Milton Ontario Disability Lawyer

In Halton, Milton has many of the area’s major employers, including major hospitals, manufacturers like Ford, and more. To attract top talent from the Greater Toronto area, local employers often offer employee benefits, including disability benefits. Many insurance companies in the area also offer group plans and private plans to individuals interested in disability insurance.

After paying your premiums faithfully, you expect your disability insurance benefits to be there for you when you can’t work. Unfortunately, many Milton residents find themselves struggling to get the benefits they deserve. If your claim has been denied or you run into other problems getting your rightful benefits, contact Derek Wilson Injury and Disability Law for a free consultation to discuss how we may be able to help you fight back.

Understanding Disability Benefits

In Ontario, disability benefits are typically provided through an employer, though you can also purchase coverage yourself directly from insurers or through a group plan. In general, you may have access to short-term disability (STD) insurance, long-term disability insurance, or both. If you have both, you may get them through different insurance providers or from the same insurer.

If you do not have LTD or your coverage is limited, you may be able to apply for CPPD (Canada Pension Plan Disability Benefits) from the government. Ontario also offers Employment Insurance (EI) Sickness Benefits for those who do not have short-term disability coverage.

Every program has its own eligibility criteria and application processes. Policies can also vary widely, depending on your coverage and provider, so always read your policy information to understand your coverage.

Let’s look at these programs in general, though.

Long-term disability (LTD) benefits in Canada are designed to offer income replacement over an extended period, in situations where you are seriously injured or ill and are expected to take some time to recover. However, they’re not necessarily permanent. The maximum time you can receive LTD benefits depends on your specific insurance policy, though many plans pay until you are recovered or until you reach 65 years of age.

There are often two phases to LTD benefits. The first is the “own occupation” period, which usually lasts two years. During this period, to qualify for LTD benefits, you must be unable to perform your own job duties. After this period, you must be unable to perform any job for which you are reasonably suited by education, training, or experience. If the insurer determines that you can perform any other job, even at a different income level, your benefits may be cut off.

Insurers often try to end benefits at the two-year mark, citing the shift in the disability definition. Derek Wilson Injury and Disability Law challenges these terminations when they are unfair or are unsupported by evidence.

Common conditions that may qualify you for LTD include:

• Chronic physical injuries. These can include back injuries, repetitive strain injuries, or degenerative disc disease.
• Mental health conditions. Conditions that may be covered include severe anxiety, depression, bipolar disorder, or PTSD.
• Autoimmune diseases. Lupus, rheumatoid arthritis, or Crohn’s disease are covered under many policies.
• Neurological disorders. These can include MS, Parkinson’s, or epilepsy.
• Cancer. If symptoms or treatment prevent work, you may be covered after your diagnosis.

Medical evidence must clearly support that the condition prevents employment. At Derek Wilson Injury and Disability Law, we help clients gather and present strong documentation, especially in cases where insurers dispute less visible conditions like mental illness or chronic pain.

The amount paid through LTD benefits in Canada depends on your insurance policy. Most policies offer between 60% and 70% of your pre-disability income, often up to a specific monthly cap.

If your payments have stopped unfairly or are lower than expected, it’s worth speaking to a long-term disability lawyer. Derek Wilson Injury and Disability Law can assess whether your insurer is acting within the scope of your policy.

Now let’s look at short-term disability benefits.

Short-term disability (STD) insurance provides temporary income replacement for employees who cannot work due to illness or injury. These policies can cover up to 100% of your income, though this depends on your policy. In Ontario, qualification depends on:

• Being unable to perform your regular job.
• Having medical proof from a licensed physician confirming your inability to work.
• Being employed and covered under a group STD plan or private insurance policy.

Most STD plans cover you for up to 17 weeks, though some can cover you up to a year. This can vary widely by policy. Qualifying conditions include injuries, severe illnesses, short-term episodes with mental health issues, and pregnancy complications.

Employers often use third-party administrators to manage claims, which can introduce challenges. Many people don’t realize that a denial from an STD insurer may later impact any long-term disability claim. That’s why it’s important to get advice early. At Derek Wilson Injury and Disability Law, we can ensure you speak with a short-term disability lawyer, so you know what to do next.

Types of Disability Cases We Handle in Milton

At Derek Wilson Injury and Disability Law, we specialize in representing clients in Milton who are facing challenges with disability claims. We help individuals who have been denied benefits. We also work with clients who are facing insurers who are acting in bad faith. If your insurance company is not returning your calls or if you’re facing unreasonable delays when seeking your rightful benefits, we can negotiate with insurers for you.

We can help in other situations, too. A common situation that occurs in Milton and across Southern Ontario is that an employee will get their benefits and then face a situation where the insurer tries to cut off or claw back the benefits.

