Niagara Falls Disability Lawyer

Whether you work in the Niagara area in Grimsby, Niagara-on-the-Lake, or any surrounding communities, you may have short-term and long-term disability benefits through your employer. You may also be part of a group plan that pays these benefits in case of unforeseen circumstances like illness or injury that leaves you unable to work.

Disability benefits provide replacement income to cover basic living expenses while you focus on recovery. If you’re injured or ill, this can be your only source of income why you can’t work, so if your benefits are denied, you will want to act fast. Contact Derek Wilson Injury and Disability Law for a free consultation with a Niagara Falls disability lawyer who can tell you what you may be able to do to pursue your rightful benefits.

Understanding Disability Rights and Claims

When you have a disability policy, you need to follow the insurance company’s rules. That means you pay your premiums faithfully and file a claim when you have a covered illness or injury. Even though you follow the rules, however, you may have your legitimate claim denied. It happens all the time.

You have the right to appeal a denial, though this rarely results in a different outcome. You also have the right to file a claim against the insurer to try to get your benefits. In addition, you can’t be forced back to work before medical professionals say it’s safe for you to return.

While you have rights, you may need a Niagara Falls disability lawyer who works in the greater Niagara region to help you protect those rights and get you your benefits. My firm, Derek Wilson Injury and Disability Law, focuses exclusively on disability claims and personal injury.

If your claim is denied, we can explain your rights and tell you how we can work with you to protect those rights.

Dealing with Denied or Cut-Off Claims

Unfortunately, many Ontarians who file for disability benefits are denied when they first apply. They may have made common application mistakes, such as not explaining a disability or illness in detail or failing to fill out application forms in full. Another common mistake is failing to submit adequate medical evidence, such as X-rays, lab results, and more.

Even if you initially get benefits, they can be cut off unexpectedly by the insurance company. Your insurers may claim you can return to work, either your own job or another role, even when your doctor has advised against it.

A denial letter can be overwhelming, especially when you’re struggling with the effects of your illness or injury and are worried about missing work. However, remember that a denial doesn’t mean the end of your fight for your rightful benefits. Consult with a disability lawyer as soon as possible after getting a denial letter. Bring your denial letter with you to your consultation to discuss what options you may have.

The Benefits of Hiring a Disability Lawyer

The average person hires a plumber or electrician when something goes wrong with their house because they don’t have the expertise to fix these systems, and DIY solutions can result in more expensive problems down the road.

When you’re facing a disability denial, it’s a similar situation. Most people don’t have the legal experience and skills to face an insurance company (and the insurer’s teams of skilled lawyers). And making a mistake now can harm you financially for years. If you don’t get the disability benefits you need when you can’t work, you need to pay for living expenses out of pocket, which can impact your savings and even put your home and other assets at risk.

Working with a Niagara Falls disability lawyer who serves the greater Niagara region evens the playing field. It’s no longer just you against the insurer and their legal team. Your lawyer will work to protect you by:

• Analyzing your denial letter and identifying the reasons for the denial.
• Making sure your policy is being interpreted correctly by the insurance company.
• Explaining your rights to you and offering possible solutions you can pursue to seek your benefits.
• Submitting additional medical evidence and challenging the insurer’s findings so the insurance company gives you rightful benefits.
• Pursuing the insurer in court if the insurance company persists in a denial.
• Continuing to seek a settlement with the insurance company, until the court date, so you can avoid the trial process if possible.
• Taking care of all the paperwork and details involved in pursuing your insurance company.
• Speaking and negotiating with the insurance company on your behalf.

If you’ve been denied disability benefits or are facing challenges in your claim, this is often too much to navigate alone, especially while you’re injured. Work with a Niagara Falls injury lawyer to make sure you get support every step of the way.

Choosing the Right Disability Lawyer

Not all lawyers specialize in disability law, and it’s important to find a lawyer who focuses on this specific practice area and who has experience pursuing insurance companies in disability claims denials.

The right lawyer will have a thorough understanding of both short-term and long-term disability insurance policies, as well as the legal strategies used by insurance companies to avoid paying legitimate claims.

The right lawyer will also be dedicated to your case. Your attorney should not pass your case on to someone with less experience and should have time for you — time to answer your questions and explain your case to you clearly.

