Osteoporosis can have a profound impact on an individual’s ability to perform everyday tasks.
In certain situations, it’s nearly impossible for Canadians 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 osteoporosis.
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 osteoporosis, don’t panic. Here are three things you need to do.
1. Get 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 this happened to you, contact your insurance company immediately and request a denial letter. This document will force them to “lock in” their reasons for rejecting your LTD claim.
READ MORE: Most common mistakes people make when they are denied long-term disability
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 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 osteoporosis. 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 situation applies to you, make sure that the doctor providing primary care for your osteoporosis 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 office clerk who was struggling with osteoporosis.
Three weeks after applying for LTD benefits, she received a letter from her insurance company – informing her that her claim had been rejected because she didn’t meet the definition of “totally disabled” under their policy.
Not sure what to do next, she decided to call Samfiru Tumarkin LLP for a free LTD consultation.
Confident that she had a strong case, we told her to get the denial letter reviewed by her treatment team, which included an endocrinologist and a rheumatologist.
The office clerk’s treating doctors were shocked by the insurer’s decision. They clearly outlined in writing why her condition prevented her from doing any work – even on a part-time basis.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
With full support from the medical professionals involved in her care, she contacted us again.
Following conversations with the office clerk’s 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 Michael Gerhard 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.