Long-Term Disability Lawyers Fort McMurray

Everyone needs income to afford food, pay bills and look after their family. An injury or illness can prevent someone from earning an income to support their family. Thankfully, many people have access to short-term disability (“STD”) benefits and long-term disability (“LTD”) benefits either through their workplace, union, or that they have purchased privately. STD and LTD benefits exist to provide income to people who are unable to work due to an illness or an injury. Most LTD plans pay monthly benefits of approximately 60% to 70% of what you earned before you became disabled.

LTD disability plans will usually apply to all health conditions, injuries or illnesses. For example, if you have a heart condition and cannot work, that will likely qualify you for LTD benefits. If you have a car accident and injure your back and cannot work, that will also likely qualify you for benefits. If you have depression or another disabling mental health condition, that too can potentially qualify you for benefits.

People who work physical jobs, such as heavy-duty mechanics, oil field workers, or other trades jobs are more likely to need to rely on LTD benefits since the physical nature of their jobs make it easier for an injury to stop them from working. If you or a loved one would like to speak to a long-term disability lawyer and are from Fort McMurray, contact our Fort McMurray long-term disability lawyers today for a free consultation.

Long-Term Disability Benefits Eligibility for Residents of Fort McMurray

Every insurance policy needs to be read carefully to know who qualifies for disability benefits. Most insurance policies have two tests to decide if you are “disabled” and entitled to LTD benefits:

  1. The “own occupation” test; and,
  2. The “any occupation” test.

The own occupation disability test considers whether you are substantially unable to perform your normal job duties. The insurance company will look at your normal job duties and decide if your injury significantly interferes with them. Usually, the own occupation test lasts for two years.

Usually, after two years of receiving long-term disability benefits, your policy will change to an “any occupation” test. The any occupation test means you receive benefits if you cannot do your own job but also other jobs you are reasonably qualified for that pay a similar amount to the job you did before becoming disabled. For example, if you are a drill operator for an oil company and injure your back, you may be unable to do your own job. But you may be able to work as a safety engineer which pays more or a similar amount. Therefore, you would not meet the “any occupation” test.

When an insurance company is deciding if you meet the “any occupation” test, they will only consider comparable jobs. For example, someone earning over $100,000 working on oil rigs should not be cut off from LTD payments because they are able to work at a fast-food restaurant. Fast food restaurant work is not comparable to high paying work in the oil industry.

It is important to note that LTD policies and the “disability tests” do not mean you can’t work in any way at all. Many people work some amount and still receive their monthly LTD payments. It is important to review your policy to know how much you can work and whether you need permission from the insurance company. Any income earned when working is usually deducted from your LTD benefits.

How To Apply for Long-Term Disability Benefits in Fort McMurray

In order to apply for LTD benefits, you will need to ask the insurance company, your employer, or your union for a copy of the application materials.

The application materials will have a series of questions. It is important to be accurate when filing out your documents. Ensure that you list evert single health condition you have that impacts your ability to work. If you miss one of your symptoms or health problems, then the insurance company may not consider it.

The second part of applying for LTD benefits is having your doctor fill our the medical section of the application. Your doctor will describe your health conditions and why you are unable to work. It is important to see your doctor before they fill out the form to ensure they know about all your symptoms and health problems. Accuracy matters.

You will also likely want to gather your medical records, such as your family doctor’s clinical notes or treatment notes from physiotherapists, other therapists, or specialist doctors you have seen. If you ask for your medical file, your treatment providers will send you a copy. You can also sign an authorization letting the insurance company gather your medical file for you.

It is important to apply for LTD benefits soon after you become disabled. Most policies have deadlines for the application to be sent in. If you miss a deadline, it may be important to speak with an LTD lawyer to pursue “relief from forfeiture”, which is a way to extend deadlines from insurance contracts.

Once you submit your application materials, the LTD insurance company may have questions for you. Answer the questions to the best of your ability.

Long-Term Disability Claims & Unions: How This Works in Fort McMurray

If you work in a unionized workplace, then you may be forced to seek help from your union.

All matters addressed by collective agreements should usually be grieved by the union in an arbitration procedure. In Hutton v. The Manufacturers Life Insurance Company (Manulife Financial), 2019 ONCA 975, an Ontario court prevented a unionized worker from suing her disability insurance company. This is because a Supreme Court of Canada decision Weber v. Ontario Hydro [1995 2 S.C.R. 929], states that courts cannot decide mattes that are in their “essential character, arises from the interpretation, application, administration or violation of the collective agreement”.

It is important, therefore, to ask your union if you can sue privately or whether the union must handle your LTD denial. It is also important to have an LTD lawyer review your collective agreement to decide if you have the right to hire a lawyer and sue privately. Some people do and others do not.