For example, some workers feel pressured by their employers to return to work, or are told their employers cannot accommodate an injury. In some cases, insurers try to claim workers are recovered enough to return to work, even if the employee’s doctor disagrees! In all these cases, even if the worker is not in any shape to return to work, they may be pressured to return to their job, or risk losing their benefits.

If you ever find yourself in this type of situation, contact our law firm. It is very important that you follow your doctor’s recommendations. Returning to work before you are ready can increase your risk of re-injury or can exacerbate your condition. Our team can negotiate with insurers and present evidence of your medical condition, which is often enough to encourage employers and insurers to act in good faith.

Qualifying for Disability

Qualifying for disability benefits in Ontario involves meeting specific criteria. The criteria you will need to meet will depend on your policy, but you will generally need the following:

• Medical Evidence. Comprehensive documentation from healthcare providers detailing the nature and extent of the disability is important to show you qualify for benefits. You must be able to show that your injuries keep you from performing the duties of your job.
• Employment History. A history of employment and contributions to the plan is usually required.
• Severity and Duration. The disability must be severe enough to prevent gainful employment and be expected to last for a specified period. This will also determine whether you qualify for long-term or short-term disability benefits.

Understanding the specific terms and definitions within your insurance policy is crucial. When you first applied for coverage, you should have received information about your plan. Many insurance providers also have online information to help policy holders. These resources can help you understand how to apply for benefits and what you need to be able to demonstrate to get your benefits.

Working with a Disability Lawyer & How Derek Wilson Helps

Engaging a disability lawyer can significantly impact the outcome of your claim. A lawyer knows insurance laws and can ensure your insurer treats you fairly. Your lawyer can also evaluate your costs accurately and ensure that you seek all the benefits you are entitled.

Who you hire as your lawyer matters. Derek Wilson founded Derek Wilson Injury and Disability Law in 2013 after working in Toronto, where he represented insurance companies in disability and personal injury cases. Derek saw how companies worked to protect their every dollar and wanted to offer those who are injured the robust representation they need.

At Derek Wilson Injury and Disability Law, we offer:

• Expertise. With over 30 years of experience in personal injury and disability law, Derek Wilson brings a wealth of knowledge to each case.
• Personalized Attention. Clients work directly with Derek, ensuring consistent communication.
• Contingency Fee Structure. We operate on a contingency basis, meaning you don’t pay unless we win your case.
• Comprehensive Support. From gathering medical evidence to representing you in court, we handle all aspects of your claim.

Our goal is to make sure that when insurance companies try to deprive you of your rightful benefits, you have a dedicated legal team representing your best interests. We have created our law firm to ensure that everything we do is designed to help you get closer to securing the compensation you need.

What to Expect from Your Disability Claim

The best time to reach out to a disability lawyer in Milton is when you have been denied disability or when you are being pressured to return to work prematurely or you get a sense that the insurer may be trying to cut off your benefits. When you contact us, here is what you can expect:

• Initial Consultation. We assess the merits of your case and advise you on the best course of action. We also answer your questions.
• Documentation Gathering. We begin collecting all necessary medical records, employment history, and other relevant documents.
• Negotiation. We engage in discussions with insurers to seek a fair resolution.
• Litigation. If necessary, we are prepared to take your case to court to pursue the benefits you deserve.

Throughout the process, we keep you informed. In many cases, we work towards a settlement. While insurance companies often suggest that you appeal a decision, it is the insurance companies themselves who review the appeal. They have already denied your claim once, and an appeal will likely have the same outcome.

We have seen settlements to be a better option. In a settlement, the insurance company pays you a set amount to cover the costs of your injury or illness, and you both get to walk away and move on. A fair settlement gives you the financial resources you need, and you will not need to continue having to work with the insurance company.

Why Choose Us?

Choosing Derek Wilson Injury and Disability Law means choosing a lawyer with more than three decades of specialized practice in disability and personal injury law. You also get a dedicated team who is committed to clear communication and to fighting for your rights.

With us, our goal is simple: to help you get the benefits your premiums have paid for. No jargon. No pressure. No run-around. We’re honest and transparent with you from the start, so there are no surprises about the process, what you can expect, or our fees. In fact, we work on a contingency fee basis, so there may be no costs up front.

Our team also works on personal injury claims, so we can explain whether you have a legal claim that can help you seek more compensation, above what your disability coverage may offer.

Derek Wilson Helps to Navigate the Complexities of Disability Claims for Clients in Milton, Ontario

If you’re in Milton and facing challenges with your disability claim, Derek Wilson Injury and Disability Law is here for you. We understand that being ill or injured is difficult, and we have built our entire practice to make getting your benefits easier. Contact us today for a free consultation if you think you could use our help. There is no cost and no obligation and you can find out more about what we may be able to do.