Insurance companies can make it difficult to start receiving long-term disability (LTD) benefits. The claims process is intimidating, especially for people coping with a physical or psychological disability.
As an LTD lawyer who used to work for insurance companies, but now advocates for disabled individuals, I believe this is all by design. Insurers make money by collecting more in premiums than they pay out in claims.
But I’ve also seen people make bad decisions that can increase the chances of their LTD claim being denied or cut off.
Here are the top three mistakes I see people make when their LTD claim is denied, and how you can avoid making them.
Mistake 1: Relying on bad advice from people unfamiliar with LTD claims
In a crisis, the people closest to you often want to try to help. I have had clients whose doctors told them to give up on their claim or not even file it because they were not totally disabled, which is a general requirement for receiving LTD benefits. But “totally disabled” is a legal term, not a medical one, and your doctor should only be providing you with medical advice, not legal advice.
Similarly, if you have had success in a family or civil legal case in the past, you might ask the same lawyer to handle your LTD claim. If a lawyer does not have sufficient experience practising in the specialized area of disability law, though, they may not understand how to deal with the insurer, and could make mistakes that cost you tens, if not hundreds, of thousands of dollars.
I see it all the time: lawyers with very limited experience (or no experience) trying to deal with LTD cases and making major errors that are then very difficult, if not impossible, to correct.
Mistake 2: Appealing an LTD denial
When your LTD claim is denied, you will receive a letter from the insurance company informing you of the bad news. In this letter they will also tell you that if you submit an appeal, they may reconsider their decision.
In my experience, this process exists largely to give claimants hope that the insurance company will miraculously change their minds.
Many LTD policies allow you to appeal a denial over and over again, which often results in repeated denials while your financial lifeline gets shorter and shorter. The longer you engage in this non-objective process, which is fully controlled by your insurer, the likelier it is that you’ll give up on your claim and the insurance company will avoid having to pay benefits.
Instead of appealing, it’s much more effective to contact a disability lawyer who resolves LTD denials for a living. That is what our lawyers at Samfiru Tumarkin LLP do on a daily basis across Ontario, British Columbia and Alberta.
You only have two years from the date you were first denied LTD benefits (not from the date your appeal was denied) to file a legal claim for compensation. After the two-year mark, your insurer will likely be in a strong legal position to keep the LTD benefits that are owed to you.
Mistake 3: Accepting the insurance company’s decision and walking away
You do not have to accept your benefits being denied or cut off — especially if you haven’t consulted a lawyer. There is no cost to speaking with the disability lawyers at Samfiru Tumarkin LLP about your LTD matter.
Taking on a giant insurance company can feel like an impossible feat. But your insurer is not the authority on your claim. If your family doctor or another treating physician says that you are not able to work, your insurer should pay you LTD benefits.
In my experience, the legal process is the best and most efficient way of forcing an insurer to pay because we take the power out of the insurer’s hands. We resolve most LTD claims quickly and painlessly.
The struggle of dealing with both a disability and an LTD denial can be overwhelming. But disability lawyers can help. When we get involved, we take over all communications with the insurance company. We interact with your doctors to get the necessary medical reports and information, and our team makes sure that nothing falls through the cracks. We will take on the insurance company for you, so that you can focus on your health.
Have your long-term disability benefits been denied? Has the insurance company told you to appeal the denial?
Contact the firm or call 1-855-821-5900 to secure assistance from a disability lawyer in Ontario, British Columbia or Alberta. 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 employment law and disability claims. He provides free advice as a host of Canada’s only Disability Law Show on TV and radio.