Disability Law Show: Ontario – S4 E69

Episode Summary

How can a claimant prepare for an IME? 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

• Access to treatment during the pandemic: Most disability policies stipulate that claimants must seek appropriate treatment and comply in order to continue to receive benefits. Unfortunately, as a result of the pandemic, many medical providers currently have long wait lists and delays for treatments and surgery. Claimants should try and communicate with their treatment providers on their specific needs and advocate for their own health despite the delays. It is important to have endorsement from a treating doctor in order to solidify a claim.
• The claimant’s mental illness progressed and was sent to an IME by the insurer: Most disability policies require claimants to attend an independent medical examination when requested by an insurer. There are many things that a claimant can do to prepare for an IME as well as after an examination has taken place. It is important to document in writing and confirm how the examination was conducted. Transparency must also be provided to the claimant by the insurer regarding the process involved in the IME and when it will take place.
• Evidence of a mental health illness: Insurers can send a file of a claimant to be reviewed by a series of certain doctors. Courts have consistently said that the reliance on this paper review by insurance companies does not hold as much weight as the reports generated by a claimant’s treating doctor and medical team.
• Unlikely to return to work but claims manager cutting off benefits: Some claimants with physical disabilities are likely unable to return to work or work in any other occupation due to their long employment history and skill set. Insurers typically do not want to continue to pay claimants for the foreseeable future and will likely cut off benefits in an attempt for a claimant to return to work. The disability insurer is responsible for performing a comparable skills analysis for a claimant and finding a comparable job.