What to know about disability claim denials | Disability Law Show TV – S6 E14

Episode Summary

WHAT TO KNOW ABOUT DISABILITY CLAIM DENIALS on Season 6 Episode 14 of the Disability Law Show with a disability lawyer, national practice leader and Partner James 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

Myth of lack of objective medical evidence

Insurance companies often deny claims based on a lack of objective medical evidence. What does this mean and is it a legitimate reason to deny disability benefits?

• Objective medical evidence: Disability policies typically do not contain provisions requiring objective medical evidence to receive approval for disability benefits. Despite this, it is a common reason insurers use to deny a long-term disability claim. A diagnosis is not required for disability benefits approval, only a medical condition.
  

Transitioning from short to long-term disability

My daughter was in a supervisor role before she had to take sick leave and go on short-term disability. When she tried to transition to long-term disability, she was denied by the insurance company.

• Short to long-term disability: The test to receive approval for short-term disability benefits is the same as the test for long-term disability. Despite this, it is not uncommon for individuals who have received approval for short-term benefits to be denied LTD.

What you need to know about disability claim denials

• The support of a treating doctor: It is not uncommon for disability claims to be denied despite the support of a treating doctor or medical professionals. Individuals with their doctor’s support to apply for LTD should not be dissuaded from doing so. Doctors unsure how to proceed to help their patients can and should seek legal advice from a disability lawyer.
• Out of options:  Disability insurers will imply claimants can appeal a denial of benefits. The appeals process is not official and is not the only option for those seeking benefits. Filing a legal claim to pursue LTD benefits is far more beneficial.
  
• The time frame after a denial of benefits: Those who are denied long-term disability benefits have up to two years after the initial denial to file a legal claim. This deadline is typically strictly enforced.

Let go from employment while on LTD

After almost a year on long-term disability, I was informed by my company’s HR department that they were shutting their doors, and I was being let go. I’m not sure how this will affect my benefit payments. Is there anything I should be aware of?

• Employment issues and disability benefits: Many individuals on disability leave are concerned about their employment status while continuing to receive benefits. Disability coverage is crystalized once a claimant begins long-term disability leave, regardless of their employment status later on if they continue to be disabled. It is important to remember, that severance pay can influence disability benefits.

PREVIOUS EPISODE: Disability Law Show S6 E13 – 3 Common myths about surveillance and LTD