Disability Law Show Global News Radio – S8 E27

Episode Summary

COVID-19 long-haulers and LTD, appealing a denial of LTD, and more on S8 E27 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

Are COVID-19 long-haulers with ongoing physical symptoms entitled to LTD benefits?

If you cannot perform the essential tasks of your occupation for the first two years that you’re on LTD, or the essential tasks for any occupation for which you’re suited beyond two years, and your doctors agree with you in writing that you cannot work, the insurance company must cover you. There are some limitations, for example, if your policy expires at age 65, and you are 64 years old, your policy is about to expire, you can apply for CPP Disability (CPPD). If you insurance adjuster tells you your policy is about to end, ask your adjuster where in the policy it says that your policy is about to expire.

LEARN MORE
• COVID-19 long-hauler rights
• 3 Tips for COVID-19 Long-haulers and LTD claims

I am suffering from psychological issues as a result of my anxiety over getting the vaccine. Can I get LTD?

If you legitimate concerns about the vaccine, or you are suffering from severe anxiety, depression, or needle-phobia, you should go to your doctor and get a referral to a psychologist or someone who can help you. If you are suffering from psychological symptoms relating to the vaccine – or anything else – and you can’t perform the essential tasks of your occupation as a result, and your doctor confirms that you are suffering, your insurance company should cover you. If you are suffering from a legitimate psychological issue, then your benefits should be approved. If the insurance company is denying your claim, you should contact us.

My disability insurance company says I have to for CPPD. Is that true?

Most policies mandate that you apply for CPPD. It would also be to your advantage to apply for CPPD, even though your insurance company will deduct your CPPD from your payments. You will still have CPPD disability if you ever lose your disability coverage benefits. Additionally, if you apply for CPPD and you are approved, you now have the validation of the government regarding your disability. In the event that a court were to look at your case, the fact that you’ve been approved for CPPD would likely mean that they the court would agree that your disability is legitimate.

You should not appeal the denial. First, because appeals often go nowhere. It’s your decision, but you will lose a lot of time, like months or years. Second, if you do appeal and are denied, you will have spent a lot of time in the process, and the bills will pile up in that time. Third, you will also risk running out of time to start a legal claim against the insurance company. If you miss the two-year deadline to take legal action, you may be out of time to file a claim. You should not appeal – you should contact us and let us tell you what the best options are, and then you can decide. It’s free to talk to us about this.

I’ve been on LTD for a year due to anxiety. My insurance company has offered to pay for me to see a psychologist. Should I accept?

Individuals should be wary of insurance companies offering to pay for medical services.  But the reality is that if you need the help of a psychologist due to your anxiety, it’s important to get that help, whether it’s through your own psychologist that you choose, or an insurance-paid psychologist. I say that because there are some places in Canada where it is very difficult to get a psychologist – rural areas for example – and if you have no alternative, and the insurance company is opening that door for you, it is the least bad option to go through the psychologist the insurance company is paying for.