Long-Term Disability Lawyers Okotoks
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Dealing with a serious physical injury or medical condition can force you to re-evaluate what’s important in life. And in that re-evaluation, you may have to take a leave from work. While the structure of your life may be disrupted, your regular expenses such as your bills and rent will continue as usual. Long-term disability serves as a source of income replacement to protect you from financial hardship. This will allow you to focus your energy on healing and recovery.
You have the option of buying long-term disability insurance privately or you may have access through your employer under a group disability insurance plan. If the latter is applicable, then you’ll need to obtain a copy of the initial application from a member of your human resources team. You also may be able to get a copy directly from your insurance company on their website. Make sure to diarize any due dates involved in the application process and do your best to stay ahead of them. Before beginning the application process, familiarize yourself with your insurance company’s policy and terms to determine that you are eligible. Navigating this process can be difficult. Our Okotoks long-term disability lawyers may be able to help answer your questions. Contact us today to schedule a free initial consultation.
What Medical Issues Are Covered Under Long-Term Disability?
Any injury or illness that prevents you from working would normally be covered under most long-term disability policies. To see if your diagnosis is covered, you should consult your insurance provider’s terms. The types of ailments that are covered are not limited to strictly physical ones either. Mental health issues such as depression, anxiety, and panic attacks are also included. While the symptoms are not always obvious, they can still cause you to stop working.
Some common issues covered under many policies are:
- Fibromyalgia
- Multiple sclerosis
- Cancer
- Back problems
- Migraines
- Arthritis
- Lupus
- Lyme disease
- Crohn’s disease
- Psychological disorders
- Bipolar mood disorder
- Panic attacks
- Herniated discs
- Neurological disorders
- Depression
- Anxiety
- Post-traumatic stress disorder (PTSD)
- And more
There may be other conditions not listed here that could still be covered. The insurance company will likely want you to demonstrate at first that your issue restricts you from working in your current job. This is known as the “own occupation test.” If you are put on LTD benefits, then usually after two years (this number can vary), your insurer will want proof that you’re unable to work in any occupation that you might normally be qualified for. This is known as the “any occupation test.” Keep this in mind as you start to consider what information you’ll need to provide on your application.
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What Information is Needed for a Long-Term Disability Benefits Application?
Your insurance company will likely require medical documentation to illustrate that your ailment prevents you from completing your occupational duties. This will likely involve visiting your healthcare provider for an examination. Your healthcare provider will also likely need to fill out a form on your behalf. While you may only need to visit your doctor(s), there’s a chance the insurance company will request that you be examined by a doctor of their choosing.
You may need to complete a phone interview with a representative from your insurance company. There may also be an in-person portion of the assessment as well. You’ll need to provide demographic information, banking information, occupational information, and any other information regarding your condition. Your experience with this assessment may be different from what you previously heard from coworkers who also went through this process. Be patient and be an active participant in the assessment. The sooner these steps are completed, the sooner your insurance company can reach a decision. These claims can be overwhelming and confusing. You may want to contact our Okotoks long-term disability lawyers to schedule a free initial consultation.
Why Was my Long-Term Disability Claim Denied?
Once you’ve provided all the necessary information, you may find yourself forced to wait up to 8 weeks. There is no set minimum amount of time within which insurance companies must make their decisions with these claims. At the end of this long wait, you may be told that your claim has been denied. This can be discouraging and disappointing. There are several reasons why a claim might be denied. If your claim is denied, it’s essential that you understand the reason given.
Some typical reasons for a denial are:
- Your insurer disagrees with your doctors regarding your condition
- Your insurance company does not believe you are “totally disabled”
- Your insurer believes you can work in a different field
- Your insurer has acquired evidence that contradicts your claims
- Your insurer believes there is no diagnosis for your disability
- A pre-existing condition excludes you from collecting LTD benefits
- You have not been following your treatment plan
There may be other reasons not cited here as this is not an exhaustive list. Any one of these reasons may be a wrongful denial and we have been successful in winning cases with all of the reasons for denial noted above. If you cannot work sustainably, you will likely want to dispute your denial. Keep in mind that your insurance company likely has lots of experience with these types of claims. You will want someone negotiating on your behalf who has similar experience, knows the law, and has experience winning LTD denial cases.
Our Okotoks Long-Term Disability Lawyers Are Available for a Free Initial Consultation
Our legal team is familiar with long-term disability claims like yours and with the tactics used by insurance companies. If you are eligible to dispute your claim, we may be able to help you recover compensation that you are entitled to. Such compensation may include damages resulting from your claim. Dial our Okotoks long-term disability lawyers to arrange 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.
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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