Navigating LTD benefits for chronic migraines and headaches | Disability Law Show TV – S7 E13

Episode Summary

NAVIGATING LTD BENEFITS FOR CHRONIC MIGRAINES AND HEADACHES on Season 7 Episode 13 of the Disability Law Show with Disability Lawyer and Partner James K. Fireman.

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

Disability benefits are cut off without warning

After a series of traumatic events, I had to take time off work and applied for disability benefits. I was approved for LTD due to severe PTSD. Without warning, after I’d been on leave for almost 2 years my benefits were cut off. What can I do here?

• Reason for cutting off disability benefits: Insurance companies often preemptively cut off disability benefits when it becomes clear an individual will be on leave for the foreseeable future. It is easier for insurers to do this rather than have a claimant assessed by a specialist. Alternatively, claimant files are often sent to consultants who have the insurer’s best interests in mind.

Asking for a different independent examiner

Can I ask my insurance company for a different independent medical examiner? The one they chose provided a report that contradicts what my family doctor and chiropractor have said.

• Rights when attending an IME: Independent medical examinations are often requested to justify a cut-off of disability benefits. Claimants must attend an IME and it can be difficult to request an alternative examiner. Claimants are within their rights to question certain elements of an assessment, such as if the location of the assessment is unreasonable.

Navigating LTD benefits for chronic migraines and headaches

• Not enough medical evidence to support claims: Chronic migraines and headache disability claims are often denied due to a lack of medical evidence. These conditions are typically considered invisible illnesses. Regardless of a diagnosis, claims should be reviewed based on the symptoms a claimant is experiencing. Disability policies typically do not require objective medical evidence to approve a claim.
  
• Detailed medical records, and specialists’ reports: Claimants need to have detailed medical records to support their claim. It is often beneficial for claimants to have a journal recording symptoms of ongoing migraines and headaches.
  
• Accepting a denial: Individuals do not have to accept a denial of benefits. It is within their rights to seek legal advice from a disability lawyer if they have the support of their treating doctors.

Mental illness is considered a pre-existing condition

My daughter was on short-term disability after being diagnosed with an anxiety disorder. She applied for LTD, but they denied her coverage. Her insurer says she mentioned anxiety to her doctor years ago before she even started this job, and they’re calling it a pre-existing condition.

• Pre-existing conditions: Pre-existing exclusions can vary depending on the particular disability policy. Claimants should look closely at the terms outlined in their long-term disability policy and are within their rights to ask for a copy. Insurers can also be skeptical regarding mental health claims.

PREVIOUS EPISODE: Disability Law Show S7 E12 – How can your medical team strengthen your LTD claim?