Long-Term Disability Lawyers Fort McMurray
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Long-Term Disability Benefits in Fort McMurray
Long-term disability insurance can be an essential lifeline for many Fort McMurray locals. These benefits can help provide financial stability by providing you with financial payments when a severe illness or injury stops you from working. In most cases, long-term disability benefits kick in once you use up your short-term disability benefits, sick days, or EI sickness benefits.
While the coverage provided by long-term disability varies, the main benefit is partial income replacement. This is important since many qualifying conditions are often severe and long-lasting and can impact your ability to earn an income. Knowing how long-term disability benefits work, how to apply for them, and your options if your claim is denied can be helpful.
Often, long-term disability insurance is provided through group insurance plans that employers will sponsor. Individual insurance plans purchased directly through an insurance broker are also quite common. If you meet the definition of being “totally disabled” under your policy, you may apply to have around 60-70% of your regular income replaced, which could help you cover your household expenses. During the first two years of benefits, being totally disabled means you cannot work in your own job. This is what is known as the “own occupation” test. After two years, the “any occupation” test kicks in, which defines being disabled as being unable to work in any occupation that is suitable for you based on your skills, experience, and training.
The type of disabilities covered can vary between plans, with some policies only covering disabilities caused by accidents, while others may cover disabilities caused by illnesses and injuries. Some plans may also only cover workplace accidents. Some plans may have exclusions and will not cover disabilities caused by certain activities, such as illegal or dangerous actions. It is essential to review your policy to understand its conditions.
Further, many plans will also have probation periods that will prevent you from making a claim when you are first enrolled; often, this period is between 90-180 days, but this can vary.
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Applying for Long-Term Disability in Fort McMurray
It is important to be mindful when applying for long-term disability benefits, as it is easy to make careless mistakes that result in denials. Because there are several steps involved and there is a significant difference between making a bare minimum application and a strong application, it can be helpful to consult a long-term disability lawyer.
Before taking a leave from work or applying for benefits, you should seek medical attention. Getting treatment is an important step and will help showcase the development of your disability.
If you are employed, you should inform your employer that you need to take a leave of absence due to a disability; you should also tell them you plan on making a long-term disability claim. This will allow your employer to prepare the necessary documents. If you are self-employed, you can disregard this step.
You should then complete the required application forms that your insurer needs. Be sure that you are detailed and provide accurate information. Inconsistencies in your application can raise red flags and risk the insurance company denying your claim. Generally, these forms ask questions about your medical condition and employment. Your employment information should outline your primary tasks and duties.
You should also make sure you have your medical records. This is what is used to support your claim. Review these records to make sure they support your claim. These records should include notes taken by your doctor, results for any tests, and treatment recommendations. Your records should show how your disability impacts your ability to work. A lawyer can advise your doctor on how to fill out the forms.
After you have gathered all the required information and have filled out the necessary forms, submit your application and follow up with your insurance company. You may be asked to provide additional information, so be sure to provide this information promptly. If you need help with any of the above, we recommend you consult a long-term disability lawyer.
Conditions That Could Be Eligible for Long-Term Disability
As highlighted by the courts, both physical and mental health issues can qualify for long-term disability as long it impacts your ability to work. Physical conditions such as cancer, AIDS/HIV, fibromyalgia, Lyme disease, multiple sclerosis, herniated discs, neurological disorders, migraines, respiratory disorders, asthma, and Crohn’s disease will often qualify for long-term disability. These conditions can make it difficult for you to complete your job functions.
Equally as impactful are mental health conditions; while these are more difficult to measure, conditions such as depression, anxiety, panic attacks, and post-traumatic stress disorder (PTSD) can also qualify for long-term disability. With mental health conditions, you may be required to provide added documentation, such as psychologist reports, to support your claim.
If an insurance company tries to deny your long-term disability claim because they do not believe your condition is serious enough, contact our Fort McMurray team. There are options available.
Reasons Why Insurers Will Deny Benefits
Even legitimate claims can be denied for a wide variety of reasons. Insurance companies will request excessive paperwork and attempt to find reasons to deny your claim. This is because insurance companies will often prioritize their profits. Some common reasons why claims are denied include:
- Lack of Medical Evidence: A common reason to deny a claim is that there isn’t enough medical evidence to support your inability to work due to your disability. This is why thorough medical reports are needed.
- You Have an Excluded Pre-Existing Condition: An insurer may try to deny a claim if your disability is caused by a medical condition that existed before you were enrolled in the policy.
- You Are Not Disabled: Insurers may try to argue that you are not disabled and can work. The definition of disability for most insurance policies is that you are unable to perform the primary functions of your job or are unable to perform the primary functions of any job that you are suited for based on your experience, skills, training, and education. Even if you can perform some of the minor tasks of your job, you may still meet the definition of disabled.
If your claim is denied, reach out to us, regardless of the reason. It is common for insurance companies to give faulty reasons to deny claims. Schedule your free initial consultation today.
Options For Denied Long-Term Disability Benefits
It can be discouraging when you are denied benefits. However, there are many options available. In most cases, insurance companies will have internal appeal procedures that they organize. These internal appeal procedures are often biased.
You can also file a lawsuit to appeal your denial. This can be a complex process. However, the benefit of suing is that you can sue for your benefits and claim the interest owed on those benefits, the losses you faced because you needed to sell your assets to pay your bills, the emotional stress from the denial, and more. Our team of long-term disability lawyers has helped many people bring forward a claim and may be able to help you. We have years of legal experience and are knowledgeable about the legal process. Reach out to our firm today to schedule a free initial consultation.
Ways Our Fort McMurray Long-Term Disability Lawyers Can Help
Many of our lawyers have worked in the insurance industry before they joined our firm. They understand the tactics and tricks used to deny long-term disability claims. Let us use that knowledge to help you and prevent insurance companies from taking advantage of your situation.
We want to help you fight for your rights and will work hard to make the appeal process easier. We will review your policy and denial letter and explain the errors the insurance company made. We will highlight your coverage and your legal rights. We will also help organize the evidence, and if needed, we will use our team of investigators to gather further evidence. We can take over the litigation process so you can focus on your well-being. We know how to navigate the appeals process and have made successful claims time and time again. Don’t wait to get the help you deserve, schedule a free initial meeting with our team.
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Commonly Asked long-term disability Questions
Here are our most asked questions on long-term disability claims.
What is long-term disability?
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.
Is there a time limit on when I can sue for long-term disability?
Yes. The Insurance Act, RSA 2000, sets a two-year limitation period that commences two years after the claims arise.
How much is my long-term disability case worth?
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.
What types of compensation can I claim in a long-term disability case?
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.
What are the common causes of disability?
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.
What are my options if my long-term disability claim is denied?
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.
What information is needed to support a long-term disability claim?
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.
When should a long-term disability lawyer be contacted?
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.
Can a mental illness be considered a long-term disability?
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.
How is the Canada Pension Plan Disability different than a long-term disability?
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.
How is short-term disability different than long-term disability?
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.
Do pre-existing conditions impact long-term disability claims?
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.
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