What to know about returning to work from LTD | Disability Law Show TV – S4 E05

Episode Summary

WHAT TO KNOW ABOUT RETURNING TO WORK FROM LTD on Season 4 Episode 05 of the Disability Law Show with disability lawyer Partner, James Fireman.

Watch above to discover the steps you need to take when the insurance company cuts off or denies your long-term disability claim in Ontario, British Columbia, or Alberta, on the only disability law show on TV and radio in Canada.

Episode Notes

Returning to work but still entitled to LTD

I had a significant condition with my legs and had to elevate them constantly so I couldn’t return to my old job on so I started a new administrative job but with less income. Am I still entitled to LTD?

• Returning to a new job after LTD: Claimants who can return to work or another position but are unable to earn a comparable income to their previous position are able to apply and receive long-term disability benefits. While the benefits will not be as much as when claimants were not working, they should offer commensurate income. Claimants who are unsure of the terms and provisions of their disability policy should contact a disability lawyer.

Transitioning to LTD from short-term disability

My cousin was just diagnosed with cancer. His employers have been great and told him to take a leave and short-term disability. Will it be easy for him to transition to a long-term disability? How long does a long-term disability last?

• Long-term after short-term disability: Typically the transition to long-term disability from short-term disability benefits is an easy process as there are internal processes set up for a transition. After short-term disability benefits end, claimants on LTD will have two years before there is a change in definition in order to qualify for benefits. In standard policies, most claimants are able to receive long-term disability benefits up until the age of 65.
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What to know about returning to work from LTD

• Return to work when approved to do so: The decision on when a claimant should return to work is not a legal decision and is purely medical. Claimants should not return to work before they are approved to do so by their treating medical team as an unsuccessful return can further worsen a claimant’s condition. It is not advisable for claimants to ignore their doctor’s advice.
• Necessary accommodations and limitations: Claimants should make sure they are given the appropriate restrictions and accommodations necessary to return successfully to work and communicate the limitations with their employer. Employers are obligated to try and accommodate an employee’s medical condition and disability up until the point of undue hardship. Insurance adjusters typically advocate for claimants to their employers for necessary accommodations.
• Claimants who attempt a return to work and are unsuccessful: Most standard disability policies contain a recurrence clause. The recurrence clause allows claimants who have tried to return to work but have been unsuccessful to resume their LTD benefits without having to wait through an elimination period. Claimants do not have to reapply for a new disability claim. In practice, insurance adjusters rarely abide by the recurrence clause and claimants should speak to a disability lawyer as soon as they are denied.

My insurance adjuster asking personal questions regarding my condition

I am currently on long-term disability because I suffer from PTSD and general anxiety after an incident that happened a year ago. Is my insurance caseworker allowed to specifically ask why I have PTSD? Some of their questions seem intrusive but I’m worried I’ll be cut off if I don’t answer.

• Mental health claims and insurance adjusters: When applying for long-term disability benefits insurance adjusters are entitled to ask many questions, unlike an employer who is not permitted to ask specific diagnosis-related questions. It is generally not enough for doctors to state a claimant is unable to work and their prognosis. Insurance adjusters however are not entitled to ask questions regarding sexuality and intimate details that are not related to the condition.

Long-term benefits will be cut off unless the claimant returns to work

My sister has been on long-term disability for nearly two years due to chronic back and knee pain. The insurer-recommended physiotherapist thinks she is able to go back to work, however, her own family doctor disagrees. Now the insurer says she must return to work or they’ll end her benefits.

• Pressured to return to work: There can be conflicting opinions between treating doctors and specialists. The reality is that a therapist can have much more hands-on time with a claimant. In some situations, doctors can refer claimants to be seen by specialists that can help determine whether or not a return to work is possible.

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Previous Episode: Disability Law Show S4 E04 – Important Facts You Need to Know if Cut Off of LTD