For many Canadians, multiple sclerosis (MS) can be physically and mentally debilitating. In certain situations, it’s nearly impossible for individuals to continue working – even with a significant amount of medication and treatment.
Unfortunately, insurance companies often deny legitimate long-term disability (LTD) claims in cases involving MS.
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 rejected your claim for LTD benefits based on MS, here are three things you need to do.
1. Confirm your insurer’s reasons for the denial in writing
Instead of sending a letter or email, some insurance companies tell individuals over the phone that their LTD claim has been turned down.
By informing claimants verbally, insurers are able to adjust their rationale in the event that the decision is challenged.
If you were notified by phone that your LTD claim for MS had been rejected, contact your insurance company immediately and request a denial letter. This document will make it very difficult for them to pivot to a different explanation at a later date.
READ MORE: Most common mistakes people make when they are denied long-term disability
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As soon as you receive the denial letter from your insurer, connect with 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 this document, you should still contact my firm. We provide consultations at no cost to you and can answer any LTD questions that you have.
2. Discuss the denial with your treatment team
After receiving the denial letter from your insurance company, schedule a meeting with the doctor providing primary care for your MS. It’s very important that the document 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.
If other medical professionals are involved in your treatment, gather their opinions as well. The more supporting documentation you can provide, the better.
READ MORE: ‘Get full support from your doctor’: Disability lawyer’s guide to making insurance claims
In some cases, insurance companies cut individuals off LTD benefits on or around the “change of definition” date. This usually occurs two years after a claim was approved.
If this happened to you, make sure that the doctor providing primary care for your MS clearly outlines in writing why it prevents you from doing any work – not just your own occupation.
3. Contact us
For many of my clients, having their legitimate LTD claim turned down was devastating. 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 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 heartbreaking case that my firm recently handled involved an office clerk who was struggling with MS.
Two weeks after applying for LTD benefits, she got a phone call from her insurance company – informing her that her claim had been rejected.
Fighting back tears, she asked her insurer why her application had been turned down. She was told that she didn’t meet the definition of “totally disabled” under their policy.
Not sure what to do next, the office clerk decided to contact Samfiru Tumarkin LLP for a free LTD consultation. We told her to call her insurance company back and request a denial letter.
As soon as she received the document from her insurer, she notified our team. After reviewing the denial letter 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 office clerk’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.