Oakville Disability Lawyer

Many employees in Oakville and across Ontario have short-term and long-term disability benefits as part of their work benefits package. Many Ontarians without such benefits buy group disability insurance plans to protect themselves in case they’re ever injured and can’t work.

The reality is that most workers rely on their paychecks to pay for essentials, and they need some sort of safety net if they can’t work due to injury or illness. Paying premiums for disability insurance is supposed to provide this peace of mind, but many workers with legitimate claims find themselves facing significant barriers when they need insurance money because they can’t work. They may find their rightful claims denied, may face delays in getting benefits, or may find that insurers try to cut off benefits before a doctor has approved a return to work.

If you find yourself in these or in any situation where you can’t access your rightful disability benefits, contact Derek Wilson Injury and Disability Law for a free consultation. Consult with an Oakville disability lawyer before you make any decisions that could affect your future.

Understanding Disability Rights and Claims

If you have short-term or long-term disability through an employer or group plan and can’t work due to an injury or illness, your first step is to consult your policy. Unless your injury or illness is excluded by the policy, you should have a claim, and as long as your doctor agrees, you can’t perform the core duties of your job.

You will generally apply for short-term disability first, which will cover 60% to 100% of your salary for a few months to a year, depending on your policy. You can then transition to long-term disability if you haven’t recovered.

As an injured employee, you have the right to seek benefits and to get benefits as long as you qualify. Your employer also can’t force you back to work against your doctor’s orders, though some workers find themselves facing this pressure.

In Ontario, understanding your rights is crucial to getting the benefits you deserve. That is why you may want to contact Derek Wilson Injury and Disability Law for a free consultation if you’ve been denied your benefits or you’re facing pressure to return to work before you’re cleared to do so.

Dealing with Denied or Cut-Off Claims

There are three major moments when you’re at risk of denials. The first happens when you apply for short-term or long-term benefits in the first place. When you first apply for benefits, the insurer will look closely at your application. If they can deny you, this is financially beneficial to them, since they don’t have to pay you benefits. If there is a lack of medical evidence or anything that doesn’t match up with your application, even if you’ve made an honest mistake, you can be denied.

The second moment of risk happens when you transition from short-term to long-term benefits. When your short-term benefits run out, you can turn to your long-term disability insurance if you have it. This essentially requires you to apply all over again, and in some cases, your long-term disability may be from a different insurance company than your short-term policy.

The third moment of risk happens when you’ve been receiving your benefits for a while. Once your benefits are in place, you may assume all is well, but it’s not uncommon for employees to find themselves pressured to return to work by the insurance company or their employer. They may be told they can return to partial duties — even if their doctor disagrees — or the employer may not be able to accommodate them.

In these situations, it’s important to consult with an Oakville disability lawyer to make sure your rights are protected, and you get access to the benefits you need to pay for your bills and living expenses.

Benefits of Hiring a Disability Lawyer

When you’re injured or ill and can’t work, the last thing you need to worry about is being denied benefits. Should you receive a denial letter, would you know what to do? Most Hamiltonians and Ontarians don’t. These hard-working employees trust the insurance company will take care of them.

An Oakville disability lawyer knows how to negotiate with the insurer and how to present a strong case. When an insurance company sees that you’re working with a lawyer, they know they can’t just pressure you to return to work or try to wrongfully deny you your benefits.

Studies out of the U.S. show that when claimants were represented by lawyers, they saw 40% higher settlements than plaintiffs who were not represented. While similar studies are not available in Canada, we can predict that here, too, employees with lawyers have a better chance of getting fairer settlements.

Another benefit is that your lawyer will take care of the details of filing a claim against the insurer after you’ve been denied. Your lawyer will speak to the insurer for you, find evidence to build a strong case and prepare your case for court. This frees you to focus on your treatment plan and doctors’ visits.

Choosing the Right Disability Lawyer

Just calling the lawyer you helped you close on your house isn’t enough. Disability insurance cases are complex, and insurers have legal teams that specialize in insurance law. You need the same to succeed.

