Stiff-person syndrome (SPS), a condition that garnered international attention following Céline Dion’s diagnosis, can make it nearly impossible for an individual to perform everyday tasks, including their job duties.
This was the reality for one of my SPS clients, a sales manager, who’d been receiving long-term disability (LTD) benefits for nearly two years. Sadly, on her “change of definition” date, the individual’s insurance company suddenly cut off her access—informing her in a denial letter that she was no longer considered “totally disabled” under their policy.
The manager’s husband, who was familiar with the Disability Law Show on Global, immediately contacted Samfiru Tumarkin LLP for a free LTD consultation.
Confident that she’d been wrongfully cut off disability benefits, I instructed the manager and her husband to bring the denial letter to her treatment team. Horrified 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.
With full support from the medical professionals involved in her SPS care, the manager and her husband contacted me again. After a brief phone call with her insurance company, I was able to secure a life-changing settlement for my client without getting the courts involved.
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For Canadians who aren’t able to work due to SPS, disability benefits are designed to provide financial peace of mind. If you’re denied or cut off LTD for any reason, here are three things you need to do.
1. Get your insurer’s reasons for the decision in writing
Instead of delivering the “bad news” in a letter or email, some insurance companies notify individuals over the phone. By informing claimants verbally, insurers are able to adjust their rationale in the event that the decision is challenged.
If this phone call has already taken place, contact your insurance company immediately and request a denial letter. This document will force them to “lock in” their reasons for rejecting your claim or cutting off your access to LTD benefits.
READ MORE: 4 common reasons long-term disability claims are rejected in Canada
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 bring the denial letter to the doctor leading your SPS care.
Request a meeting with them at their earliest convenience to go over the document. If your doctor disagrees with the insurer’s decision, have them explain in writing why your condition prevents you from resuming your job duties.
In the event that other medical professionals are involved in your SPS 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
If your access to LTD benefits is cut off on or around your “change of definition” date, like the sales manager, remain calm. In this situation, 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 wrongfully denied or cut off LTD can be incredibly distressing. It’s never easy seeing the despair in the eyes of my clients—unsure how they’re going to support themselves or loved ones financially without access to disability benefits.
Following an unjust denial, it’s crucial that you get the right legal advice before appealing your insurance company’s decision.
READ MORE: 3 reasons you shouldn’t appeal a denied long-term disability claim
The compassionate team at Samfiru Tumarkin LLP regularly resolves issues involving LTD, short-term disability, 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 tens of thousands of Canadians, including Sandra Bullock, Amanda Jollymore and Mitchell Murphy, secure the compensation they’re legally entitled to.
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.
