Disability Law Show Global News Radio – S8 E26

Episode Summary

Anxiety disorders, Independent Medical Examinations, reporting to your insurer, and more on S8 E26 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.

Listen to the Episode

Episode Notes

My employer is mandating vaccines for all employees, and it’s made me very anxious. I was diagnosed with generalized anxiety disorder and severe depression. My doctor has said I should be off work, but I was denied LTD.

That is absolutely inappropriate. Your LTD claim has nothing to do with whether or not your anxiety and depression arises from vaccine hesitancy –  it has to do with whether or not you’ve been diagnosed or not diagnosed, whether or not you have a disabling condition that does not allow you to work or to fulfill the essential tasks of your occupation. The insurance company should be paying you.

LEARN MORE
Can My Employer Mandate the COVID-19 Vaccine?

I’m a teacher with mental health-related illnesses and psoriatic arthritis. I’ve been on LTD for 10 years. My new doctor has decided I should go back to work. What can I do?

You need to find a supportive doctor, and it’s not unreasonable for you to shop around different doctors to find someone who is supportive of every single disabling issue that you have. Try to see someone with a specialty in mental health illnesses, and someone else with a specialty in psoriatic arthritis. Perhaps you want to go to a rheumatologist, perhaps you want to see a psychologist and psychiatrist and basically get some treatment providers to help undermine this new doctor. You just need to combat the issue with real opinions from real doctors who have actually met with you.

I’ve been on LTD Since 2018. The insurance company is asking me to prove each year that I’m unable to work. Must I keep reporting every year to the insurance company?

Unfortunately, the insurance company does have a right or obligation to assess your medical evidence. You do have a contract with the insurance company, and their end of the contract is that they have to pay you every month. Your end of the contract is you have to prove that you are totally disabled in order for them to pay you every month. And it becomes a question of what’s reasonable here.  But if it’s not going to kill you to go in once a year, get your doctors to fill out some forms, it’s probably best just to do it.

LEARN MORE
Obtaining a Copy of Your LTD Policy FAQ

My insurance company sent me to an Independent Medical Examination (IME). They said they will release the report to my employer. What can I do about that?

First, your LTD lawyer can amend the consent form and can tell them that you want to make it explicitly clear that the IME report does not go to the employer.  Second, since they’ve said you won’t get the report, send them an email and confirm in writing that you will need a copy of the full report that is generated by the IME assessor. The reason is that in the event that the IME assessment contradicts your doctors, say you want to have the ability to look at that report and go through all the errors in it and have your doctors then respond to it.

My husband was sent to an IME by his insurance company. The report had a number of errors. What can he do?

Your husband needs to make a list of all the errors in the report. Include any errors about medical history, what happened during the examination, and anything else that is wrong with the report. Get his own doctors to look at the report and provide their opinions in response. Send the list to the adjustor and say you want to make sure that all the errors in the report are on the record. It’s important to respond and not leave anything in the hands of the insurance company. This will help you protect yourself against the insurance company.

LEARN MORE
Independent Medical Examinations (IME) and Long-term Disability FAQ

I suffer from fibromyalgia and I am on LTD. My insurance company’s doctor is recommending narcotics, and they told me I will be cut off if I’m not compliant. What can I do?

You’re doing the right thing by opposing your insurance company’s doctor’s opinions. It’s important to listen to your doctor because they are the one who is treating you for your fibromyalgia. Your doctor is clearly stating that you should not be taking this highly addictive opioid because it’s highly addictive and it’s just not a long-term solution. You should absolutely call us because you have a case. If the insurance company is going to try and cut you off on this basis, they don’t have a leg to stand on and no judge is ever going to tell them that they’re right.