Burlington Disability Lawyer

If you have disability insurance through work or a group plan, you’re supposed to have a safety net in case you’re ever injured or ill and can’t work. However, many Ontarians find that even after diligently paying their premiums, they encounter problems when they have a legitimate claim.

You need disability to replace lost income when you can’t work, so if you get a denial letter or if the insurance company tries to cut off disability you’re already receiving, contact a Burlington disability lawyer at Derek Wilson Injury and Disability Law. I’m happy to offer a free consultation so you can find out how you may be able to secure your rightful benefits.

Understanding Disability Rights and Claims

In Ontario, there are two types of disability, both of which replace part of your lost income while you’re too injured or ill to work. Short-term disability (STD) benefits are meant to replace part of your lost income quickly, so you can get approved in as little as one day to two weeks. Depending on your policy, you may be able to get from 60% or even up to 100% of your income replaced for up to a year.

If you have both short-term and long-term disability (LTD), you may be able to transition into LTD benefits if your short-term benefits run out and you can’t return to work. Long-term disability benefits have a longer waiting period, up to a year in some cases. Your LTD benefits typically replace 35% to 70% of your income for years or even up to your retirement, though this depends on your policy.

Dealing with Denied or Cut-Off Claims

If your doctor says you can’t work, you expect to get your rightful disability benefits, but each year many legitimate claims are denied. Common reasons for denial include:

• Lack of objective medical evidence. The most common reason to get denied benefits is a lack of hard data, such as MRIs, surgical reports, lab test results, blood test results, and more. Work closely with your doctors to make sure they submit evidence that shows exactly why you can’t perform the core duties of your job.
• Pre-existing conditions. In long-term disability insurance policies, there is a “period of exclusion,” which lasts from about six months to two years. If you receive medical treatment for a medical condition during this period, your claim may be denied if you then apply for disability for the same condition.
• Transitioning from short-term to long-term disability. When you transition to long-term disability, you’re effectively applying for disability all over again. You’re dealing with a new policy and sometimes even a different insurance provider. A new insurer may deny you, even if you were approved for short-term disability before.
• Lack of ongoing medical treatment. Taking breaks from treatment or failing to follow your doctor’s treatment plan is bad news for your disability claim. Your disability policy usually requires you to get “ongoing care” to keep receiving your benefits. Even if you receive medical care, an insurance company can decide whether your care or the specialist you’re seeing isn’t the right fit for your disability and may deny your claim.
• Surveillance reports. Insurance companies will sometimes hire private investigators to check to see whether you’re being honest about your disability. This can easily lead to denials and confusion. For example, a surveillance camera may catch you taking out your garbage, and the insurance company may claim this means you’re not disabled when, in fact, your doctor has determined you can’t do the core duties of your job — duties that don’t involve taking out the trash.

A Burlington disability lawyer can address each of these situations and seek to get you the benefits you’re entitled to. By negotiating with the insurance company and providing strong evidence of your disability, your long-term or short-term disability lawyer can address your denial letter and make sure you get your benefits.

Another situation that can happen is that you may be approved for disability, but after some time, the insurance company may try to cut off your benefits. Usually, this happens because the insurer claims you can return to work — even if your doctor disagrees.

You don’t have to return to work if you’re injured and cannot perform your duties. If you have received a denial letter or the insurance company or your employer is pressuring you to return to work before you’re healed, contact Derek Wilson Injury and Disability Law for a free consultation.

The Benefits of Hiring a Disability Lawyer

Working with a Burlington disability lawyer when your claim is denied can help you seek the benefits you deserve. There are many benefits to working with a disability lawyer rather than trying to navigate this situation on your own:

• A disability lawyer can help you understand your policy. These policies can be so confusing that it can be hard to tell what’s covered and what’s excluded. Your lawyer explains everything in plain English so you understand your rights and obligations.
• A disability lawyer can help you interpret your denial letter. Understanding your denial letter is the cornerstone for building a strong response.
• A Burlington disability lawyer helps you avoid common pitfalls. Common mistakes, such as errors on forms or saying the wrong thing to an insurance company, can hurt your disability claim. Your lawyer represents you, so these common errors don’t prevent you from getting your disability.
• A disability lawyer can address your questions. You may not know what to expect, or you may wonder how much you can get through disability or how long it will take you to get your benefits after a denial. Every situation is different, and your lawyer can explain what you can expect.
• A Burlington disability lawyer explains your options. To know what to do about a denial, you need to understand what your options are, as well as the benefits and drawbacks of each.
• A Burlington disability lawyer talks to insurance companies for you. Talking to insurance companies can be a minefield because anything you say can be used to deny your claim. An experienced disability lawyer knows exactly what to say and can take care of negotiations so you can attend to your health.

