For British Columbians who can’t work due to an illness or injury, getting their long-term disability (LTD) claim approved is only half the battle.
The other half is maintaining access to disability benefits until they are ready to re-enter the workforce.
Unfortunately, it’s not uncommon for insurance companies to cut individuals off LTD while they are still disabled.
If you are currently receiving disability benefits, here are four “red flags” to watch for.
1. Your insurer randomly asks you to complete daily activity logs
Being asked out of the blue to start documenting everything you did from the moment you woke up to when you went to bed should set off alarm bells.
If you find yourself in this situation, proceed with caution. Your insurance company might be trying to prove that you no longer need to be on LTD.
READ MORE: Invisible illnesses: Can I still get long-term disability even if I don’t look sick?
When completing an activity log, be thorough and honest. Any details you fail to include, even if it was an accident, could be used to sever your access to disability benefits.
2. Your insurer asks you to participate in an independent medical examination
Despite the name, independent medical examinations (IMEs) are rarely independent.
Since these assessments are paid for by your insurance company, they get to pick which doctor will evaluate your ability to work.
In our experience, insurers use IME reports to justify cutting a claimant off LTD or to demand a change to their treatment program – often without input from the medical professionals involved in their care.
READ MORE: Asked to submit to an IME? Here’s what you need to know
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If your insurance company asks you to participate in an IME, contact an experienced disability lawyer at Samfiru Tumarkin LLP. We can help you prepare for the assessment and explain what you need to do afterwards.
3. Your insurer recommends a work hardening program or rehabilitation
To get the ball rolling on a return to work, some insurance companies will recommend a work hardening program or rehabilitation.
For claimants who aren’t ready to re-enter the workforce, suddenly being asked to participate in either of these programs can create a significant amount of anxiety.
If your insurer calls you and recommends a work hardening program or rehabilitation, ask them to provide you with the details in writing.
READ MORE: Insurer forcing you back to work in British Columbia? 3 things you must do
As soon as you receive the specifics from your insurance company, contact our firm. We can review the proposed return-to-work plan and advise you of potential next steps.
Even if you don’t have this document, you should still reach out to us. We provide LTD consultations at no cost to you and can answer any questions that you have.
4. Your insurer mentions that your “change of definition” date is approaching
After being on LTD for two years, most policies require claimants to pass a new test to be considered “totally disabled.” This is known as the “change of definition” date.
To continue receiving disability benefits, you must prove that your condition prevents you from doing any work, not just your own occupation.
In some cases, insurance companies use this change as an excuse to cut individuals off LTD – claiming that they no longer meet the definition of “totally disabled” under their policy.
If your insurer randomly mentions that your change of definition date is approaching, or suggests you can do other jobs, seek legal counsel immediately.
READ MORE: Most common mistakes people make when they are denied long-term disability
A troubling case that our team will never forget involved an accountant in Vancouver.
The individual, who was struggling with depression, received a phone call from his insurance company – notifying him that his change of definition date was two months away.
Worried that his insurer was getting ready to cut off his access to LTD benefits, he contacted Samfiru Tumarkin LLP for a free consultation. We informed him of his rights and potential options in the event that his insurance company decided to stop his benefit payments.
As he feared, his insurer sent a denial letter on his change of definition date – explaining that he had been cut off LTD because he no longer met the definition of “totally disabled” under their policy.
For a moment, the accountant considered appealing the decision without consulting a disability lawyer. However, he ultimately decided to bring the document to us.
Confident that he had a strong case, we told him to get the denial letter reviewed by his treatment team.
The accountant’s treating doctors were shocked by the insurance company’s decision. They clearly outlined in writing why his condition prevented him 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 his care, he contacted us again.
Following conversations with the accountant’s insurer, we were able to secure an extremely favourable amount of compensation for our client.
Let us fight for you
If you believe that your insurance company is getting ready to cut off your access to disability benefits, or they already have, contact an experienced disability lawyer at Samfiru Tumarkin LLP.
Our compassionate team regularly resolves issues involving LTD, short-term disability, life insurance, critical illness and mortgage insurance claims across Canada.
READ MORE: Insurer being difficult? 3 reasons you should hire a long-term disability lawyer
We provide free consultations for these types of matters 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.
Think you’re about to be cut off long-term disability? Received a denial letter?
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 Martin Willemse 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.