Disability Law Show Global News Radio – S8 E28

Episode Summary

CPP Disability (CPPD), return-to-work programs, lump sum payouts, and more on S8 E28 of the Disability Law Show on Global News Radio in Toronto and Vancouver.

Listen below to Sivan Tumarkin, a Toronto disability lawyer and Partner at Samfiru Tumarkin LLP, as they guide you through the proper steps to take when your insurance provider cuts off your long-term disability or denies your insurance claim. Learn how to get the compensation you deserve, from leading Ontario long-term disability lawyers.

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Episode Notes

How often can a long-term disability insurer require you to apply for CPPD?

Unless the long-term disability (LTD) policy specifically requires the insured person or claimant to reapply for CPPD, they have no obligation to do so. Remember that the LTD policy is the contract that provides the terms of the relationship between the insured individual and the insurance company. That means that the insurance company cannot force you to do certain things which they don’t have a right to ask you for under the policy.

What are the advantages of applying for CPPD?

One of the advantages is that CPPD is a government program, and it’s a more difficult test that you may have to meet to get that kind of benefit, as opposed to regular LTD benefits. For regular LTD, you have to demonstrate with the help of your doctors by way of reports, notes, and applications, that you are disabled from performing the essential tasks of your own occupation for the first two years. For CPPD, the test is more difficult. You have to show that you have a disability that is severe and prolonged. If you are able to get CPPD, it actually means that your insurance company may have a more difficult time down the road cutting you off on the basis that you’re not disabled, because the government has deemed you disabled.

LEARN MORE
• CPPD and Long-term Disability FAQ

Can my insurance company ask me to apply for CPPD?

If you’re on LTD and the insurance company asks you to do it, and if your policy contains a provision that says that you must apply for CPPD, yes, you must apply for it.  If the policy says you must apply for CPPD and you don’t apply, you are potentially in breach of that policy, and they could cut off your benefits. However, if the insurance company asks you to apply for CPPD and you refuse, they may try to estimate how much they think you should be getting from CPPD and then reduce your monthly LTD payments accordingly. You might as well apply for CPPD because if you don’t, they’re going to unilaterally reduce your payments.

LEARN MORE
5 Things you MUST do if your LTD is about to be cut off

I’m on LTD and my adjuster says if I don’t proceed with their return-to-work plan my file will be closed. What can I do?

If you know that you’re not ready to go back to work, and if your doctors have put on paper that you are not ready to go back to work, you need to convey that to your adjuster and the insurance company in writing. You can tell them that to return-to-work would be against your doctor’s medical advice at this given point in time. If the adjuster doesn’t back down, get in touch with us immediately.

Can a person on LTD request a lump sum payout?

Generally speaking, unless you have a very specific situation, stay away from that kind of request. If the insurance company is paying you monthly, let them pay you monthly. If you’d like to discuss your situation you can reach out to my firm, and we will review your case.

I’m in the midst of a successful return-to-work program. I received a letter that said my benefits will be terminated. What should I do?

If you are in the middle of a successful and positive return to work program, what the insurance company is effectively saying is that based on the information they have, your benefits will terminate at a certain date. That makes sense because if you are earning money through work, your case will basically close with the insurance company because you are successfully reintegrating. But not every person will actually find that the reintegration into work is successful. What happens then? In your LTD policy, there is a recurrence provision that deals with that. It says that if within a certain period of time your attempt at a return-to-work has not been successful then you will go back on LTD without waiting the initial elimination period.

LEARN MORE
• Return to Work and Long-term Disability FAQ

I’m on LTD and the insurance company has said that my claim will close soon. Can they continue providing income while I’m trying to return to work?

It depends on what your LTD policy says. Regardless of what your insurance adjuster says, you need to look at what is specifically written in your policy, and if it contains any provisions regarding top-ups. If you have any questions, or you want us to review the policy for you again, free of charge, just reach out to us. We would be happy to look at the documents and tell you what your options are.

Can you help unionized workers on LTD?

We can help a unionized employee deal with a potential long-term disability problem with their insurance company. We would still have to look at the collective agreement because that defines the relationship between the employer and the union, and that affects the employees. But in many cases, we can help a unionized employee deal with their insurance company. If you’re unionized, contact us first.