It is an unfortunate truth that many long-term disability benefits in Canada end up being initially denied. Private insurance companies do not publish statistics on denied claims, but it’s common for people applying for disability benefits to be initially denied. After all, insurers maximize profits by minimizing payouts. If you’re denied disability and can’t work, you may find yourself in a financially precarious situation and in need of immediate help.
When you receive the initial denial letter, the insurer is required to provide you with an opportunity to appeal the decision. Most appeals are handled internally though, so they are often not fair decisions. Seeking legal help immediately can help you get the benefits you need. However, even the fastest settlements take time, so following are some possible options for additional relief.
What Options Do You Have If You Cannot Work?
If you’re denied disability benefits, the Government of Canada lists several other types of benefits you might be entitled to. Some of these benefits may include:
- Employment Insurance (EI) benefits. EI benefits provide payments to individuals who lost their jobs or cannot work through no fault of their own. A person could be eligible for up to 15 weeks of EI sickness benefits when they are unable to work because of sickness, injury, or quarantine.
- Ontario Disability Support Program Benefits (ODSP). Social assistance payments from a province or territory, a municipal government, or a First Nation may be available to you, depending where you live.
- Canada Pension Plan Disability Benefit (CPPD). A person may get compensation from CPPD Benefits when they have made contributions into CPP and have a mental or physical disability that regularly stops them from doing any type of substantial and gainful work.
How Can Taking Legal Action Help?
Because insurance companies’ appeals processes are handled internally, the results of appeals are often a reaffirmation of the denials. You may be far better served by filing a claim against your LTD Benefit insurance carrier rather than spending time on an appeal process that is likely to be unfair. You may be asking: “Why would disability benefits be denied” when I clearly can’t work. An experienced lawyer can not only help you understand the answer to that question, but also quickly and efficiently strategize on what to do after being denied your disability benefits.
A denied disability claim could result in a possible settlement. In most cases, settlements are achieved by calculating the current value of future payments, reviewing medical evidence, considering the possibility of recovery, and calculating future litigation risk. A settlement could involve either a reinstatement of benefits or lump sum payout, and a waiver of premiums if you paid premiums to keep a policy in place despite the denial of benefits.
If the insurance company refuses to settle, your claim can be brought before a judge to determine whether your disability prevents you from working, in which case, the insurer will likely have to pay benefits. While in theory, any layperson could attempt to bring a case against an insurer, big insurance companies have deep pockets and teams of lawyers, so it pays to have someone representing you who has a deep understanding of the law and insurers’ legal tactics. Additionally, someone facing a new disability will likely have lots to deal with in terms of adapting to life with functional limitations. Taking on complex legal processes can feel overwhelming.
A skilled long-term disability lawyer who has been through the process many times can help you focus on the road ahead while they work to get you the benefits you deserve. Denied disability lawyers will also be able to assist you with completing all necessary claim forms, reviewing your medical records, securing expert witness testimony when necessary, and filing a lawsuit if one proves necessary. Most insurance companies are happy to deal with individuals who are not represented by lawyers because their claims are much easier to deny.
Why Choose Derek Wilson?
Derek Wilson Personal Injury Law is a long-term disability lawyer who has been practicing insurance litigation since 1995. More than a quarter-century of experience means he has a deep understanding of how insurance companies think, so he can mount an appropriate legal response.
Derek Wilson represents clients throughout the greater Ontario area, including in Hamilton, Guelph, Kitchener, and St. Catharines. He also handles every single case himself, so you will never have to worry about your case being delegated to junior associates with minimal experience. When it comes to how to choose a disability lawyer, Derek Wilson meets the criteria — personalized service, experience with cases like yours, and intimate understanding of how insurance companies work.
To get in touch, fill out our online contact form or give us a call at 289-274-9567 to set up a free consultation.
