Sciatica can make everyday tasks, such as getting out of bed or performing one’s job duties, nearly impossible to do—even with a significant amount of treatment.
For Canadians who can’t work due to this debilitating condition, long-term disability (LTD) benefits can provide a crucial financial lifeline.
READ MORE: Is chronic pain a disability? A Canadian disability lawyer explains
Sadly, it’s not uncommon for insurance companies to deny legitimate LTD claims in cases involving sciatica.
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 sciatica, 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
Get daily National news
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, it’s still in your best interest to contact my firm. We provide free consultations for issues involving LTD.
2. Discuss the denial with your treatment team
While it can be extremely tempting to throw in the towel after being denied disability benefits for sciatica, don’t lose hope.
Once you have the denial letter in your possession, schedule a meeting with your treating doctor. It’s very important that the document is brought to this appointment.
During the meeting, ask your physician if they agree with the insurance company’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 care, 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, insurers 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 your treating doctor clearly outlines in writing why your condition prevents you from doing any work—not just your own job.
3. Contact us
For many of my clients, having their legitimate LTD claim turned down was devastating. They weren’t sure how they were going to pay bills or put food on the table without access to disability benefits.
If you’ve been denied or cut off LTD, contact an experienced disability lawyer at Samfiru Tumarkin LLP. It’s crucial 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 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 my team and I will never forget involved a machine operator who was struggling with sciatica.
Less than a week after applying for LTD benefits, the individual got a phone call from his insurer—informing him that his claim had been rejected.
Shocked by the update, he asked his insurance company why his application had been turned down. He was told that he didn’t meet the definition of “totally disabled” under their policy.
Resisting the urge to lash out at his insurer, the machine operator politely requested a denial letter before ending the call.
While he waited for the document to arrive, he contacted Samfiru Tumarkin LLP for a free LTD consultation. We explained his rights and potential options, which helped him feel more confident about his case.
As soon as he received the denial letter from his insurance company, he reached out to us again.
After examining the document and the reports from the worker’s treating doctor, it was clear that the insurer didn’t do a comprehensive review of his file.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
The machine operator’s physician specifically noted in multiple reports that his condition prevented him from doing any work—even on an hourly basis.
Following conversations with his insurance company, 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 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 is a disability lawyer and co-founding partner 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.