Long-Term Disability Lawyers Grande Prairie

How Do You Apply for Long-Term Disability Benefits?

When your ability to work stops due to a serious injury or medical condition, your regular expenses like bills, rent, or mortgage payments do not. When Albertans find themselves in a situation like this, they need some form of income replacement to avoid financial hardship. Long-term disability insurance serves as that income replacement with many plans covering 60%-70% of your income. You probably hope you’ll never need it, but it’s better to have it than not.

You can buy long-term disability insurance privately through an insurance broker. You may have access to it through your employer’s group insurance policy. If this is the case, your employer is likely paying the premium cost, but sometimes this cost is shared between the employer and the employee. The application process can vary depending on your insurance provider. You should familiarize yourself with your insurer’s policy to determine if you are eligible to receive long-term disability benefits.

You’ll need to obtain a copy of the necessary application form. Your human resources representative should have these on hand, but you can also reach out directly to your insurance company. Be aware of any deadlines with the application and make sure you’re not late with handing in any forms. It’s also vital that you’re completely honest on these forms and do not embellish any details regarding your injury or condition. The wording in these policies can be confusing and the process can feel overwhelming at times. Consider reaching out to our Grande Prairie long-term disability lawyers today for a free initial consultation.

How Do Pre-Existing Conditions Affect my Long-Term Disability Claim?

When applying for long-term disability insurance or reading up on your company’s policy, you may have a pre-existing medical condition on your mind already. Many insurers have also had this concern and have included provisions to address this in their policies. When reading your insurance company’s conditions, pay attention to see if your particular medical condition has been named.

Sometimes insurance companies will specify pre-existing medical conditions as grounds to exclude individuals from collecting long-term disability benefits. These potential exclusions can vary depending on the provider. Acquaint yourself with your insurance company’s terms and policies to determine what may be applicable for you.

What Type of Information is Needed for a Long-Term Disability Claim?

Long-term disability benefits don’t only cover physical medical issues. They can also cover mental health issues as well. In fact, in 2022 mental health disabilities were among the most common types. Here are a few medical issues that policies usually cover:

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

Your insurance company will likely need suitable evidence that your injury or condition is preventing you from working. Each company has their own assessment process, but you will likely need to see your doctor(s) to have them complete the necessary documentation. The opinions of healthcare professionals are typically a vital element in this process. It may be helpful to keep a detailed notes of any meeting or phone call you have regarding your disability claim. This may include doctors’ appointments and any discussions you have with insurance representatives. This process can be perplexing at times so it may be strategic to organize your thoughts.

There may also be telephone interviews with a representative from your insurance company. They may also come and observe you in person to see what duties you’re capable of in your current occupation. The steps you go through may be different from what you might have previously heard from friends or coworkers who applied for LTD benefits. It’s important to be patient and participate in every step with your insurance company. The insurer will likely want you to demonstrate that you are unable to perform the duties for your own occupation. This is known as the “own occupation test.” After two years, they will likely want you to demonstrate that you are unable to work in any comparable occupation. This is known as the “any occupation test.”

This process can feel daunting, but you are not alone. Consider reaching out to our Grande Prairie long-term disability lawyers for a free initial consultation.

I’m a Unionized Employee. Will This Affect My Long-Term Disability Application?

Being in a union can affect how your long-term disability benefits are managed and how claims are disputed. This can vary heavily depending on the employer and the specific union itself. To fully educate yourself on how your union can affect these claims, it is best to familiarize yourself with your union’s collecting bargaining agreement and your insurance company’s policies.

What if My Long-Term Disability Benefits Are Terminated Before or at the Two-Year Mark?

After you have submitted all the required information for your long-term disability claim, you may find yourself waiting as long as 8 weeks for a decision. There is no set timeline for the insurer to reach a decision and you may be dealing with mounting expenses and your own recovery process in the meantime. Sometimes all this waiting can result in a denial of your claim.

In other instances, your claim may be accepted, and you’ll start to receive benefits. Then, before or at the two-year mark, your insurer may terminate your benefits. There are several reasons why an insurer may deny your claim or terminate your benefits. Some of these reasons are:

• The insurance company has evidence that refutes your claim
• Your insurer does not believe you are “totally disabled”
• Your insurer disagrees with your doctor
• Your insurance company requested you to return to work and you have not
• You have not been completing your treatment plan
• This covers only a few possible reasons and is not an exhaustive list

If your claim is denied or your benefits are terminated, it is important that you fully understand the reason. While one of the above reasons may be cited, there is a chance that you have received a wrongful denial. You may wish to dispute the decision because you may have no other options for income replacement while you are out of work. If you do plan on arguing your denial, it’s important to keep in mind that the insurance company likely has plenty of experience with claims like yours. It may be advantageous to have someone with similar experience negotiating on your behalf. Consider reaching out to our Grande Prairie long-term disability lawyers for a free initial consult today.

Contact Our Grande Prairie Long-Term Disability Lawyers for a Free Initial Consultation Today.

Deciding whether to hire a lawyer to help dispute an LTD denial is a very personal choice and should not be taken lightly. It may be strategic to have someone on your side who is familiar with these types of claims as well as the tactics employed by different insurance companies. Call our Grande Prairie long-term disability lawyers today for a free initial consultation. And remember, you don’t pay unless we win.

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