How your doctor can help your LTD application | Disability Law Show TV – S6 E12

Episode Summary

How your doctor can help your LTD application on Season 6 Episode 12 of the Disability Law Show with disability lawyer, and Partner Tamar Agopian.

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

Defining total disability

I was denied disability benefits a few times and told I was not “totally disabled”. I was in an administrative role before I developed several debilitating symptoms was diagnosed with diabetes and was unable to continue working. What can I do?

• The terminology used by insurance adjusters: Insurance adjusters often refer to a claimant’s “total disability” when determining approval for disability benefits. Many mistakenly believe this term refers to a complete inability to function. In reality, the term “total disability” refers to an inability to perform the basic tasks of an occupation due to ongoing symptoms.
  

Disability leave due to mental health reasons

I was on disability leave due to a health condition that was triggered by my work environment. I’ve submitted all necessary medical reports from my doctor and therapist to the insurer. I have yet to receive any benefits and have now sent in my third appeal.

• Appeal attempts after a denial of benefits: The appeals process was created by the insurance company to continue to control the situation. Appeals are rarely successful and conducted internally by the insurance company that initially denied the claim. It is far more beneficial to file a legal claim to pursue benefits.

How your doctor can help your LTD application

• Detailed reports that offer specific information: A claimant must have the support of their own treating medical team and doctor. A doctor must document all symptoms and treatment measures in detailed medical reports to provide to an insurer.
• Refer a claimant to necessary specialists: Doctors can and should refer a claimant to necessary specialists such as physiotherapists, psychiatrists, etc. Some specialists can have long wait times for those awaiting treatment. A referral can demonstrate to an insurer that treatment is being pursued.
• Seeking and following recommended treatment: Claimants must seek and continue to follow recommended medical treatment. Most disability policies stipulate that a claimant must comply to receive disability benefits.

A gradual return to work

I’ve been on LTD for 4 years now due to inflammatory arthritis. I hoped to try a gradual return to work but was not approved by my treating doctors. I have contacted my union, but they have been less than helpful or supportive. Is it possible for me to consult a lawyer?

• Rights of unionized members and disability claims: Unionized members should consult their unions regarding disability claims, however, they can consult with a disability lawyer. Consulting the collective bargaining agreement should determine whether external advice is possible.

Applying for CPPD while on LTD leave

I applied for long-term disability due to a heart condition and my application was approved. I’m now being told by the insurance company that I must apply for CPP disability benefits. Do I have to do this? If denied, will this affect my LTD benefits?

• CPPD program and benefits: Many disability policies require claimants to apply for CPP disability benefits. Claimants who do receive approval for CPPD will receive fewer benefits from the disability insurer however, approval typically strengthens a disability claim. The test to qualify for CPPD is much more severe than that of long-term disability benefits.

PREVIOUS EPISODE: Disability Law Show S6 E11 – 3 Myths about Disability Claims