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Long-Term Disability Lawyers Wood Buffalo

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Long-Term Disability Benefits in Wood Buffalo

Long-term disability insurance is an essential lifeline for many Albertans. It provides financial assistance when you cannot work due to a disabling medical condition or serious injury. These benefits help cover your expenses, protecting you from financial instability while you focus on your recovery. The coverage provided by long-term disability insurance policies varies, but generally it can cover 60-70% of your income of your income.

Long-term disability insurance is often either part of an employee benefits package or purchased privately through a broker. Some policies may cover disabilities that are caused by an illness or injury, while others may only cover disabilities caused by an accident. It’s important to check the details of your plan to understand what conditions are covered by your plan.

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Applying for Long-Term Disability

Applying for long-term disability can be a long and confusing process. You should familiarize yourself with the procedure laid out in your provider’s policy as you consider your options. While the steps may vary depending on the insurance company, some common steps are:

  1. Notify Your Employer: If you are insured under a group insurance plan, you should let your employer know that you plan on claiming long-term disability benefits. Do this as soon as you realize that your condition may prevent you from working. Notifying your employer early will help them prepare for your leave and have the needed paperwork ready.
  2. Complete the Application Forms: You will need to fill out forms that are provided by your insurer, which ask you for your personal information, occupational information, and medical information. Be as detailed and precise as possible when filling out these forms. Missing information and mistakes can delay your claim and slow your application.
  3. Collect Medical Evidence: Detailed medical evidence will be required to support your claim. Insurers will often ask for diagnostic tests, treatment plans, and doctors’ notes. Make sure that your medical documentation clearly outlines how your condition affects your inability to work.
  4. Employment Information: Your employer may be requested to provide details about your job duties and benefits. This information is used by the insurer to understand the demands of your job and how your condition may prevent you from working.
  5. Submit Your Application: After submitting your application, follow up with your insurance company. Your insurer may ask for additional information or testing. Try to provide this information as quickly as possible.

Conditions That Qualify for Long-Term Disability

A wide range of medical conditions can qualify for long-term disability benefits, including both physical and mental health conditions. Some conditions that will commonly receive benefits include:

  • Herniated discs
  • Post-traumatic stress disorder (PTSD)
  • Migraines
  • Back pain
  • Fibromyalgia
  • Multiple sclerosis
  • Cancer
  • Heart disease
  • Neurological disorders
  • Psychological disorders
  • Crohn’s disease
  • Arthritis
  • Paralysis
  • Lyme disease
  • Lupus
  • Panic attacks
  • Bipolar mood disorder
  • Musculoskeletal injuries
  • Depression
  • Anxiety
  • And more

Reasons Why Your Long-Term Disability Claim May be Denied

Long-term disability claims often get denied for various reasons, even when the claim is legitimate. Common reasons for denying claims include:

  1. You Lack Medical Evidence: Insurers may feel the medical evidence given does not adequately reflect the seriousness of your condition. To avoid this, make sure that your medical records are detailed and explain how your conditions stop you from working.
  2. You Have a Pre-existing Condition: Some policies may specify that certain pre-existing conditions can exclude you from collecting LTD benefits. Check your policy to understand how pre-existing conditions are defined and how they are applied to claims.
  3. Your Insurer Thinks You Are Not “Totally Disabled”: Policies will clearly define what it means to be disabled. Usually, it means you are either unable to work in your own job or in any job that is appropriate for you. If you fail to meet this definition, your claim may be denied. Insurers will often try to argue that you can work in another job.
  4. Missed Deadlines: Waiting too long to make a claim or not filling out all of your paperwork in a timely manner can lead to a denial.

What To Do If Your Long-Term Disability Claim is Denied

It can be disappointing and disheartening when your benefits claim is denied. It is important not to lose hope, as there may be options available to you. In most cases, insurance companies will allow you to appeal their decision through an internal appeal process or through legal action. If you decide to appeal, gather additional medical evidence and get additional testing to support your case. It is essential to remember that these appeals are often biased as the insurance company organizes them.

You can also pursue legal action against the insurer. A lawyer can help you with the complex claims process by taking care of everything on your behalf. You may be able to claim past benefits owed, emotional distress, and other losses caused by the denial. Reach out to our long-term disability lawyers to learn more through a free initial consultation.

How Our Wood Buffalo Long-Term Disability Lawyers Can Assist You

Navigating a long-term disability claim can be bewildering and daunting. Insurance companies do not always apply their terms fairly and you may pay the price. Our legal team may be able to help you recover previously denied benefits and additional costs such as aggravated damages and punitive costs. To learn more about how we can help, schedule a free initial consultation today.

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Commonly Asked long-term disability Questions

Here are our most asked questions on long-term disability claims.

Long-term disability claims arise when you have disability insurance, either through your work or privately, that denies your claim after you have become disabled.

Yes. The Insurance Act, RSA 2000, sets a two-year limitation period that commences two years after the claims arise.

Long-term disability cases are several heads of damage that are assessed independently. First, there is the arrears or the past benefits that have not been paid. Next, there are potential future benefits. Finally, if a denial was made in bad faith, there may be extracontractual damages that can include aggravated damages or even punitive damages against the insurance company.

You can claim contractual damages for past benefits that should have been paid. In a settlement discussion, you can claim for future benefits that will be paid, but in a trial, you cannot make this claim. Finally, if the denial was in bad faith, you can make an extracontractual claim for aggravated damages and/or punitive damages.

The most common causes of disability are related to chronic pain and psychiatric disorders like anxiety or depression. However, there are many causes of disability, including:

  • Chronic pain;
  • Depression;
  • Anxiety;
  • Brain injury;
  • Stroke;
  • Heart attack;
  • Cancer;
  • Injury;
  • COVID;
  • Stroke;
  • Orthopaedic injury;
  • Paralysis;
  • And more.

The insurance company will provide you with options to appeal their decision. Keep in mind these appeal processes are usually created by the insurance company and adjudicated by the insurance company. And they do not stop the limitation period from running. Our lawyers will file a lawsuit instead and put the claim into the impartial realm of the court system.

Copies of your policy, the denial letter, and your medical records are generally needed to support your long-term disability claim. Our lawyers can work with you to determine what documents exist and how to collect them to make sure nothing is missing.

If you have been denied long-term disability benefits, it is time to contact a lawyer to discuss next steps. Our consultations are always free, and there is no obligation to sign up.

Yes. Mental illness is increasingly being recognized as a real and problematic cause of disability for a substantial percentage of the population. In addition, these ailments are often invisible. Because of that, insurance companies will suggest that you have not met your burden to prove your mental illness exists and is disabling to deny your claim.

The long-term disability claims we handle are from private long-term disability companies. Canada Pension Plan Disability is a statutory pension plan run by the Federal Government that you may or may not qualify for depending on your contributions to CPP and your injuries.

Short-term disability is similar to long-term disability but has a shorter waiting period to kick in and a shorter duration. Sometimes, the insurer or entity that pays short-term disability is different than the insurer that pays long-term disability. Since it is a different benefit, there is often some difference in the compensation formula between the two.

Sometimes yes. Long-term disability contracts are often set up to have an exclusion for pre-existing conditions. These exclusion clauses typically only apply if you become disabled within the first year of coverage on most group policies. However, it is very important to read the specific language of your insurance policy if you have become disabled from a long-standing or pre-existing ailment.

FIGHTING FOR LTD BENEFITS IN WOOD BUFFALO?

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