For many Ontarians, applying for long-term disability (LTD) benefits can be daunting.
In our experience, it’s not uncommon for individuals to delay submitting a claim because they don’t believe they meet the necessary conditions to be considered “totally disabled” under their insurance policy.
If you are thinking about applying for LTD in Ontario, here are three crucial things you need to know.
1. Complete inability to work isn’t required
Many people assume that they need to be severely incapacitated, or even paralyzed, to qualify for disability benefits. However, this is not the case.
Disabilities come in a variety of forms. Even if your condition does not completely prevent you from performing your job duties, you are likely eligibly for LTD if working exacerbates your condition. Similarly, you would be considered disabled if your ability to lead a normal life is significantly impacted by your work.
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2. You don’t need to disclose a specific diagnosis
When applying for LTD benefits, your insurance company will require your treating doctor to submit a physician statement. This document doesn’t need to include your specific diagnosis. Instead, it’s crucial that it clearly outlines why your condition prevents you from performing your job duties.
If other medical professionals are involved in your care, gather their opinions as well. The more 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, insurers cut individuals off LTD benefits on or around the “change of definition” date, which usually occurs two years after a claim was approved. If this happens to you, make sure that your treating doctor clearly explains in writing why your condition prevents you from doing any work – not just your own occupation.
3. You don’t have to handle a denial on your own
For many of our clients, having their legitimate LTD claim turned down is devastating. They aren’t sure how they were going to support themselves or their loved ones financially without access to disability benefits.
If your LTD claim is rejected for any reason, request a denial letter and contact an experienced disability lawyer at Samfiru Tumarkin LLP. It’s very important that you get the right legal advice before appealing the insurance company’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 for these matters 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 recent case that our firm handled involved a logistics supervisor in Ontario struggling with osteoporosis.Three weeks after applying for LTD benefits, she received a letter from her insurer informing her that her claim had been rejected because she didn’t meet the definition of “totally disabled” under their policy.
Tempted to challenge the decision on her own, the logistics supervisor ultimately 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.
Our client’s treating doctors were shocked that her LTD claim had been rejected. 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 logistics supervisor’s insurer, we were able to secure an extremely favourable amount of compensation for our client.
Denied or cut off long-term disability? 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 and Mackenzie Irwin 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.