Long-Term Disability Lawyer Brantford

When faced with a health condition that changes your life, such as a disabling illness or injury and you have disability benefits, then you may be able to collect insurance benefits if you cannot continue working. Long-term disability insurance benefits are often part of an insurance plan provided by your employer. Alternatively, you can purchase a private plan from an insurer.

If you intend to file a long-term disability claim or your claim has been denied, Derek Wilson will help you get the compensation you deserve. He has worked with insurance companies and knows the complicated tactics they use to either deny or reduce compensation amounts. That’s why he launched a law firm that focuses on helping people get the disability benefits they are legally entitled to.

Eligibility for Long-Term Disability Benefits

The first step is to review your employment agreement and confirm whether you have long-term disability insurance coverage. Your eligibility for benefits will depend on how your insurance policy defines ‘disability.’ If you have insurance coverage that meets your policy’s definition, we will help you file an LTD benefits application. Once approved, you could recover financial support amounting to 60% to 80% of your salary when you are disabled and unable to resume your official duties.

‘Own Occupation’ and ‘Any Occupation’

Suppose your disability is severe, and you cannot go back to the job you had before the disabling condition. In that case, experienced long-term disability lawyers can help you compile comprehensive evidence to prove to your insurance company that you’re eligible for long-term disability benefits. That means you must prove that you suffered a total disability.

Initial Application for Disability Benefits

During the initial application, you only need to show that you cannot perform substantially the essential duties of your ‘own occupation’ due to your health condition. Once approved, you will get short-term disability benefits – the benefits payments will last only two years. Afterward, you must prove that you cannot perform duties in ‘any occupation’ for which you’re reasonably qualified in terms of education, experience, or training.

How long will the Benefits be paid?

If you’re successful and your disability is deemed severe, you may qualify for long-term disability benefits until you are 65 years (the retirement age). Note that it can be challenging to prove that you cannot perform any occupation. This is because insurance companies usually have experienced lawyers to challenge lawsuits. The lawyers don’t have your best interest in mind and will find reasons to get your claim denied or reduced.

However, having Derek Wilson and his team help you build a strong claim can increase your chances of getting fair compensation. Derek is one of the most experienced disability lawyers and will protect your right to fair compensation.

Can Disability Insurance Benefits be denied?

Disability insurance is designed to provide financial support if you’re unable to work due to illness or injury. However, it’s not always guaranteed that your claim will be approved, particularly if you don’t involve long-term disability lawyers. For instance, about 60% of the claims for Canada Pension Plan disability benefits get denied initially.

If your benefits application was denied, consult experienced disability lawyers like Derek Wilson. The legal professionals specialize in navigating the complexities of long-term disability claims. Our law firm can assist you in gathering the necessary evidence and advocate on your behalf to ensure you receive the benefits you deserve.

Why was your Disability Claim Denied?

Here are the reasons long-term disability claims get denied.

Failure to Adhere to Treatment Plan

Failing to adhere to a prescribed treatment plan can negatively affect your long-term disability (LTD) benefits claim. In Ontario, insurers stipulate in their disability policies that beneficiaries must be under the care of a qualified doctor and follow the medical treatments deemed necessary for their conditions. These policies are designed to ensure disability claimants are actively engaged in efforts to manage or improve their health.

Suppose you do not comply with the treatment plans, participate in recommended rehabilitation programs, or cooperate in medical assessments. In that case, your insurance provider may interpret this as a lack of commitment to your recovery. Such non-compliance can be grounds for the insurance company to deny or terminate your LTD benefits.

The rationale is that by not following through with the advised medical or rehabilitative actions, you might be hindering your chances of recovery or return to work.  This can jeopardize the validity of your claim for ongoing financial help even when you have a team of skilled long-term disability lawyers.

Social Media Information that Contradicts Your Claim

Social media investigations are increasingly utilized by long-term disability insurers as a cost-effective strategy to scrutinize claimants’ daily lives. By monitoring your social media profiles, your insurance can gather critical insights into your activities, social engagements, and even your physical abilities. If the content you post contradicts the limitations you have reported due to your disability, this could raise questions about your disability.

Given these practices, it’s advisable to be mindful of your digital footprint, especially when involved in an LTD claim. Most long-term disability lawyers advise their clients to be cautious or refrain from posting content on social media if they’re pursuing legal action against an insurance company.

Insufficient Medical Proof or Documentation

When you file a claim for LTD benefits, the onus is on you to provide detailed medical evidence that substantiates the severity of your health condition. Insurance companies require a thorough and consistent record of your medical history, treatments, and the impact of your disability on your daily life and work capabilities. For health issues such as chronic pain, depression, anxiety, or injuries, your disability policy provider expects a detailed record of your health profile.

