Two-year mark on Long-Term Disability: What you need to know | Disability Law Show TV – S7 E14

Episode Summary

TWO-YEAR MARK ON LONG-TERM DISABILITY: WHAT YOU NEED TO KNOW on Season 7 Episode 14 of the Disability Law Show with Disability Lawyer, Partner and National Practice leader 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

A long-COVID disability claim

I applied for long-term disability benefits due to symptoms of long-COVID. This claim was denied, and I was told there is no evidence to support this. What can I do?

• Evidence to support a claim: Individuals who have filed disability claims due to the symptoms of long-COVID are often denied. Insurers often deny claims on the basis that there is no objective evidence to support the medical condition. While the effects of COVID-19 are still being studied, and as of yet, there are no tests to determine a long-COVID diagnosis, a diagnosis is not a requirement to receive disability benefits.

Disability benefits are cut off too quickly

I was on medical leave, then tried to return to work. Unfortunately, I was still unwell, and the attempt was unsuccessful. My benefits were supposed to cover me for the long term, but they were cut off after a few weeks. What are my options?

• Reasons for cutting off benefits: Employers cannot determine whether or not a claimant is well enough to return to work or if they must remain on medical leave. Claimants should listen solely to the advice of their treating doctors.
• Short-term disability benefits: Typically, employers will pay short-term disability benefits to staff through an insurance company to administer the policy. The test to qualify for short and long-term disability benefits is the same.

Two-year mark on Long-Term Disability: What you need to know

• The first two years on long-term disability: In the first two years on long-term disability benefits. claimants must prove they are unable to work in their own occupation due to ongoing symptoms. Individuals must be able to answer whether or not they would be able to work for a new employer, or would their symptoms prevent them from doing so.
  
• Any occupation period: After two years on long-term disability, the “change in definition” period occurs on long-term disability leave. Individuals on disability leave must now prove they are unable to work in any occupation they are qualified for. Potential occupations must be in line with the compensation claimants can receive through disability benefits.
  
• Options for those on claim: Individuals who continue to receive disability benefits past the two-year mark on long-term disability, but later have their benefits cut off, should seek legal advice.

Harassed by disability insurance adjuster

I have PTSD, OCD, depression, and high anxiety. I regularly see a psychiatrist and send updates to my disability insurer. Despite this, I feel harassed by my case manager. She calls me weekly, accuses me of avoiding her or my doctor, and has even implied I’m lying about my condition. Is there anything I can do to protect myself?

• Communicating with the insurer: To protect ongoing benefits and claims, individuals on disability leave should ensure all communication with the insurance adjuster is documented in writing and sent to the insurer. A record of communication ensures that if there is a legal claim at a future date, the claimant’s perspective is documented. Individuals should also document the impact of communication with the insurer with their treating medical team.

PREVIOUS EPISODE: Disability Law Show S7 E13 – Navigating LTD benefits for chronic migraines and headaches