Diabetes, including Type 1 and Type 2 diabetes, can have a profound impact on an individual’s ability to perform everyday tasks.
For Canadians who can’t work due to this chronic condition, long-term disability (LTD) benefits can provide a crucial financial lifeline.
Unfortunately, insurance companies often deny legitimate LTD claims in cases involving diabetes.
One excuse frequently used by insurers to prevent claimants from accessing disability benefits is that they don’t meet the definition of “totally disabled” under their policy.
If your insurance company rejected your claim for LTD benefits based on diabetes, don’t lose hope. Here are three things you need to do.
1. Get your insurer’s reasons for the denial in writing
In our experience, it’s not uncommon for insurance companies to tell individuals over the phone that their LTD claim has been turned down.
If you are informed of the decision verbally, ask your insurer to provide you with a denial letter. This document will force your insurance company to “lock in” their rationale for rejecting your LTD claim.
READ MORE: Denied long-term disability? 4 reasons to get your insurer’s decision in writing
Once you receive the denial letter from your insurer, contact an experienced disability lawyer at Samfiru Tumarkin LLP. We can review your situation, assess your legal options and help you secure the compensation you deserve.
Even if you don’t have a denial letter, you should still reach out to our firm. We provide consultations at no cost to you and can answer any LTD questions that you have.
Get breaking National news
2. Talk to your doctor
After your insurance company provides you with their reasons for turning down your LTD claim in writing, bring the denial letter to your treating doctor. Ask them if they agree with the insurer’s decision.
If you are receiving treatment from several medical professionals, this information should be given to the doctor providing primary care for your diabetes. Depending on the extent of your condition, this could be your endocrinologist.
In the event that your physician disagrees with the insurance company’s decision, have them explain in writing why you can’t resume your job duties due to your diabetes.
READ MORE: ‘Get full support from your doctor’: Disability lawyer’s guide to making insurance claims
If you are already receiving LTD benefits, it’s possible that your insurer could cut off your access on or around the “change of definition” date. This usually occurs two years after your claim was approved.
In this situation, it’s very important that the medical professional providing primary care for your diabetes clearly outlines in writing why it prevents you from doing any work – not just your own occupation.
If your insurance company sends you a list of potential roles that you are qualified for, ask your treating doctor to review it. Make sure that their report explains why you wouldn’t be able to fulfill the needs of each position, or would be limited in doing so, due to your condition.
3. Contact us
For many of our clients, having their legitimate LTD claim turned down was incredibly distressing. They weren’t sure how they were going to pay bills or put food on the table without access to disability benefits.
If you are denied or cut off LTD for any reason, contact an experienced disability lawyer at Samfiru Tumarkin LLP. It’s crucial that you get the right legal advice before appealing your insurer’s decision.
Our compassionate team regularly resolves issues involving LTD, short-term disability, life insurance, critical illness and mortgage insurance claims across Canada.
We provide free consultations and don’t get paid unless we get results. Over the years, we have helped thousands of Canadians, including Sandra Bullock and Julie Austin, secure the compensation that they are legally entitled to.
READ MORE: Insurer being difficult? 3 reasons you should hire a long-term disability lawyer
A troubling case that our firm recently handled involved an office clerk who was struggling with diabetic retinopathy, which is a serious sight-threatening complication of diabetes.
Two weeks after applying for LTD benefits, he got a phone call from his insurance company – informing him that his claim had been rejected.
Shocked by the update, he asked his insurer why his application had been turned down. He was told that their medical consultant didn’t believe he was disabled.
Doing his best to maintain his composure, the employee requested a denial letter before ending the call.
While he waited for the document to arrive, he contacted Samfiru Tumarkin LLP for a free LTD consultation. We explained his rights and potential options, which helped him feel more confident about his case.
As soon as he received the denial letter from his insurance company, he reached out to us again.
After reviewing the document and the reports from the worker’s treating doctor, it was clear that the insurer’s medical consultant didn’t do a comprehensive review of his file.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
The employee’s physician specifically noted in multiple reports that his condition prevented him from doing any work – even on a part-time basis.
Following conversations with the office clerk’s insurance company, we were able to secure an extremely favourable amount of compensation for the worker.
Long-term disability claim denied? Asked if you want to appeal the insurance company’s decision?
Contact the firm or call 1-855-821-5900 for a free consultation with a disability lawyer. We help Canadians across all provinces (excluding Quebec). Get the advice you need and the compensation you deserve.
Sivan Tumarkin and James Fireman are disability lawyers at Samfiru Tumarkin LLP, Canada’s most positively reviewed law firm specializing in employment law and long-term disability claims. The firm provides legal insight on Canada’s only Disability Law Show on TV and radio.