Tourette syndrome, or simply Tourette’s, can make it nearly impossible for individuals to perform their job duties—even with appropriate treatment.
For Canadians who aren’t able to work due to this debilitating 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 Tourette’s.
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 Tourette’s.
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 Tourette’s 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
No matter how many years go by, it’s always heartbreaking when my clients share that being denied or cut off LTD has completely upended their financial well-being.
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 and compassionate 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 Tourette’s case that my team and I will never forget involved an office manager whose access to LTD benefits was cut off on his change of definition date.
The individual, struggling with almost constant tics, received a denial letter via email from his insurance company—informing him that he no longer met the definition of “totally disabled” under their policy.
His family, familiar with the Disability Law Show on Global, immediately contacted Samfiru Tumarkin LLP for a free LTD consultation.
Confident that the office manager had been wrongfully cut off disability benefits, we told him and his family to get the denial letter reviewed by his treatment team. Stunned by the decision, his treating doctors 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 Tourette’s care, the office manager and his family contacted us again.
In the end, all it took was a brief phone call with his insurer—not a legal battle—to obtain a life-changing settlement for our client and his family.
Denied or cut off long-term disability? Asked if you want to appeal your insurance company’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.