If the medical documentation provided is sparse, inconsistent, or isn’t detailed, it may not adequately convey the full extent of your disability. Such gaps in medical evidence give long-term disability insurers insufficient grounds to assess the validity of your claim. This lack of evidence can lead to skepticism regarding the necessity of the benefits, resulting in LTD denial. Insufficient medical evidence can also get your disability benefits terminated.

Therefore, it’s imperative to work with Derek Wilson to ensure that your medical records are comprehensive, up-to-date, and detailed. He is an experienced long-term disability lawyer who will ensure your records cover all aspects of your medical condition and its implications on your ability to work. This will strengthen your claim and enhance the likelihood of receiving the benefits you are entitled to.

Your Insurer’s Doctor or Adjuster says, ‘You can work’

Differences in medical opinions can significantly affect your long-term disability claim. This is particularly true when an insurance company’s doctor or claims adjuster concludes that you are capable of working, contrary to your physician’s medical assessment. You need a disability lawyer with a wealth of disability law knowledge to challenge such opinions.

The issue often lies in the potential for bias when an insurer’s doctor reviews your case. Given their employment by the insurance company, there may be an underlying pressure, whether conscious or subconscious, to produce findings that favour the insurer’s financial interests. Such evaluations can lead to conclusions that you are not disabled or that you can return to work. This can result in the denial or termination of your LTD benefits.

Can a Lawyer Help?

Derek Wilson has a strong reputation for providing client-oriented practical solutions for clients who want to file disability claims or are denied long-term disability benefits. He understands how disability law applies in different circumstances and the many reasons LTD benefits are denied. As a long-term disability lawyer, he will review your case and recommend the best course of action.

Failure to Disclose Pre-Existing Health Condition

Most long-term disability insurance policies have a clause that excludes coverage for health conditions that were diagnosed or present before the policy was active. Note that a pre-existing condition is any illness, injury, or condition for which you sought treatment, received medical advice or took medication within a year before your policy came into effect. This could be anxiety, chronic pain, depression, or any other health condition.

Your insurer will scrutinize your medical history even before the onset of your policy. If your disability is linked to a pre-existing condition, your benefits claim may be denied. Therefore, it’s best to consult a long-term disability lawyer who can help compile comprehensive evidence to clear all doubts about your disability. Derek Wilson and his team have recovered millions in compensation for clients in Ontario. Therefore, you can count on us to get paid the benefits you deserve.

Fighting Insurance Claim Denial

Learning that your LTD claim has been denied can be frustrating and add to the stress already caused by your health condition. You may be tempted to use the appeal process allowed by the insurance company to try and get your disability settlement. However, this could be a mistake.

An insurer’s internal appeal process can prolong your file and you only have 2 years from the original date of the denial letter to file a claim against the insurer. This can be frustrating and could mean an extended period will have passed for you to sue the insurance company for the disability benefits you deserve. That’s why it’s recommended to consult an experienced long-term disability lawyer to fight for your rights and win your LTD benefits.

Disability Claim Denied?

Here’s what to do if your claim is wrongfully denied:

Call Derek Wilson

The moment you are informed (through a claim denial letter) that your claim has been denied, schedule a free consultation with Derek Wilson. He is a skilled disability lawyer with an unmatched understanding of the disability law. Derek will personally review your disability benefits contract in order to accurately assess your claim, determine if it was wrongfully denied, and recommend the best course of action to get your disability benefits reinstated. Beware that all insurers have different wording and nuances in their contracts so it’s important to review your contract carefully for clauses that may hinder your access to benefits.

Skip the Internal Appeal Process

The internal claim appeal process rarely works. Keep in mind that someone from the same insurer who refused to pay your benefits will review a co-worker’s decision. Unless you have new and credible information that the insurer can’t ignore, it can be quite difficult to win an appeal. This is why most claimants retain a team of knowledgeable disability lawyers.

Continue Seeing your Doctor

Even after the initial claim denial, there’s still hope that Derek Wilson will get you the disability insurance benefits you deserve. Therefore, you will need up-to-date medical information to support your case. Adhere to all treatment and prescription recommendations from your physician.

Obtain Supporting Documents

If your claim was denied due to insufficient documentation, have your physician provide a well-filled physician statement. Also, work with your lawyer to avoid some omissions or errors that could make your documents perceived as insufficient.

File a Legal Claim

Derek Wilson will assess your initial claim and evaluate the reasons for the denial. We will recommend whether to appeal the denial or file a legal claim in court. Remember, not all disability claim appeals work after the initial denial by the insurance company.

Schedule a Free Consultation

If you need help navigating the legal process of getting compensation in a disability case, we are ready to help. We offer a contingency fee arrangement, which means you do not have to pay any legal fees until we win your case.