Pre-Existing Medical Conditions & Long-Term Disability Claims

Most insurance policies will have pre-existing medical conditions clauses. Pre-existing medical conditions clauses generally apply to the first year that someone joins a workplace or is added to the LTD benefits plan. The purpose of these clauses is to prevent people from joining jobs to get coverage and then quickly making a claim for benefits. The pre-existing medical condition clause usually only lasts for the first year that you become eligible to receive LTD coverage (which is usually your first year at the job providing you with benefits).

Pre-existing medical condition clauses need to be read carefully. Insurance companies can apply them too broadly and in unfair ways. For example, if you have depression and then are in a car accident and injure your back, the insurance company might argue the pre-existing condition clause applies even though your depression is not what stopped you from working; that would be unfair. It is important to have an LTD lawyer review all denials based on pre-existing medical conditions carefully.

Common Reasons People Apply for Long-Term Disability Benefits

There are many reasons that people apply for long-term disability benefits. Common reasons include:

  • Back injuries
  • Shoulder injuries
  • Knee or other joint injuries
  • Chronic pain or complex regional pain syndrome
  • Fibromyalgia
  • Cancer
  • Heart conditions
  • Anxiety or depression
  • Arthritis
  • Other mental health concerns
  • PTSD
  • Car accident injuries
  • Injuries from falls
  • Injuries at work

Long-Term Disability Claims and Taxation

Some LTD plans are taxable, meaning the insurance company will withhold taxes in the same way an employer does for payroll.

Not all LTD plans are taxable, however. Generally, if you contribute in some way to your LTD plan, such as by paying for part of the premiums before you become disabled, your plan will be non-taxable, meaning you receive 100% of the monthly benefit without tax deductions.

CPP Disability

All Canadians who pay into CPP also pay into CPP disability (“CPPD”).

Most people think of CPP as a retirement pension that Canadians pay into over their working years and then receive when they turn 60 or 65.

CPP is not only a retirement pension. It also includes a federal disability plan that can pay you up to $1,600 per month (increasing each year) if you are disabled and cannot work.

You can receive CPPD benefits until the age of 65.

Another benefit of CPPD benefits is that they will contribute to your CPP retirement pension to ensure you can still receive retirement benefits at the age of 65. If you cannot work, then you would not be contributing to CPP benefits so your retirement pension could be much smaller than it otherwise would be. This is one of the main reasons it is important to apply for CPPD if you are disabled and cannot work: it will make sure you have ongoing disability benefits and will also ensure you have a retirement pension at the age of 65.

Most LTD plans require you to apply for CPPD. It is important that you follow through with this obligation otherwise the insurance company may reduce your monthly LTD benefits as a sort of penalty for failing to apply to CPPD.

Your LTD benefits will usually be reduced by your monthly CPPD benefit. For example, if your LTD benefit is $3,000, and you then get approved for $1,000 per month in CPPD benefits, your LTD benefits will be reduced to $2,000 per month.

Many people believe that it is not fair for the federal government’s CPPD plan to essentially supplement LTD insurance companies. If anyone should receive a “discount”, it should be the government and taxpayers. Or perhaps, instead, disabled people should be able to keep their full LTD benefits and CPPD benefits since they have usually paid premiums for both. Until the law changes, this issue will remain unresolved.

Why Are Long-Term Disability Benefits Terminated In Fort McMurray?

Unfortunately, insurance companies often wrongfully terminate LTD benefits, leaving disabled people without any source of income.

Common reasons for wrongfully denying people can include:

  • Saying you are not “totally disabled” because of your health condition
  • Suggesting your doctors are wrong about your disability
  • Ignoring your doctor’s opinions
  • Saying you can return to work
  • Saying you cannot do your own job but you can return to some form of work
  • If you refuse to go back to work when the insurance company asks, even if it is not safe
  • Saying you do not have “objective” proof of your disability, even though your policy does not require it
  • Listening to the opinions of doctors they hire over your treating doctors
  • You have a pre-existing condition
  • Saying your pain does not disable you
  • Saying you did not follow medical advice

Our lawyers have seen the denials above used to wrongfully deny LTD benefits, forcing our clients into desperate financial circumstances. When our clients are wrongfully denied, we insure we seek back the LTD benefits owed and punitive or aggravated damages to punish the insurance company’s bad behavior.

Schedule A Free Consultation With Our Fort McMurray Long-Term Disability Lawyers

Our Fort McMurray long-term disability lawyers know that LTD denials can cause serious financial problems for our clients and their families. Our lawyers do everything we can to remove financial barriers to accessing justice, including offering contingency fee agreements where there are no up-front fees and no fees at all unless we are able to win your case.

If you wish, we will also seek to settle your LTD claim on a lump sum basis so you can instead focus on your family and your health.

To learn more about working with our long-term disability lawyers, contact us today and receive your free initial consultation.