In short, your lawyer understands how insurance companies work — and how they try to deny your claim. Your lawyer also has insights into your rights and obligations as a disabled person and can make sure you avoid any missteps that could hurt your claim.

Choosing the Right Disability Lawyer

The right Burlington disability lawyer is one who is compassionate and cares enough to pay attention to your claim and answer your call. The right disability lawyer for you is one who will seek every chance to get your disability.

I established my law firm, Derek Wilson Injury and Disability Law, because I believe the right disability lawyer should be there for you during the toughest times. I have more than 30 years of experience in trial and negotiation, and I also have experience representing insurance companies, so I know what tactics they will use to try to deny your claim.

I have purposely kept my law firm small, with a tight focus on disability and personal injury claims. This allows me to put my full attention into your case. In fact, when you work with Derek Wilson Injury and Disability Law, you work with me and not a junior lawyer. I’m the one who will get to know you and your claim, who will answer your questions, and who will work on your claim.

The Role of a Disability Lawyer in Long-Term Disability Claims

The primary role of a Burlington disability lawyer is to look out for your best interest and get you long-term disability benefits. While insurance companies are beholden to their shareholders, as your lawyer, I’m obligated to act in your best interests — this means seeking the fairest disability possible.

Acting in your best interests means making sure you understand the claims process, finding all relevant medical evidence to support your case, and helping you fight back if your claim has been wrongfully denied.

Navigating the Appeals Process

When you get a denial letter from the insurance company, the insurance company may suggest an internal appeals process. This may sound good, but you’ll want to avoid the internal appeal in most cases.

Here’s how it works: the same company that denied your claim is looking at the same information you sent as part of your application. Why would they reach any other conclusion but a denial?

The internal appeals process can also go through several rounds, and at each stage, you may be asked to submit more information. By the time you have exhausted this process, your deadline for filing a legal claim may have passed, leaving you with no other avenue to seek your benefits.

A better option in most cases is to skip the internal appeal and immediately work with a Burlington disability lawyer who can file a claim and start seeking a settlement from the insurance company.

Insurance Company Tactics and Strategies

One of the most common strategies that an insurance company will use is to discourage you from contacting a disability lawyer. They may claim you don’t need one and encourage you to use their internal appeals process, even though they know that many such appeals don’t result in benefits for applicants.

You also need to be aware that long-term disability definitions are subject to change. With most policies, after two years, the definition of “disability” will change from “own occupation,” meaning you’re disabled if you can’t perform the duties of your own job, to “any occupation,” meaning you’re only disabled if you can’t perform the tasks of any job you’re qualified for.

What happens with this change of definition is that you may be getting LTD for two years and relying on that source of income to pay your bills when suddenly the definition changes. You may suddenly face a lot of pressure to return to work, even if your doctor hasn’t cleared you to do so. Working with a long-term disability lawyer is important to make sure you’re not pushed back to your work duties when it’s still unsafe to return to the workplace.

Building a Strong Disability Claim

Building a strong disability claim starts with two things: having the right evidence and understanding how insurance company claims work. To start gathering evidence, work closely with your doctor and specialists. Make sure they understand you’re applying for disability and bring them any forms or information they need. Make sure they describe not only your disability but how it affects your work. Corporate with your doctor’s treatment plan to the letter and take part in all medical tests, exams, and appointments.

Make sure you keep detailed notes about your medical conditions, your medical appointments, your symptoms, and your treatment. A common mistake can happen if you write down the name of your condition incorrectly or if you misunderstand something about your treatment. If you’re not clear about your treatment or condition, ask your doctor to write it down and refer to your notes when filling out any insurance paperwork.

Finally, understand that insurance companies profit when they don’t pay claims. Don’t give insurers any reason to deny your claim. Always fill out any paperwork completely and accurately. If you have been denied and the insurance company contacts you, work with a disability lawyer to make sure you build the strongest case possible.

Need a Disability Lawyer in Burlington? Contact Us for a Free Consultation

Has the insurance company been treating you unfairly? Have you received a denial letter, or are you in danger of losing your long-term disability benefits? Don’t delay. Contact Derek Wilson Injury and Disability Law for a free consultation. When you act quickly, I can start taking action to protect your rights and secure your rightful disability benefits.