Guide to transitioning from short to long-term disability | Disability Law Show TV – S7 E11

Episode Summary

GUIDE TO TRANSITIONING FROM SHORT TO LONG-TERM DISABILITY BENEFITS on Season 7 Episode 11 of the Disability Law Show with Disability Lawyer and National co-Managing Partner Sivan Tumarkin.

Watch above to discover the steps you must 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

Advice to doctors about LTD

I’m a family doctor and frequently watch the Disability Law Show. I have a patient currently on short-term disability who will need to apply for LTD. As a treating physician, what can I do to ensure his claim is successful?

• Support of a treating doctor: The support of a treating doctor is vital for individuals applying for long-term disability benefits. Detailed doctor’s reports should include how long their patient has been receiving treatment, as well as the nature of the impairment and a potential prognosis. Treatment providers and medical professionals can seek legal advice from a disability lawyer to get a better understanding of the application process.

Change in definition of disability

I worked as a case manager for trauma-specific insurance claims. Last year I hit a breaking point with the unexpected death of my mother and was diagnosed with depression and PTSD. It has now been over a year, and I’m still getting LTD benefits. I recently got a letter telling me there’s a definition change under my policy.

• Terms included in a disability policy: Under most long-term disability policies, in the first two years of benefits, claimants must prove they are unable to work in their own occupation. After two years, the definition of “disabled” in the disability benefit context changes. For those on long-term disability after two years, to continue to receive benefits, they must prove they are unable to work in any occupation.

Guide to transitioning from short to long-term disability benefits

• An automatic transition from short to long-term benefits: The transition from short to long-term disability benefits is not automatic, even if the benefits are offered through the same insurance company. The test to qualify for short and long-term benefits, however, remains the same.
  
• Strong and updated medical information: Claimants should make sure their medical information is strong as well as up-to-date. It is important to stay in continuous communication with treatment providers.
  
• Accepting a denial of benefits: A denial or cut-off from disability benefits by the insurer does not have to be accepted. Claimants should seek legal advice from a disability lawyer to determine their next steps.

Requesting a medical examiner

Is it possible to request an independent medical examiner other than the one recommended by the insurer? The initial IME was very distressing. The specialist wouldn’t listen to me, and heavily implied I was lying about my mental health symptoms. He also contradicts the assessments from my family doctor and psychiatrist.

• Independent medical evaluations: Insurers can request claimants attend an independent medical examination. Insurers typically choose and employ the consultant conducting the assessment. The reports produced by IMEs are often heavily skewed in favour of the insurer. Courts do not favour medical professionals who appear biased.

PREVIOUS EPISODE: Disability Law Show S7 E10 – 3 Myths about Invisible Disabilities