Long-Term Disability Lawyers St. Albert
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Table of Contents
Why Do I Need Long-Term Disability Insurance?
Not everything in life is expected. A serious injury or medical condition can easily throw you for a loop and cause you to miss work. Your daily routine may be thrown off course but your daily expenses and mortgage or rent will continue as usual. The chances of experiencing these types of ailments can increase as you get older. In fact, the growth of Canada’s senior population between 2017 and 2022 contributed to the rising disability rate. Long-term disability insurance serves as an income replacement to help protect you from financial hardship while you’re unable to work.
This may be the only option for income replacement for some Albertans recovering from an injury or a debilitating medical condition. Ideally you should focus your time and energy on recuperating instead of worrying about your expenses. Navigating these claims can be confusing at times. Consider reaching out to our St. Albert long-term disability lawyers for a free initial consultation.
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How Do I Apply for Long-Term Disability Benefits?
The application process for long-term disability benefits can be time-consuming and tedious. Long-term disability insurance can be purchased privately through an insurance broker, or it may be available through your employer’s group disability insurance coverage. If this is the case, then your employer may be paying the premium for this insurance. Sometimes this cost is shared by the employer and employee. While some of the possible steps for applying for LTD will be outlined here, you should consult your insurance company’s guidelines to see what they will expect.
Some typical steps in the process are:
- Secure a copy of your application form: A representative from your human resources department should be able to provide you with the required documents to begin your application. You can also reach out directly to your insurance company or it may be available on their website.
- Speak with your healthcare provider: Your insurer will likely require medical documentation to demonstrate that your ailment prevents you from working in your occupation. Medical support is often an essential part of any long-term disability application. You may need to remind your doctor(s) to complete their section of the application form.
- Submit your portion of the application form: There will likely be a section of the application that you are responsible for completing. Make sure to include all the information that is requested. If the application is incomplete, it could slow down the decision-making process for the insurance company.
- Participate in your insurer’s assessment: The assessment process can vary on a case-by-case basis. This could involve a phone interview with a representative from the insurance company or an in-person assessment. This could be different from what you may have heard from friends or coworkers who applied for long-term disability benefits. It’s important to be patient and remember that the sooner the assessment is complete, the sooner a decision can be reached.
- This is not an exhaustive list and there may be additional steps.
You should also be mindful of any deadlines in the application. Make sure to diarize these dates and do your best to stay ahead of them. This process and the steps involved can feel formidable but remember that you are not alone and there are helpful resources available. Contact our St. Albert long-term disability lawyers today for a free initial consultation.
What Conditions Are Covered Under Long-Term Disability Insurance?
To determine if your condition is covered under your long-term disability insurance plan, you should consult your company’s policy. Generally, any issue that prevents you from working should be covered. This doesn’t stop at physical injuries or medical conditions. It also includes mental health issues.
Some conditions that are frequently covered under these policies are:
- Heart disease
- Cancer
- Crohn’s disease
- Fibromyalgia
- Arthritis
- Musculoskeletal injuries
- HIV and AIDS
- Back pain
- Migraines
- Paralysis
- Herniated discs
- Anxiety
- Neurological disorders
- Multiple sclerosis
- Depression
- Post-traumatic stress disorder (PTSD)
- Psychological disorders
- Lupus
- Lyme disease
- Bipolar mood disorder
- Panic attacks
- And more!
To demonstrate that your condition prevents you from working, you may be required to specifically prove that you are unable to complete work in your current position. This is known as the “own occupation test.” After two years or another specific period of time chosen by your insurer, you may be required to prove that you are unable to complete work in any position that you might normally be qualified for. This is known as the “any occupation test.” Consult your policy to see what may apply to your situation. You may want to contact our St. Albert long-term disability lawyers for a free initial consultation.
What is the Difference Between Long-Term Disability and Short-Term Disability?
You may experience an injury or medical issue that causes you to miss work, but not indefinitely. In two to three months, you may be fully recovered and be ready to go back to work. In situations like this, short-term disability insurance may be the best solution for income replacement. For short-term disability insurance, the coverage can usually last for about 120 days, but this can vary depending on the provider.
When what was initially a temporary problem continues for longer than expected, then a more permanent solution is needed. This is when long-term disability insurance can step in and provide an income replacement. It’s not unusual to start off on short-term disability insurance and transition to long-term later on. Your insurance company’s guidelines will outline your options in this area.
What Are Some Reasons Why my Long-Term Disability Claim Might be Denied?
After providing copious amounts of proof and documentation regarding your condition, you may find yourself waiting for a decision from your insurance company. There is no set timeline for when your insurer must respond to your application, so you may find yourself waiting up to 8 weeks. At the end of this process, you may unfortunately receive a denial. This can be frustrating and intimidating as you try and figure out your options for dealing with mounting expenses. There are several reasons why your claim may have been denied.
Some common reasons for denial are:
- Your insurance company does not agree with your doctor’s opinion
- Your insurer believes you are not disabled
- You’re missing necessary medical documents
- Your insurer considers you capable of working in a different field
- You have been ignoring the steps in your treatment plan
- You have violated or breached a term in your LTD policy
- Your insurer acquired evidence that brings your claim into question
- Due to a pre-existing condition, you are excluded from receiving LTD benefits
- And more
Some of these reasons may require simple solutions, but others are more complex. If your claim is denied, it is vital that you completely understand the reason for the denial. Any one of the reasons mentioned above could potentially be a wrongful denial. You may wish to dispute the denial, especially if you have no other options for income replacement. Fighting an insurance company on their decision can be daunting and difficult. You may wish to have someone negotiating on your behalf who has experience with these types of claims. Reach out to our long-term disability lawyers to arrange a free initial consultation.
Contact Our St. Albert Long-Term Disability Lawyers for a Free Initial Consultation. We are Here to Help.
The idea of taking on an insurance company in an effort to have them reverse their decision on your long-term disability benefits may feel nerve-racking. If you are eligible to argue against the denial of your claim, our legal team may be able to help recover compensation that you are potentially owed. This could include interest on loans that have built up while dealing with the claim or damages due to the worsening of your condition. To find out if our long-term disability lawyers can help, schedule a free consultation today.
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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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