Disability Law Show: Ontario – S4 E53

Episode Summary

Why are mental health disability claims often denied? Disability lawyer and partner Tamar Agopian at Samfiru Tumarkin LLP answers this question and more on the Disability Law Show on 640 Toronto and Newstalk 580 CFRA.

Listen below to discover important information about your rights and a guide through the proper steps to take when your insurance provider cuts off your long-term disability or denies your insurance claim.

When you need a disability lawyer in Ontario, Tamar and her team can get you the advice you need, and the compensation you deserve.

Listen to the Episode

Show Notes

• The importance of mediations for disability claims: Nothing that is said or done in the mediation process can be disclosed in court and in front of a judge. Mediations promote dialogue and talk through fundamental disagreements between the insurance company and the claimant and representing disability lawyer.
• Claimant presented with a settlement by the insurance company: Insurance companies often offer claimants a buyout or settlement in a lump sum. In many cases, this is offered to claimants who are progressing slowly and who are not likely to be able to return to their jobs in the near future. Claimants should not be pressured into agreeing to this settlement and should seek advice from a disability lawyer.
• Mental health disability claims: Insurance adjusters will often question an employee’s employer regarding their performance and these answers can influence whether or not a mental health claim will be approved. Mental health claims are also not as visible or easy to measure in comparison to a physical medical condition. In many cases, mental health illnesses can ebb and flow and many claimants can relapse. The uncertain nature of a mental health claim can also influence a disability insurer’s approval or denial of benefits.
• Appeal denied multiple times: Many claimants are encouraged by the insurance company to appeal a denial of their benefits however, this is a typically ineffective process. Appeals are rarely effective and often waste a claimant’s time and energy. Claimants have two years after the initial date of denial to pursue their benefits.
• Claimant’s file sent to insurance company doctor: Often, the doctor that is hired by the insurance company is only given specific information that is sent by the insurance company. The questions and answers that the insurance company’s doctor provides to the insurer are used typically to deny or contradict a claimant’s treating medical team. An independent medical examination or assessment for rehabilitation is typically more thorough than a paper report.