Our team of disability lawyers at Samfiru Tumarkin LLP regularly speaks to people in Ontario and British Columbia who are stressed and scared because their long-term disability insurers are pressuring them to return to work before they are ready.
Recently a disabled individual came to MyDisabilityQuestions.com, our website where people can get accurate advice about long-term disability claims, with some very common questions.
They wrote, “I am currently on long-term disability (LTD) due to stress from work and severe grief after my father passed away. The insurance company is pushing me into the return-to-work program. Can they force me to get back to work? Do I have the right to refuse? If my insurer cancels my claim, will I be immediately fired by my employer or do I have the right to continue getting better at home and get back to work when I am ready?”
These are all common questions that routinely come up in our legal practice. Here are the answers.
Your insurance company can’t force you back to work
An insurance company can pressure you to go back to work by threatening to stop your monthly LTD benefits, but they cannot force you.
A disability insurer must continue paying your benefits so long as you remain disabled under the applicable insurance policy.
This means that if you are not ready to go back to work, and your doctor agrees that you are not ready, an insurer should continue paying your LTD benefits. The insurance company should not pressure you to try a return-to-work program against your doctor’s advice.
Unfortunately, disabled individuals often bow to pressure from their disability insurers to try a return-to-work program even though they’re not ready, and, in the process, exacerbate the physical or psychological conditions that have disabled them from working in the first place.
Your insurance company can’t overrule your doctor
Insurers do not have the power to unilaterally override your doctor’s recommendations and opinions. They can get their own medical consultants to provide an opinion that contradicts your doctor’s opinions. This does not, however, give them the legal right to terminate your benefits if you have not been cleared to try a return-to-work program by your own doctor.
Talk to your doctor, insurer and lawyer if you are pressured to return to work
There are three things you can do if your disability insurer wrongfully pressures you to return to work.
First, ask your doctor for a letter that explains why you are not medically ready to return to work.
Second, provide that letter to your insurance adjuster and advise them in writing that you are concerned a return-to-work program is premature and will cause you harm.
This is an important step, because if the insurer stops your monthly benefits despite your doctor’s letter and the concerns you shared in writing, your insurer may be exposed to a legal claim for extracontractual damages. These are a form of punitive and aggravated damages, which means they are compensation awarded above and beyond what you’d receive for missed disability benefits payments.
Third, contact our team of disability lawyers at Samfiru Tumarkin LLP immediately so we can protect you if your insurer disregards your doctor’s letter and your stated concerns. Our lawyers focus exclusively on disability and employment law.
READ MORE: How to choose the right disability lawyer
How we can help as disability lawyers
Contacting a lawyer is particularly important because every case is different and calls for a nuanced approach to resolve the conflict with the insurer.
In many instances, we are able to intervene on behalf of the disabled individual and communicate directly with the insurer, with the result that the insurer backs off.
In other instances, such as when an insurer tells an individual that their LTD benefits will stop, we immediately initiate a legal claim against the insurer. These cases require urgent action so the insurer does not cut off a disabled person’s financial lifeline.
You can’t be fired if your benefits are cut off
If your insurer stops your benefits because you refuse to return to work against medical advice, your employer is not legally allowed to terminate your employment.
It is a human rights violation in Ontario and British Columbia to terminate the employment of a disabled employee. Doing so means that the employer is not only required to pay a person’s termination entitlements, but also potentially human rights damages.
Are you being forced back to work? Is the insurance company threatening to cut off your payments?
Contact the firm or call 1-855-821-5900 to secure assistance from a disability lawyer in Ontario or British Columbia. Get the advice you need — and the compensation you deserve.
Sivan Tumarkin is a disability lawyer and partner at Samfiru Tumarkin LLP, one of Canada’s leading law firms specializing in disability claims and employment law. He also provides free advice as the host of Canada’s only Disability Law Show on TV and radio.