Guide to returning to work from LTD | Disability Law Show TV – S5 E30

Episode Summary

GUIDE TO RETURNING TO WORK FROM LTD on Season 5 Episode 30 of the Disability Law Show with disability lawyer and National Co-Managing Partner Sivan Tumarkin.

Watch above to discover the steps you need to take when the insurance company cuts off or denies your long-term disability claim anywhere in Canada, on the only disability law show on TV and radio in the country.

Episode Notes

Medical condition considered “mild”

I was diagnosed with osteoarthritis and COPD and have been on LTD for almost a year. My insurer is sending me to a 2-month rehabilitation program. I am in an incredible amount of pain despite the “mild” diagnosis. What are my options?

• Rehabilitation programs: Claimants can be pressured to return to work early or to attend rehabilitation programs. Often, return-to-work programs can be gruelling and can lead to regression for claimants trying to recover. Claimants should ensure that their treating medical team knows of the program and approves of what is being suggested. It is also important to question why an insurer will pressure claimants to seek treatment from a particular clinic and practitioner.

Pursuing a settlement from a disability insurer

My wife was recently diagnosed with lupus but was denied long-term disability. Should we continue to pursue regular benefits, or would it be better for her to ask for a settlement?

• Settlements from insurance companies: Generally, claimants are unable to approach the insurance company for a settlement instead of ongoing disability benefits. Insurance companies will view a request for a settlement with suspicion and question why a claimant does not want continuous benefits. Cases such as this resolve after a legal claim has been filed either through a settlement, or a retroactive approval for benefits. It is important to seek legal advice from a disability lawyer if a denial of benefits occurs.

 Guide to returning to work from LTD

• Support of treating medical professionals: Claimants cannot be forced to return to work without the support of their treating medical team and doctors. It is important that claimants listen to medical advice and not return before they are ready to do so. Doctors should be clear in their reports that a return to work is an attempt and is not guaranteed to be successful.
• Provide detailed accommodations: Upon approval for a return to work attempt, claimants should provide their employer with a detailed list of accommodations and possible restrictions from their doctor. Employers have an obligation to accommodate an employee’s limitations. A refusal to accommodate can be considered a human rights violation. Claimants facing pushback from their employer should also seek advice from an employment lawyer.
  
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    • Employment issues and long-term disability
• Benefits can resume: An attempt to return to work might not always be successful. Claimants should not worry about their benefits however as most disability policies contain a recurrence clause. A recurrence clause provides a safety net for claimants as it allows benefits to resume almost immediately if a claimant is unsuccessful at returning to work.

Repeated unsuccessful appeal attempts

I work in the manufacturing industry and have been off work for a year due to a back injury. I applied for LTD shortly after going on leave but was denied. I’ve just sent in my second appeal, but I’m worried I will be denied again. Do I have any other options?

• Appeals and long-term disability: The appeals process was created by insurance companies and is typically unsuccessful. An appeal ensures that the power and influence remain with the insurer, and not the claimant. Appeals can waste valuable time for claimants as there is a two-year limitation period after an initial denial. It is far more beneficial to file a legal claim with a disability lawyer in order to pursue benefits. The legal process can worry claimants however in most cases, it is quick and successful.

Approval for LTD after short-term disability

I’ve been receiving short-term disability for an ongoing mental health issue. My doctors believe I’m still not ready for a return to work and my health would regress. If I apply for LTD, is approval automatic?

• Mental health and transitioning to LTD: Generally claimants that have short-term disability benefits are receiving benefits through their employer. Often, short-term disability benefits and long-term disability benefits are not provided through the same insurer. Approval for short-term benefits does not mean automatic approval for LTD. Despite this, the test in order to qualify for long-term benefits and short is the same. Insurers believe that denials will prevent claimants from pursuing their rights, particularly those with mental health claims.
  

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