Disability Law Show: Ontario – S5 E35

Episode Summary

Why are mental health disability claims often denied by insurers? Disability lawyer and Partner Tamar Agopian at Samfiru Tumarkin LLP answer 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

• Mental health stress conditions: Individuals can develop a chronic mental health condition over time due to ongoing stressors. There appears to be an increased resistance to mental health claims. There appear to be more restrictions and overly critical ways in which insurers view mental illnesses and approval for disability benefits. Ultimately, individuals that have the support of treating doctors and medical professionals should qualify for benefits.
• Social activities while on long-term disability: Mental health disabilities should not prevent claimants from pursuing activities that can aid their recovery and treatment. Many claimants on leave for a mental illness worry about their daily activities and the possibility of their benefits being cut off. Insurers often make assumptions regarding a claimant’s function and abilities. Claimants should continue to follow the recommended treatment from their doctors and ensure they are aware of their daily activities. Individuals do not require permission from their insurers for social activities.
• Applying for CPP Disability due to chronic illness: Most disability policies contain provisions that allow insurers to deduct from a claimant’s benefits based on certain estimates. These deductions are possible as insurers assume claimants have applied for other programs, such as CPPD, and will receive other benefits. It is beneficial for claimants to apply for CPP Disability as it can offer a safety net if approved. The test in order to qualify for CPPD is more difficult than long-term disability.
• Limitation periods and deadlines: After a denial of long-term disability benefits, claimants have up to two years after the date of denial to file a legal claim. Many insurers upon denial of benefits will encourage claimants to appeal. The appeals process is typically not successful and can waste valuable time for claimants.