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What to expect when hiring a lawyer to fight your disability claim denial

Navigating a long-term disability (LTD) claim on your own can be confusing and intimidating. The application process can be difficult, and adjusters may reach out often for additional medical records and updates on your recovery.

In my experience as a disability lawyer, once a claimant is cut off or denied benefits, they’re often psychologically drained and want a break, or have considered giving up.

So the idea of starting a legal claim against the insurance company for having wrongfully stopped payments can seem daunting. But here’s why using a disability lawyer might be easier than you think.

READ MORE: 4 reasons why long-term disability claims are rejected

The burden shifts to your disability lawyer

Most people try to handle their disability claims alone. That means you’re the one who must fill out the paperwork, contact doctors for additional records, answer calls and emails from the insurance adjuster, and figure out if your best interests are truly being protected.

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But once you’ve been denied and you retain a lawyer, the baton is passed. You no longer need to do any of those things, because your lawyer will do them all for you. In fact, you’ll likely never have to speak to an adjuster about your LTD claim ever again.

One of my primary goals as a long-term disability lawyer is to help alleviate clients’ stress. While you may feel like legal action is going to be a mountain of work you just can’t handle, with a lawyer’s help, it could actually be very little compared to the work you’ve already done for your claim.

READ MORE: Can my insurance adjuster force me back to work when I’m not ready?

How getting a disability lawyer works

What should you expect if your LTD claim has been denied and you’re looking for a lawyer’s help? The first step is to do an intake call with a disability lawyer, like the team at Samfiru Tumarkin LLP, and give them all the information they require to evaluate your claim.

The lawyer will then ask you to sign some authorization forms so they can request the relevant medical and financial documents. They’ll use these to build your file, which means presenting information in the most advantageous legal way for you.

Next, your lawyer may call or email if they have questions or need updates.

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Often, after legal action has been initiated and all necessary documentation has been exchanged, both sides will agree to go to a mediation. This is essentially a formal meeting where an exact amount of compensation is decided upon.

If that happens, you do have to attend the mediation (either in person or virtually), but you don’t have to say a word (other than to your lawyer in private) when you’re there.

READ MORE: Fighting a disability claim denial during COVID-19? Here’s how to choose the right lawyer

In some cases, you may be required to go to an examination for discovery prior to your mediation. (If you’ve ever watched an American legal drama on TV, discovery is very similar to deposition.) In this process, the parties meet at a neutral location, and the defence lawyer has an opportunity to ask you questions about your health and work history. A discovery usually lasts a few hours, and while it isn’t fun by any means, it’s typically not very stressful in LTD cases.

Most LTD cases are resolved

Going to discovery prior to mediation is rare in our firm’s extensive experience. Once you get to mediation, there’s a very good chance your claim will resolve, resulting in proper compensation from the insurance company.

There are no guarantees on how long a resolution takes, but settling an LTD claim in a matter of months is common at our office.

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READ MORE: What to know about your long-term disability rights in the age of COVID-19

If mediation does not yield an agreement with the insurance company, you may have to proceed with next steps. But there are many opportunities to resolve your claim, which is why LTD matters rarely go to trial.


Has your long-term disability claim been denied or cut off? Not sure if you need help from a disability lawyer?

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.

Michael Gerhard is a disability lawyer and senior associate at Samfiru Tumarkin LLP, one of Canada’s leading law firms specializing in employment law and disability claims. The firm provides free advice through Canada’s only Disability Law Show on TV and radio.

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