Being diagnosed with schizophrenia can change an individual’s life forever. 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 schizophrenia.
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.
READ MORE: Invisible illnesses: Can I still get long-term disability even if I don’t look sick?
If your insurance company rejected your claim for LTD benefits based on schizophrenia, 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: 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.
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Even if you don’t have this document, it’s still in your best interest to contact our firm. We provide free consultations for issues involving LTD.
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 schizophrenia. 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 has been approved.
If this situation applies to you, it’s crucial that the medical professional providing primary care for your schizophrenia clearly outlines in writing why it prevents you from doing any work – not just your own occupation.
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
One case that our firm will never forget involved a receptionist who was cut off LTD on her change of definition date.
Struggling with schizophrenia, the individual received a letter from her insurance company – informing her that she no longer met the definition of “totally disabled” under their policy.
After reading the document to her family, the receptionist’s husband encouraged her to contact 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.
The receptionist’s treating doctors were shocked that they weren’t consulted before she was cut off LTD. They clearly outlined in writing why her condition prevented her from doing any work – even on an hourly 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 receptionist’s 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 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.