Disability Law Show Global News Radio – S8 E30

Episode Summary

Independent medical assessments, LTD denials, employment issues, and more on S8 E30 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

Will the new vaccine mandates affect employees who are on LTD and not in the workplace? Can they cut off my benefits if I don’t get the vaccine?

The only way you can stop receiving your LTD payments is if you don’t comply with your policy, if you are not totally disabled from doing any occupation anymore, or if you’ve reached the age limit under your policy to be covered. I don’t think not getting vaccinated puts you in any of those three categories. Unless you’re in those three categories, there is no reason not getting the vaccine should prevent you from continuing getting your LTD payments.

My insurance company wants me to see an occupational therapist. I can’t find childcare during their hours, but they’ll cut me off if I don’t go. What can I do?

You need to email your adjuster and explain the issue and why you cannot go to the assessment during certain hours. Tell them the hours you are available to go. Make it clear that you are compliant and that you want to go to the assessment, as long as the timing doesn’t interfere with your childcare needs. If the insurance company tries to cut you off in the future, you can point to this letter and demonstrate that you were not refusing to go. The insurance company can’t demand unreasonable things from you to attend an assessment.

Can an LTD claimant refuse to participate in an independent medical examination requested by the insurer?

Generally, no, you cannot refuse to participate in an independent medical examination (IME). However, if your insurance company asks you to attend multiple assessments, ask them to show you where in your LTD policy it gives them the right to do so. Because generally speaking, they cannot ask you to attend multiple assessments with the same type of assessor or doctor.

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

My short-term disability application was denied. Do I need a lawyer?

Don’t waste your time appealing. The process will take you in circles. That’s because LTD appeals most often get denied because you’re appealing to the same person who denied your claim in the first place. Most people waste several years on appeals and run out of time to start the legal process against the insurance company. If you’re having a problem with your short-term disability, talk to us. We’ll look at your case and your documentation and tell you what your options are.

I have breast cancer, and the treatments and stress from work have become too much. I was denied LTD, should I appeal?

In Canada, under the common law system, a contractual dispute would result in you getting what is owed to you under your LTD policy since the company breached its obligations. But not only are you entitled to what’s owed to you but you could potentially be owed more in the form of aggravated and general damages. Our team goes after insurance companies all the time for these kinds of damages, as compensation for the mental distress caused to our clients. The insurance company may also owe you punitive damages for their malicious behaviour in this case.

I’ve been on LTD due to diverticulitis and anxiety issues, and my insurance company cut me off because they said the disability was related to employment issues.

Some insurance companies will try to say that a disability is employment-related, so they don’t have to pay. They claim that if you were to work somewhere else, you wouldn’t have those issues. That may be correct, but the problem here is that psychological disabilities, regardless of their cause, become generalized, such as generalized anxiety disorder or generalized depression. In other words, if an individual has psychological issues that are debilitating, the issues are no longer specific to their work location, where they started. Once that happens, the disabled individual cannot work somewhere else, and the insurance company must pay you.

LEARN MORE
Employment Issues and Long-term Disability FAQ

I have been on LTD for two years, and I’m being assessed to see if I can do any occupation. I’m currently still experiencing symptoms and haven’t been cleared to go back to work. What should I do?

If your LTD insurer says they’re going to cut you off at any point when you’re still disabled and your doctors say you can’t work, you need to get legal advice. Call my firm, we will give you a free disability consultation, discuss your case, and explain your options. Don’t wait until you’re cut off, talk to us right away.