Tinnitus can have a profound impact on an individual’s ability to perform their job duties—even with appropriate treatment.
For Canadians who aren’t able to work, 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 tinnitus.
READ MORE: 4 major reasons long-term disability claims in Canada are denied
If your insurer prevents you from accessing LTD benefits, here are three things you need to do.
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 did so 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?
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Once you have the denial letter in your possession, seek legal advice. Even if you haven’t received this document yet, it’s still in your best interest to schedule a consultation with a disability lawyer.
2. Discuss the decision with your treatment team
Another important step is to get the denial letter reviewed by the doctor providing primary care for your tinnitus.
Schedule a meeting with them at their earliest convenience. During the appointment, ask your doctor 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 tinnitus 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 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 your treatment team clearly outlines in writing why your condition prevents you from doing any work—not just your own occupation.
3. Contact a disability lawyer
Being denied or cut off LTD can cause a significant amount of mental and financial distress. Many of my clients are devastated—unsure how they’re going to pay bills or put food on the table without access to disability benefits.
In the heat of the moment, it can be extremely tempting to appeal your insurance company’s decision. However, your best course of action is to contact the experienced disability law team at Samfiru Tumarkin LLP.
My firm has a proven track record of successfully resolving issues involving LTD, STD, life insurance, critical illness and mortgage insurance claims across Canada.
We provide free consultations for these types of matters and don’t get paid unless we get results. Over the years, we’ve helped thousands of Canadians, including Julie Austin, Mitchell Murphy and Sandra Bullock, secure the compensation they’re legally entitled to.
READ MORE: Insurer being difficult? 3 reasons you should hire a long-term disability lawyer
A troubling tinnitus case that my team and I will never forget involved an administrative assistant whose access to LTD benefits was cut off on her change of definition date.
The individual received a denial letter from her insurance company—informing her that she no longer met the definition of “totally disabled” under their policy.
Overwhelmed by the update, the administrative assistant turned to her best friend for guidance. She was encouraged to contact Samfiru Tumarkin LLP for a free LTD consultation.
Confident that she had a strong case, we told the administrative assistant to get the denial letter reviewed by her treatment team. Dumbfounded by the insurer’s decision, her treating doctors 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 tinnitus care, the administrative assistant contacted us again.
In the end, all it took was a brief phone call with her insurance company—not a legal battle—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 Samfiru Tumarkin LLP 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 long-term disability claims and employment law. The firm provides legal insight on Canada’s only Disability Law Show on TV and radio.
