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Can you get disability benefits for cystic fibrosis? 3 things to do if your claim is denied

A man looks at his phone while using a machine that assists with mucus buildup caused by cystic fibrosis. RyanJLane / Getty Images

Cystic fibrosis (CF) can have a profound impact on an individual’s ability to perform their job duties—even with a significant amount of treatment.

For Canadians who can’t work due to this chronic genetic disorder, short-term disability (STD) and long-term disability (LTD) benefits are designed to provide financial peace of mind.

Sadly, the path to securing LTD benefits is rarely smooth. It’s not uncommon for insurance companies to deny legitimate claims, including in cases involving CF.

READ MORE: 4 reasons long-term disability claims in Canada are denied 

If your insurer prevents you from accessing LTD benefits, don’t panic. Here are three things you need to do.

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1. Request a denial letter 

In the event that you didn’t receive one, denial letters force insurance companies to “lock in” their rationale for turning down an individual’s disability claim.

If your insurer denied you access to LTD benefits for CF without a legitimate reason, this document will make it very difficult for them to pivot to a different explanation at a later date.

READ MORE: Invisible illnesses: Can I still get long-term disability even if I don’t look sick? 

Once you have the denial letter in your possession, 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 my 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 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 insurer’s decision. In the event that they disagree, have them explain in writing why your condition prevents you from resuming your job duties.

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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, insurance companies 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 occupation.

3. Contact us 

For many of my clients, having their legitimate LTD claim turned down was incredibly distressing. 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 your insurer’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’ve helped thousands of Canadians, including Julie Austin and Sandra Bullock, secure the compensation they’re legally entitled to.

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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 mechanic who was cut off LTD on his change of definition date.

Struggling with CF, the individual received a denial letter from his insurance company—informing him that he no longer met the definition of “totally disabled” under their policy.

The insurer’s decision left the mechanic and his family flabbergasted. His son encouraged him to contact Samfiru Tumarkin LLP for a free LTD consultation.

Confident that he had a strong case, we told the mechanic to get the denial letter reviewed by his treatment team.

His treating doctors were shocked that they weren’t consulted before he was cut off LTD. They clearly outlined in writing why his condition prevented him 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 his care, the mechanic contacted us again.

Following conversations with his insurance company, we were able to secure an extremely favourable amount of compensation for our client.

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Denied or cut off long-term disability? Asked if you want to appeal your insurer’s decision? 

Contact the firmor 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 Tumarkinis 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. 

 

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