Disability Law Show: Ontario – S5 E39

Episode Summary

Do disability claimants have to listen to occupational therapists? 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.

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Show Notes

• Pre-existing condition clauses: Some disability policies contain clauses that deny claimants who have a pre-existing condition. Claimants who are denied disability benefits on the basis of a pre-existing condition should not be dissuaded from pursuing their benefits. The pre-existing clause was created in order to ensure individuals were not “shopping” for insurance coverage. Unfortunately, this clause prevents many legitimate claims from being approved.
• Returning to work after seeing an occupational therapist: Individuals can often be pressured to return to work by their insurer or an insurer-recommended treatment provider. Claimants should listen to the advice of their own treating medical team. Rehabilitation programs recommended by an insurance company can be aggressive and conflict with the medical advice claimants receive from their own doctors.
• Medication while on mental health claim: Most disability policies will require claimants to seek and undergo appropriate treatment. Claimants that do not comply with recommended treatment could lose their benefits. Treatment must be reasonable, however, and in many cases, some treatment plans can lead to negative outcomes. For those on a mental health claim, it is advisable to listen to the advice from their own therapists. Claimants can request their doctors provide their insurer with a detailed report on why a medication or treatment plan is not possible.
• Struggling with a return to work plan: During the change in definition period, insurers often pressure claimants to return to work. After two years on a long-term disability claim, insurers review claims to determine if another occupation is possible. Claimants should only return to work with the approval of their own treating doctors. Return-to-work plans can often require extensive accommodations, and in some cases, claimants should continue to receive benefits despite returning to work.