Long-Term Disability Lawyer Oakville

Many Ontarians sustain serious injuries or develop medical conditions that make it challenging to carry out the duties associated with their employment. In these unanticipated circumstances, ill or injured individuals who can no longer work find themselves worrying about how they will pay for their treatment and other needs if they cannot earn a living wage.

Suppose your injuries or illness has become a disabling condition, and you can’t work. In that case, you may be eligible for long-term disability benefits. This is an insurance benefit that could provide other income to cushion you financially. Remember, it’s recommended to work with a skilled disability lawyer who can ensure your insurance provider provides the fair compensation that you deserve.

Derek Wilson is a trusted and experienced disability lawyer in Oakville. He knows how insurance providers work and the tactics they use to lowball or deny disability insurance benefits. Derek has worked with some of the leading insurance companies and knows how to advocate for your best interests. Therefore, if you are looking for personalized legal advice, get it from Derek Wilson, a reputable lawyer who will work tirelessly to ensure you get a positive outcome.

What’s Long-Term Disability?

Some mental and physical conditions may make it impossible for you to handle your official duties at your workplace. Physical injuries, chronic pain, mental disorders, and other health conditions can prevent you from working or even handling seemingly minor household chores for an extended period. Some of these maladies may be so severe that you are no longer capable of working in any occupation.

If the symptoms of such disabling conditions persist for a long time, there’s a chance you will exhaust all the insurance benefits available to you. These may include short-term disability benefits and employment insurance. Once you exhaust these benefits, you may be eligible to collect long-term disability benefits from your insurance company.

Eligibility for LTD Benefits

Long-term disability coverage is intended to provide income replacement for individuals with medical conditions that prevent them from working for an extended period. Your disabling condition could be the result of any situation, such as a car accident, hereditary condition, or serious illness.

You can have long-term disability coverage through your employer or you can purchase a private policy. This policy will have a ‘test’ intended to determine your eligibility for LTD insurance benefits. Here are the tests for disability.

Own Occupation

This definition of disability assesses whether you can return to the specific job you had before the disabling condition. It’s particularly relevant for those in specialized roles because the inability to perform in such positions can lead to significant financial loss. Insurance policies based on the “own occupation” test without a time limit are associated with high premiums but offer comprehensive coverage.

Consult with skilled long-term disability lawyers to understand how the ‘own occupation’ test can affect your ability to get the insurance benefits you’re entitled to. Remember, you worked diligently and probably paid for long-term disability insurance. You deserve all the benefits that come with this coverage.

Percentage Test

This test specifies a certain percentage of job duties an individual cannot perform due to disability. For instance, if you are unable to execute 65% of your previous job responsibilities, you may be deemed disabled under this test. It quantifies your incapacity and aligns the benefit eligibility accordingly.

Any Occupation

The “any occupation” test evaluates whether your disability is severe enough to prevent you from working in any capacity. It considers your work experience, education, and training to determine if there’s any profession you can engage in despite your disability. This test is applied in cases of severe and permanent disabilities. It ensures only those who are truly unable to work in any field receive benefits.

Derek Wilson is a seasoned Oakville disability lawyer. His law firm focuses on helping ill and injured individuals to claim the disability benefits they legally deserve. Thus, we don’t assess disability claims or interpret the disability law the same way insurance companies do. Our law firm only focuses on getting you the financial assistance (LTD insurance benefits) you need to get through this difficult time.

Can LTD Benefits be denied?

When faced with circumstances that make it impossible to work, you should be able to rely on your LTD benefits. Unfortunately, most insurers find reasons to deny LTD claims. That’s why you need to work with experienced long-term disability lawyers like Derek Wilson to avoid mistakes that could lead to claim denial. Some of the reasons for claim denial include:

Insufficient Medical Evidence or Documentation

This is a primary reason for the denial of long-term disability benefits. Your insurance company may argue that the medical evidence provided does not sufficiently substantiate the disability. Often, the denial letter may be detailed and can seem overwhelming. It’s intended to convince you to stop pursuing your claim further.

Disagreement on the Severity of the Disability

Insurance companies often use their medical professionals to assess the claimant’s medical condition. In some cases, your insurer may want you to believe that your condition doesn’t meet the definition of long-term disability. That means the condition is not severe enough to prevent you from working in any occupation for which you are qualified. This could be grounds for your LTD insurance claim denial.

Change of Disability Definition

Insurance policies may have specific clauses that define disability in various ways. For instance, some policies switch the definition of disability after a certain period (often two years), from being unable to perform duties of one’s ‘own occupation’ to inability to perform duties of ‘any occupation’. Remember, the eligibility criteria for short-term disability benefits are different from the requirements for LTD benefits.

During the first application, you only needed to prove that your condition made it impossible for you to handle duties in the occupation you were in before disability. Thus, your insurer is likely to deny your long-term disability claim if you are residually or partially disabled. That means if you can still work on modified tasks or part-time, your disability insurance benefits may be denied. Other reasons for LTD benefits denial include:

• Failure to be examined by a doctor approved by the insurance company
• Late submission of the claim beyond the policy’s time limits
• Misrepresentations or omissions in the claim application, such as not disclosing pre-existing conditions
• Contradictory evidence from surveillance or other sources suggesting you are not as disabled as you claim

However, a disability claim denial isn’t the end. Derek Wilson can help compile comprehensive and accurate medical documentation to support your claim. He is a dedicated long-term disability lawyer with a wealth of knowledge of disability law and professional experience in handling long-term disability claims even after initial denial.

Indeed, he will protect your legal rights under the disability law and provide the legal support you need to ensure your disability claim gets the best outcome.

Fighting a Long-Term Disability Claim Denial

If your disability insurance benefits claim was denied, do not lose hope even when the insurance company identified several reasons for denial. Derek Wilson can help you question the denial and challenge the insurer’s decision. He has a deep understanding of both the disability law and the entire process of pursuing disability insurance benefits.

Once you receive a denial letter, don’t hesitate to contact experienced Oakville long-term disability lawyers like Derek. Even when you are confident you understand the reason for your LTD claim denial, disability law can be complicated, and disability lawyers know how it works. Therefore, schedule a free consultation with Derek Wilson, a reputable disability lawyer in Oakville who offers outstanding service throughout the appeal process.

Derek Wilson Personal Injury Law Can Help

If you have been denied or are about to be denied by your LTD insurer, we can review your documents and ensure you understand the terms of your contract and why you have been denied. We have a track record of successfully handling any legal process involving disability law. We have helped our clients get the compensation they deserve and can help you too.

Whether your disabling condition is associated with an illness you are suffering or an injury from a car accident, we will speak to the top medical professionals in Ontario to understand your condition better. This way, we can do a skillful job of addressing concerns that may lead to the denial of your disability insurance claim. Schedule a free consultation, and my team will review your claim file.