Attention Deficit Hyperactivity Disorder (ADHD) can dramatically affect 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 vital financial lifeline.
Unfortunately, insurance companies often deny legitimate LTD claims in cases involving ADHD.
One excuse commonly 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 rejects your claim for LTD benefits based on ADHD, here are three things you need to do.
1. Get your insurer’s reasons for the denial in writing
After your LTD claim has been turned down, there is a very good chance that your insurance company will inform you of the decision over the phone.
If this happens to you, ask your insurer to provide you with a denial letter before hanging up. This document will force your insurance company to “lock in” their rationale for rejecting your LTD claim.
READ MORE: Invisible illnesses: Can I still get long-term disability even if I don’t look sick?
As soon as 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.
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Even if you don’t have a denial letter, you should still reach out to my firm. We provide consultations at no cost to you and can answer any LTD questions that you have.
2. Talk to your doctor
Once you have your insurance company’s reasons for turning down your LTD claim in writing, schedule a meeting with your treating doctor. It’s very important that the denial letter is brought to this appointment.
During the meeting, ask your physician if they agree with the insurer’s decision. In the event that they disagree, have them explain in writing why your condition prevents you from resuming your job duties.
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 insurance company 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 crucial that the medical professional providing primary care for your ADHD clearly outlines in writing why it prevents you from doing any work.
If your insurer sends you a list of potential roles that you are qualified for, have your treating doctor 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 my clients, having their legitimate LTD claim turned down created a substantial amount of mental and financial distress. They weren’t sure how they were going to support themselves or loved ones 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 very important that you get the right legal advice before appealing the insurance company’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 Julie Austin and Sandra Bullock, 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 my firm recently handled involved a receptionist who was struggling with ADHD.
Two weeks after applying for LTD benefits, she got a phone call from her insurer – informing her that her claim had been rejected.
Shocked by the update, she asked her insurance company why her application had been turned down. She was told that she didn’t meet the definition of “totally disabled” under their policy.
Doing her best to maintain her composure, the receptionist requested a denial letter before ending the call.
While she waited for the document to arrive, she contacted Samfiru Tumarkin LLP for a free LTD consultation. We explained her rights and potential options, which helped her feel more confident about her case.
As soon as she received the denial letter from her insurer, she reached out to us again. After reviewing the document and the reports from the worker’s treating doctor, it was clear that the insurance company didn’t do a comprehensive review of her file.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
The receptionist’s physician specifically noted in multiple reports that her condition prevented her from doing any work – even on a part-time basis.
Following conversations with her insurer, we were able to secure an extremely favourable amount of compensation for our client.
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 is a disability lawyer and co-founding partner at Samfiru Tumarkin LLP, Canada’s most positively reviewed law firm specializing in long-term disability claims and employment law. He provides legal insight on Canada’s only Disability Law Show on TV and radio.