Disability Law Show Global News Radio – S8 E33

Episode Summary

Obtaining IME reports, applying for CPP Disability, and more on S8 E33 of the Disability Law Show on Global News Radio in Toronto and Vancouver.

Listen below to Sivan Tumarkin and Albert Klein, Toronto disability lawyers, and partners 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

My husband had his LTD benefits cut off. The insurance company requested all of his medical information, which he submitted. They keep saying his claim is under review. How long should it take for the review to be completed?

If you are in a situation where your benefits are either denied or they’re cut off or if the insurance company is saying they haven’t decided yet, you have to think about this from a reasonable and standpoint. Do you think that you’ve provided to them everything they need in order to make a decision? If you think that’s the case and a month has passed and you’re still getting nowhere, get in touch with us. No two cases are the same and sometimes our advice will differ and remember, it doesn’t cost anything to speak with one of our team members

My insurance adjuster insists on speaking on the phone, which makes me anxious and stressed. Can they cut off my benefits if I don’t speak to them on the phone?

This can happen when an adjuster is unusually aggressive, or the claimant has difficulties with stress and anxiety. You can advise your adjuster in writing that speaking on the phone is creating a lot of stress for you, and that you want to communicate in writing. Speak with your doctor and explain that the situation is creating psychological pressure for you and that your anxiety is increasing. It’s important to make sure there is a record of the situation. It’s even better if your doctor can write something for you that says it is their medical recommendation that further communications with the insurance company be done in writing. That way, the insurance company, can’t cut you off for non-compliance in the future, although that would be an extreme reaction. If they did that, you would have a basis for a legal claim in the future.

LEARN MORE
• Dealing with Difficult Adjusters and Long-term Disability FAQ

Recently I attended two IMEs requested by my insurance company. How can I request copies of the reports from the IMEs?

Since you are the subject of the independent medical examination (IME) you should have the right to review what is written about you. They also do not have a right to send you to as many IMEs as they want – there has to be a reason to send you to the IME, and the examination has to be relevant to your disability issues. The report will also include treatment recommendations, so you can explain to the insurance company that you would like to see copies of the reports with the recommendations of treatment. Explain that your doctor also needs copies of the reports.

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

I started a behavioral activation program for mental health, and I’ve been told if I don’t complete the activities my benefits will be cut off. What can I do to protect myself?

Under every LTD policy, claimants have an obligation to try and get better. It can become a problem, however, if you are being pushed beyond your limits. Speak with your doctor and explain the issue in a frank way. Your doctor can create a record that you are trying to complete the program and may be able to make a recommendation to slow down or stop the program for a period of time. Your doctor can give that report or record to your insurance company, and they should comply or listen to what your doctor is saying. If they don’t listen and they cut off your benefits, you can start a legal claim against the insurance company.

My spouse has been on LTD for four years with chronic vertigo. She received a letter requesting she apply for CPP Disability. Does she have to apply, and will it reduce her pension later on?

If you are on long-term disability and the insurance company says you need to apply, you have to apply. Generally, there is a provision in most LTP policies that obligates you to apply. If you don’t apply, most likely the insurance company will request an estimate of the amount the CPPD payments would be and deduct that amount from your monthly payments. One of the benefits of applying for CPPD is that you will be getting approval for your disability from the government, which is actually a much more difficult threshold to meet than the insurance company. This means the insurance company will have a harder time cutting you off because you have already been determined to suffer from a severe and prolonged disability by the government. If the insurance company does cut you off, come speak to us, we deal with these situations all the time, and we are successful in getting a positive result.

LEARN MORE
• CPP Disability and Long-term Disability FAQ