on phone communications. Is there an obligation for the insurance company to put communications in writing after being asked by the claimant?

In legislation and law, it states that an insurance company must when they communicate with a claimant regarding their claim, put all communication in writing. However, in day-to-day communications with the individual, the insurance company is obligated to put anything in writing. Whenever an individual speaks with an adjuster, they should get the adjuster’s email address and on the same day they speak with the adjuster, put in writing, how they wish to communicate and keep all email communication. If a claimant feels they want to document communication that has previously been verbal, they should indicate this to their adjuster.

Watch to Learn More
Disability Law Show Season 3 – Conduct that constitutes as “bad faith” by LTD insurer

If I am an LTTE permanently can my LTD insurance company cut me off if I move to another country?

It is important to look closely at what the policy itself says regarding relocation.  A policy is a contract between the claimant and the insurance company, and that’s the only thing that matters. Some insurance policies do have a provision stating a claimant must remain in the country, but it’s not in every single policy. If the policy does contain that provision, then the claimant will have to remain in the country for up to six months.

I’ve been struggling with depression and was denied disability. I forced myself to work but eventually, my psychologist signed me off. My union is fighting my denials but I can’t afford to do anything. Can you help me?

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Depression and Long-term Disability Claims

When it comes to fighting long-term disability denials, unions are not always aware of what is necessary for their members as it’s not their expertise. Dealing with LTD is a specialty and claimants need somebody who knows what they’re doing. Disability consultations are often free or on a contingency basis with many disability lawyers.  Claimants should also not return to work until their doctor has approved of a return and provided possible accommodations.

My sister has been on LTD for over a year. She has a lot of back issues from the work she’s done all her life. Due to her physiotherapist’s report, the insurer has told her that she must start to return to work or they’ll end her benefits. Can they do that?

Only a treating doctor can determine when a claimant is ready to return to work and ultimately their opinion has the most significance. A judge is always going to value the opinion of a treating doctor much higher than that of a physiotherapist that might have seen a claimant for a few weeks. Claimants in this situation should get a return to work plan from their doctor. Alternatively, claimants can get a referral from their own doctor, to see a specialist.

My friend suffers from severe depression and anxiety. Due to COVID-19 he applied for LTD but was denied because they say there was not enough medical information provided, even though he has a psychologist’s support. His union now says that he should go to a lawyer for help.

The idea that a claimant does not have enough medical information or enough support when their treating physician has confirmed they are unable to work is often used by the insurer to deny claims.  After a disability lawyer is involved, the insurance company often changes their tune. Insurance companies will often claim there’s just not enough medical documentation. It is also important to remember that appeals are a waste of time. Insurance companies want claimants to appeal as a means to delay the claim and delay paying benefits.