Post-traumatic stress disorder (PTSD) can have a profound impact on an individual’s ability to perform everyday tasks.
For Canadians who can’t work due to this debilitating condition, long-term disability (LTD) benefits can provide a crucial financial lifeline.
Unfortunately, insurance companies often deny legitimate LTD claims in cases involving PTSD.
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 PTSD, here are three things you need to do.
1. Request a denial letter
Denial letters force insurers to “lock in” their rationale for turning down an individual’s LTD claim.
If your insurance company didn’t have a legitimate reason for denying you access to disability benefits, this document will make it very difficult for them to pivot to a different explanation at a later date.
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.
Even if you don’t have this document, you should still reach out to our firm. We provide free consultations for issues involving LTD and can answer any 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 PTSD. 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.
The more supporting medical documentation you can provide, the better. If you are seeing other specialists or treatment providers, gather their opinions as well.
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 has been approved.
If this situation applies to you, it’s crucial that the medical professional providing primary care for your PTSD clearly outlines in writing why it prevents you from doing any work – not just your own job.
3. Contact us
For many of our 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 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 consultations at no cost to you 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 accountant who was struggling with PTSD.
Three weeks after applying for LTD benefits, she got a phone call from her insurance company – informing her that her claim had been rejected.
Shocked by the update, she asked her insurer why her application had been turned down. She was told that their medical consultant didn’t believe she was disabled.
Doing her best to maintain her composure, the accountant requested a denial letter before hanging up.
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 insurance company, she reached out to us again.
After reviewing the document and the reports from the worker’s treatment team, it was clear that the insurer’s medical consultant only examined certain aspects of her file.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
The accountant’s treating doctors specifically noted in their assessments that her condition prevented her from doing any work – even on an hourly basis.
Following conversations with her insurance company, 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 your insurer’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 Albert Klein 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.