At Derek Wilson Injury and Disability Law, I focus exclusively on representing clients in disability and personal injury cases. I started my law career defending insurance companies, so I saw firsthand the strategies insurers use to delay and deny claims. I recognize those tactics and know how to fight back when insurance companies try to deny your claim. I also am the only lawyer who will be working on your case when we work together. I never pass on my cases to junior attorneys. When you call me, you reach me, and I have purposely kept my boutique law firm small so I can devote attention and time to you and your case.

Choosing a Niagara area disability lawyer is a big decision, so I offer a free initial consultation. You can meet with me at no cost and with no obligation. Bring your denial letter. You can ask me questions, get my opinion of your situation, and see what it might be like to work together. 

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

The role of your disability lawyer is to navigate the complex legal system for you. Your lawyer pursues your rightful benefits for you and takes care of the paperwork, negotiations, filing, and more so you can take care of your health. Your lawyer’s role is also to protect you from the tactics used by insurers to delay or deny claims so you can get the benefits you deserve.

Your lawyer’s role may involve obtaining records, consulting medical professionals, and documenting how your condition prevents you from performing any job. It also usually involves negotiating with the insurer to try to get you your benefits and pursuing the case in court if the insurance company refuses a settlement.

Navigating the Appeals Process

When you get your denial letter, your insurance company will usually tell you that you can appeal the decision. This involves requesting an internal review of your claim. While this can seem like a good solution, it’s important to understand that this internal review is often biased. After all, it’s the same insurance company that denied your claim that is now reviewing it. In most cases, insurers will use the same evidence to uphold their original decision, which means the outcome may not change.

There is another option. Rather than spending time in a prolonged internal appeals process, your lawyer can file a legal claim against the insurance company. Your lawyer can also seek a settlement from the insurance company. If you are able to reach a settlement, both you and the insurance company get to walk away from the situation — you with the money you need for your living expenses and the insurance company with the knowledge that they won’t be sued. This can be the best outcome, but if a settlement can’t be reached, your lawyer can pursue the case all the way to court if that’s what’s needed.

Insurance Company Tactics and Strategies

Like any business, insurance companies want to maximize profits and keep shareholders happy. This can, unfortunately, mean they have a vested interest in minimizing the amount they pay out on claims, even when those claims are legitimate.

There are many strategies and tactics insurers use to try to deny, delay, or minimize your claim. They may try to dispute or downplay your condition, question your medical documentation, or look for technicalities to deny your claim. They may interpret your policy so they can deny your claim.

As a former insurance defense lawyer, I have witnessed firsthand how insurers tell injured workers they don’t need a disability lawyer. When insurance companies say this, they’re hoping you’ll go through the process on your own, without anyone looking out for your best interests. Unlike insurance companies, lawyers are working for you and are obligated to act in your best interest.

I have also seen insurance companies try to claim that an injury or illness was a pre-existing condition and refuse to cover it. I have seen them try to challenge doctors’ evaluations. In some cases, insurers even use surveillance of injured workers to try to deny claims. Or, an insurance company will delay, encouraging you to spend time on useless internal reviews until you run out of time to file a lawsuit. At that point, your options are limited. 

No matter what tactics your insurer is using, I’ve probably seen them, and I know how to fight back. I know how to present a strong case, how to negotiate, and how to protect your rights. If we can’t reach a settlement, I have trial experience and am willing to face large corporations in court to get you your benefits. 

Building a Strong Disability Claim

When seeking disability benefits, it’s essential to document everything  —  from your medical condition to how it impacts your ability to work and live day-to-day. A detailed and accurate claim, backed by comprehensive medical evidence, gives you the best chance of success.

One of the most important steps is working closely with your doctor. Your healthcare provider will need to create a clear record of your condition, its progression, and how it affects your ability to perform your job. It’s also important that you provide supporting evidence like medical reports, test results, and specialists’ opinions that show the severity of your condition.

The more detailed and relevant this medical evidence is, the stronger your case will be. This evidence should not only establish what your medical condition is but also provide plenty of detail about how this condition prohibits you from performing the core duties of your job.

It’s also crucial that the forms are properly completed, the medical statements are consistent, and all deadlines are met. Insurance companies will use even the smallest mistake as a reason to deny your claim.

Contact Us for a Free Consultation

If your short-term or long-term disability claim has been denied, don’t try to solve the problem on your own or by agreeing to the insurer’s internal review without at least considering other options.

Contact Derek Wilson Injury and Disability Law for a free consultation to get my honest thoughts about your situation and what you can do to get your benefits. It doesn’t matter if you’ve been denied when you first apply or whether the insurance company is trying to cut off your benefits after months or years.