Long-Term Disability Lawyers Camrose
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Long-Term Disability Plans in Camrose
If you are unable to earn an income due to a disabling illness or medical condition, long-term disability benefits can protect you as an income replacement. In Alberta, the most common source of long-term disability benefits is through group disability insurance policies which are frequently available through employers. This is when an employer provides benefits as part of a group policy. You can also purchase long-term disability insurance privately through a broker.
Long-term disability plans can vary depending on the provider. It is essential to check your plan to know what benefits you may potentially receive.
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How Much Your Long-Term Disability Claim May Be Worth
The value of a long-term disability claim varies depending on your insurance company. Specific plans will provide a monthly payment covering a certain percentage of your income, usually around 60-70%. Other plans may provide a fixed value while some will provide a percentage of your income but cap it at a specific value. For example, a plan may pay you 65% of your income, up to $2,500 a month.
It’s important to familiarize yourself with your insurance company’s policy to determine what percentage of your income you may receive. Consider contacting our Camrose long-term disability lawyers to schedule a free initial consultation.
Suing for Long-Term Disability
If you are denied long-term disability benefits, you may be able to sue. You may be able to claim the past benefits that were owed, interest on those benefits, mental anguish due to the denial, and punitive damages, among others. When suing, you can request a continuation of monthly payments with a payment for covering the past benefits owed, or you can also request a one-time lump sum payment to be provided. The type of payment you receive is often negotiated with the insurance company.
Hiring a lawyer to help you with your lawsuit can be helpful, as disability law is complex. If your long-term disability claim is denied, and you wish to sue, you must do so within two years of the denial. You may want to reach out to our long-term disability lawyers to arrange a free initial consultation to discuss your potential claim.
Difference Between Own Occupation and Any Occupation
When you apply for long-term disability benefits, you will need to demonstrate that you are unable to complete your duties at your current job. This is known as the “own occupation test.” After a certain period, usually two years, insurance companies will assess whether your medical condition stops you from working in any job that would be appropriate for you based on your training, skills, and experience. This is known as the “any occupation test.”
These tests are used to assess the severity of your disability and to assess if you meet the insurance company’s threshold for “totally disabled.” At the minimum, you can only apply for long-term disability benefits if your illness or medical condition prevents you from working. It may be useful to keep these two tests in mind as you consider starting your application.
How to Apply for Long-Term Disability Benefits in Camrose
Applying for long-term disability benefits requires foresight and planning. Before making a claim, you should review your policy to see the specific requirements, such as waiting periods before you can apply and how disability is defined in your plan.
You should then consult with your doctor. Getting medical attention is the most essential part of a long-term disability claim. Your doctor should work with you to determine if your medical condition stops you from being able to work. Without a precise diagnosis from your doctor, it is unlikely that your claim will be approved. Make sure to gather the necessary medical documents to support your claim.
For most long-term disability claims, there are three key parts: an application form, acquiring medical documentation, and employer reports. These parts will outline the details of your claim, disability, and employment. Once you complete these forms, submit them to your insurance company. Often, the insurance company will follow up and ask for additional information.
Once the insurance company reviews your application, they will notify you of their decision. If they deny your claim, contact our long-term disability lawyers for a free initial consultation. We may be able to assist with disputing the decision.
Reasons Insurers Provide for Rejecting Claims
If you receive a denial for your long-term disability claim, it’s vital that you understand the reason for the denial. Common reasons to deny your claim include:
- Your insurance company doesn’t consider you “totally disabled”: You may not meet your insurer’s standards to qualify for LTD benefits. This may have to do with the symptoms of your condition or a number of other factors. Typically, any condition that stops you from working should be covered.
- There isn’t enough proof of your disability: This is a common way to reject claims. If your doctor states that you have a disability and can explain how, you should generally have a valid claim. Sometimes, insurance companies will also fail to review your evidence correctly.
- Your insurer thinks you can still work: The test for total disability is whether you can do your job, or an appropriate job based on your education, training, age, and experience. The insurance company cannot force you to work in any profession.
- Your Insurer doesn’t agree with your doctor: Insurance companies often have their professionals working behind the scenes to assess your disability. They may reject your doctor’s findings.
- There is a pre-existing condition: Some policies will exclude certain conditions from a policy. Usually, though, exclusions due to pre-existing conditions only apply when you become disabled within the first year of being enrolled in a policy.
What You Should Do If You Are Denied Long-Term Disability Benefits
If you are denied long-term disability benefits, the insurance company will provide a rejection letter that outlines their reasons. If their reasoning is not clear, you should reach out to the insurance company for further clarification on why they are denying your claim.
Keep your rejection letter, as it limits an insurance company’s ability to change their reasons for denial later on. It will also help you craft a strong appeal that highlights why you are, in fact, disabled and are entitled to long-term disability benefits. This letter usually outlines their appeal procedures and formally starts the timeline for making a legal claim.
If you are eligible to dispute your claim, our legal team may be able to help. We know the tactics insurance companies use to deny valid long-term disability claims and have experience with claims like yours.
How Our Camrose Long-Term Disability Benefits Can Help
It can be easy to feel like your world is ending when you are forced to take time off work because of an illness or injury. For many Camrose locals, long-term disability benefits are a much-needed protection from financial hardship. Without these benefits, it can be challenging to stay afloat. This is where our expertise comes in.
Our Camrose long-term disability lawyers are here to support you. We look out for your best interests and will fight for the benefits you deserve. The best part is we don’t get paid unless you win. Reach out to our team to schedule a free initial consultation with our long-term disability lawyers to learn more about how we can help you.
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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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