Epilepsy can have a profound impact on an individual’s quality of life—turning everyday tasks, including one’s job duties, into nearly impossible feats.
For Canadians who can’t work due to this neurological disorder, short-term disability (STD) and long-term disability (LTD) benefits are designed to provide financial peace of mind.
Sadly, it’s not uncommon for insurance companies to deny legitimate LTD claims in cases involving epilepsy.
READ MORE: Invisible illnesses: Can I still get long-term disability even if I don’t look sick?
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 rejects your claim for LTD benefits based on epilepsy, 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 disability 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 happens 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
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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
Once you have the denial letter in your possession, schedule a meeting with the doctor providing primary care for your epilepsy. 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 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’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, STD, 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 my team and I recently handled involved a data analyst who tried to claim LTD benefits for epilepsy.
Two weeks after submitting her application, the individual got a phone call from her insurer—informing her that her claim had been rejected.
Shocked by the update, she asked her insurance company why she wasn’t eligible for LTD benefits. She was told that their medical consultant didn’t believe she was disabled.
Resisting the urge to lash out at her insurer, the data analyst politely requested a denial letter before ending the call.
While she waited for the document to arrive, she contacted Samfiru Tumarkin LLP for a free LTD consultation. We explained her rights and potential options, which helped her feel more confident about her case.
As soon as the data analyst received the denial letter from her insurance company, she reached out to us again.
After examining the document and the reports from her treatment team, it was clear that the insurer’s medical consultant didn’t do a comprehensive review of her file.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
The data analyst’s treating doctors specifically noted in multiple reports that her condition prevented her from doing any work—even on a part-time basis.
Following conversations with her 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.