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Long-Term Disability Lawyers Edmonton

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

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A sudden accident or a slowly progressing illness can disrupt your entire life including your ability to work. According to the Canadian Life and Health Insurance Association, 1 in 3 people will be disabled for 90 days or more at least once before retirement. A disability can stop your income, but not your bills. Long-term disability insurance is a type of income replacement benefit that provides income if you are not able to work because of injury or illness. Most LTD plans cover between 60% to 70% of your income if your injury or illness prevents you from working.

How to apply for long-term disability benefits in Edmonton

A long-term disability policy can be purchased through an individual insurance plan or through your employer’s group insurance provider. In many cases, disability coverage starts with short term disability benefits which may later transition into long-term benefits. Short term disability benefits generally provide coverage between 3 to 6 months. It’s important to note that every disability policy will vary from provider to provider so we recommend you review your policy or contact a member of our legal team for help.

Every disability policy comes with a policy booklet which outlines the terms and conditions of the agreement. Most policies also outline the steps to follow if you need to apply for disability benefits. The most common steps are to obtain a claim form, have a medical certificate completed by your physician, and complete and submit the application to the insurance company.

At Preszler Injury Lawyers, we understand Insurance policies can be difficult to understand. If you are having difficulty navigating your claim, you can schedule a free initial consultation with our Edmonton disability lawyers.

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How is eligibility determined for long-term disability claims?

In order to receive long-term disability benefits you must meet the “disability test” in your policy. The test for eligibility usually changes depending on how long it has been since your disability started. For the first two years of your disability, most policies offer coverage if you cannot work in your “own occupation”. After two years this test can become more difficult by requiring you to prove that you cannot do “any occupation” to which you are reasonably suited to do by training, education, or experience.

Every disability policy can vary so it is very important to read the policy carefully. If you have questions about your eligibility, or if the insurance company has denied your disability benefits, we recommend you contact our Edmonton disability lawyers today for help. You don’t pay anything unless we get compensation on your behalf.

Common reasons LTD benefits get denied or terminated

Insurance companies often deny disability claims, and this can be for a number of different reasons. The denial can come at any stage of your claim, including right at the outset. Here are some of the most common reasons that claims are denied:

  • Your insurer believes you are not “totally disabled”
  • You are considered to have a pre-existing condition that is not covered under the policy
  • You have not followed medical recommendations
  • You are not receiving appropriate medical care
  • A change in your health and function
  • You refuse to return to work when the insurance company wants you to
  • You applied for long-term disability benefits too late
  • And more

Regardless of the reason for a denial, it is recommended that you review your case with a disability lawyer. Our team of Edmonton disability lawyers can help you navigate your claim and help you hold the insurance company accountable for what they owe you and your family. Call our legal team for your no-obligation, free consultation today.

What happens if your LTD benefits are terminated before or at the two-year mark?

While you receive long-term disability benefits, insurers work in the background, continually assessing your progress, function, and review updated medical records. It is not uncommon for disability benefits to be denied after being paid for some months or even years. The denial can be difficult to understand when your health has not improved but the insurance company stops paying you.

Under most policies, the two-year mark is an important stage in the life of a long-term disability claim. At this stage, the “own occupation” test can end and the new “any occupation” test comes into effect, making the eligibility for disability benefits more difficult. In some cases, the insurance companies will suggest you can do another job and deny your benefits. In some cases, this might include a job you have never done and one that you don’t think you are healthy enough to do.

If you are facing this situation, our legal team can help you understand the denial and formally dispute the insurer’s decision. Our lawyers can make a claim against the insurance company for the disability coverage you are entitled to as well as punitive and aggravated damages..

Contact our Edmonton long-term disability lawyers for your free, no-obligation consultation

Navigating a long-term disability claim can be difficult and confusing. No two claims are the same and both your obligations and that of the insurance company vary from policy to policy. Insurance companies do not always apply the confusing and technical terms fairly. This can result in an unreasonable denial of disability benefits.

No one should have to face a serious injury or illness while watching their bills pile up – especially when you paid for a safety net. Our legal team can help you recover previously denied benefits, money you have lost because of the denial such as interest on loans, aggravated damages for the worsening of your condition in the face of a denial, and in some instances even pursue punitive damages to punish the insurance company for handling your case in an unfair way. To learn more about how our Edmonton disability lawyers can help you and your family, 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 EDMONTON?

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