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Long-Term Disability Lawyers Cochrane

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Speak with our Cochrane long-term disability lawyers and get legal answers to your long-term disability questions.

Table of Contents

How Can I Apply for Long-Term Disability Benefits?

You might find yourself in a situation where you cannot work due to a serious injury or a medical condition. Your hydro bill, mortgage or rent payments, and other expenses will still pile up while you’re away from work. Long-term disability insurance serves as an income replacement to keep any financial hardship at bay while you focus on your recovery. Sometimes it is the only solution Albertans have. You can purchase long-term disability privately, but it is often available through your employer’s group disability insurance policy. In which case, your employer is likely paying the premium on the policy. Sometimes the cost is shared between the employer and the employee.

When starting the process of applying for long-term disability benefits, it’s important to carefully read your insurance company’s policy and terms to determine if you are eligible. Each company’s policy can vary, and one may not be like the other. Be aware of any deadlines involved in the process and make sure to hand in all the necessary forms on time. It may be useful to diarize any important dates in an effort to stay ahead of them.

Consider keeping a careful written account of everything related to your disability case. This could include making notes during any visit with a healthcare provider or insurance adjuster. The process can be confusing, and you may feel like you’re going in circles, but organizing your thoughts like this can help keep you on track.

Some common steps in this process are:

  • Speaking with your doctor(s): It will likely be necessary to obtain medical support for your LTD claim to demonstrate that your condition prevents you from working. You may need to encourage your doctor to submit their section of the application in a timely manner.
  • Phone interview with your insurance adjuster: A representative from your insurance company will likely have some questions regarding your condition as well as your duties in your current job. The assessment process can vary and is handled on a case-by-case basis. Be patient and don’t be alarmed if the process is different from what you may have previously heard from friends or coworkers.
  • Submit your portion of the application: There will likely be a section of the application that you must fill in yourself. Make sure to be completely truthful and provide all the requested information. Incomplete forms can potentially slow the process.
  • These are only a few potential steps, and this is not an exhaustive list. 

This process can feel confusing and overwhelming at times. You may wish to reach out to our Cochrane long-term disability lawyers and schedule a free initial consultation.

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What Should I Look for in a Long-Term Disability Policy?

Reading insurance policies on long-term disability benefits can be bewildering. The wording can be difficult to understand, and you may not be finding the answers to your questions. While these policies can vary depending on the company, it can be useful to look out for a few specific details in your research:

  • Does the policy exclude any specific injuries or medical conditions: Some insurance companies won’t cover certain categories of ailments that might stop someone from working. It may be useful to consider your own medical history and see if any of these exclusions might apply to you.
  • Do any pre-existing conditions exclude you from collecting benefits: Similar to the above-mentioned point, it’s vital to be aware of these types of exclusions to make sure you won’t be barred from collecting LTD benefits.
  • The benefit period: Sometimes benefits are only payable for a limited period of time. Many insurance companies operate with two-year periods in mind. For other companies, it may be until age 65.
  • Are the benefits taxable: Usually, benefits are taxable, especially when premiums are paid by the employer on behalf of the employee.
  • While these details are important, this is not an exhaustive list. 

What Types of Disabilities are Eligible for Long-Term Disability Benefits?

When people think of long-term disability benefits, physical conditions and injuries are likely the first things to come to mind. But mental health issues are also covered by many insurance policies as well. In fact, in 2022, mental health disabilities were among the most common types. It’s still important to consult your own insurance company’s policy to determine your eligibility.

Some common conditions that policies cover are:

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

The common threshold for a condition being covered is whether said condition prevents you from working. Insurance companies may require evidence at first that you are unable to work in your current occupation. This is known as the “own occupation test.” After a two-year period, they may ask for evidence that you are unable to work in any comparable occupation, which is known as the “any occupation test.” If you are struggling with determining your eligibility or understanding a decision on your long-term disability benefits claim, consider reaching out to our Cochrane long-term disability lawyers for a free initial consultation today.

Why Might My Long-Term Disability Claim Be Denied?

After you’ve submitted everything you need for your LTD benefits application, you may find yourself waiting up to 8 weeks. There are no set timelines for when insurance companies need to reach a decision. At the end of this process, you may receive a denial. There are many reasons why insurance companies deny long-term disability benefits applications.

Some common reasons for denials are:

  • You are not following your treatment plan
  • You were too late when submitting your application
  • Your insurance provider is not convinced you are “totally disabled”
  • You have not completed a necessary form
  • A pre-existing condition prohibits you from claiming LTD benefits
  • There is evidence that contradicts your claims
  • Your insurer believes you’re capable of working in a different job
  • And more

Some of the reasons mentioned involve simple solutions, but other issues are more complex and can take more time to solve. You may be considering reaching out to our Cochrane long-term disability lawyers to schedule a free initial consultation.

What Should I Do if My Long-Term Disability Claim is Denied?

You may find yourself in a position where your long-term disability claim has been denied, yet you have no other options for income replacement. Make sure you have carefully read over your denial letter and completely understand the reasons cited for the denial. You may wish to dispute the claim, but keep in mind that your insurance company likely has significant experience dealing with claims like yours. You may wish to have someone help you negotiate who is more familiar with LTD claims and the maneuvers often used by insurance companies.

Our Cochrane Long-Term Disability Lawyers are Here to Help. Contact us for an Initial Free Consultation.

If you qualify to argue your claim’s denial, our legal team may be able to help. When facing a denial of your LTD benefits, you might be feeling hopelessness or despair. Remember, you are not alone. Many Albertans have faced these same challenges, and our Cochrane long-term disability lawyers are experienced with these claims. Reach out today for a free consultation. And remember, you don’t pay unless we win.

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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.

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