What to know about invisible medical conditions and LTD | Disability Law Show TV – S5 E28

Episode Summary

WHAT TO KNOW ABOUT INVISIBLE MEDICAL CONDITIONS AND LTD on Season 5 Episode 28 of the Disability Law Show with disability lawyer and National Co-Managing Partner Sivan Tumarkin, and Partner Tamar Agopian.

Watch above to discover the steps you need to take when the insurance company cuts off or denies your long-term disability claim across all Canadian provinces, excluding Quebec, on the only disability law show on TV and radio in the country.

Episode Notes

Mediations for disability claims

What are mediations and why are they necessary for disability claims?

• Disability claim process: Claimants are often unaware of what the legal process is like after filing a disability claim for benefits. Mediation takes place between a claimant, their disability lawyer, and the insurer. A judge is not present and it does not take place in court. All communications that take place at mediation are considered privileged. The vast majority of mediations result in a resolved disability claim.

Conflicting doctor’s reports

I applied for long-term disability after a serious injury. It was denied because my doctors’ reports were allegedly conflicting. While my treating GP says I can’t work due to chronic pain, a specialist thinks there’s a small chance I might be able to.

• Medical reports while on disability leave: In the event that medical reports are conflicting, it is important for the retained disability lawyer to communicate with all parties involved. Some medical professionals can articulate diagnoses and recommendations differently than others. Doctors rarely limit themselves to terminology that is all-encompassing. Insurers will often pick on details out of context within a medical report to justify the end of benefits.

What you need to know about invisible medical conditions and LTD

•  Psychological claims are considered invisible illnesses: A common myth many believe is that psychological conditions are not considered disabilities. Many mental illnesses, such as depression and anxiety, can be debilitating and prevent individuals from working. Insurers often deny mental illness claims on the assumption that claimants will give up.
• A lack of medical documentation: Insurers often deny claims on the basis of a lack of medical documentation. This can mean no diagnosis or specific testing and imaging results. Many invisible illnesses, like chronic pain or headache disorders, will not have medical documentation. Claimants should note that a diagnosis is not required in order to receive approval for disability benefits.
• The support of a doctor: Claimants that have ongoing debilitating symptoms should speak to their treating medical professionals. With the support of a treating doctor, disability benefits should be approved. A diagnosis is not necessary for approval of a disability claim.

Approved for STD but denied LTD

After being diagnosed with a degenerative disease, I’ve undergone every treatment and medication. I was approved for short-term disability benefits but my claim for LTD was denied. I appealed twice but both appeals were rejected.

• Appealing an LTD denial: Insurers often encourage claimants to appeal a long-term disability claim denial. It is not advisable for claimants to file an appeal as they are often unsuccessful. The appeals process was created by insurance companies to ensure insurers retained power and influence. It is far more beneficial for claimants to file a legal claim to pursue their disability benefits.

PREVIOUS EPISODE: Disability Law Show S5 E27 – 3 Common reasons for an LTD denial