The right disability lawyer is someone who has experience with disability claims in Ontario specifically. For example, as the founder of Derek Wilson Injury and Disability Law, I’m a lawyer who has chosen to focus exclusively on disability claims and personal injury claims so that I can put all my resources into these kinds of claims.

I handle your case personally, rather than giving it to a junior lawyer. This is important because early in my career, in the 1990s, I worked in insurance defense litigation. I worked for insurance companies and saw how these corporations operated and how they worked to deny claims. Today, I can use this inside look to fight back when insurers try to use their typical tactics to try to deny your claim.

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

Your Oakville disability lawyer represents you when you’ve been denied a disability claim. The role of your disability lawyer is to:

• Contact the insurer and ask them to act in good faith if the insurance company is acting unprofessionally or is refusing to answer your calls.
• Explain your rights and the basics of disability insurance to you, answering your questions.
• Can review your specific policies and help you understand what benefits you should be getting and what is and isn’t covered.
• Talk to insurance companies for you, so you don’t have to.
• Address situations where your insurance company is trying to tell you that you can do another job or return to work.
• Talk to you about your financial worries after you’ve been denied disability, and come up with a plan for the next steps.

If you’ve been denied disability, if your relationship with the insurer is breaking down and you think a denial letter is coming, or if your insurance company or employer is trying to force you back into the workplace while you’re still injured, contact Derek Wilson Injury and Disability Law for a free consultation with an Oakville disability lawyer. Let’s talk about what you can do next.

Navigating the Appeals Process

Should the insurance company deny your claim, you may have the option of an internal appeals process. While this can seem like a good solution, it rarely works. After all, it is the same insurance company reviewing the same application they have already denied. Unless there is a very persuasive reason for them to come to a different conclusion — for example, you have completely new and compelling medical evidence — they are likely to agree with their earlier denial.

Even worse, the appeals process can take a long time, and by the time you’ve gone through the whole process, you may have lost out on the chance to file a lawsuit against the insurance company. That’s why, in many cases, it’s better to skip the internal appeals process entirely.

Insurance Company Tactics and Strategies

It’s important to know that insurance companies are not legally obligated to act in your best interests, even though you have been paying premiums and insurance companies claim they are helping you. Insurance companies are businesses with a fiscal obligation to their shareholders, and they earn more for their shareholders by minimizing and denying claims. In other words, insurers have a financial incentive to pay less than full benefits.

Insurers may act like your friends when you file a disability claim, but it’s important to understand that they work for shareholders, not you. In addition to trying to get you to go through the internal appeals process, insurance companies will often try to persuade you not to call a lawyer. They will say you don’t “need” a disability lawyer and may tell you it’s an additional expense. It’s to their advantage if you don’t have a lawyer protecting your rights.

While you want to maintain a cordial and professional relationship with your insurer, weigh their words carefully. Keep in mind that these companies deny legitimate claims every day, leaving Canadian workers struggling. Consult with an Oakville disability lawyer if your claim has been denied to find out what you can do.

Building a Strong Disability Claim

Building a strong disability claim means giving the insurance company fewer reasons to cut off your benefits or deny your claim in the first place. Here’s how to do that:

• Pay attention to deadlines. There may be multiple deadlines you need to pay attention to when filing your claim, providing medical information, and filing a lawsuit if you need to. Always clarify the deadlines with your employer or insurance company and write the deadlines down. Work to submit all required information well in advance of every deadline.
• Gather evidence. One of the most common mistakes workers make when applying for disability is failing to provide enough medical evidence. Work with a doctor or specialist to make sure they submit an Attending Physician Statement, which should clearly outline your injury or medical condition and your limitations when it comes to work. Your doctor should also submit any supporting documentation to prove your medical condition. This can include X-rays, blood test results, biopsy results, imaging scans, and anything else that may be relevant.
• Be accurate with your descriptions. One common mistake that employees make when filing for disability is using language that is slightly different than what their doctor uses. Any discrepancies or inaccuracies can mean your claim gets denied, so be careful in the language you use.
• Follow your doctor’s recommendations. It is important that you keep seeing your doctor or specialists and that you follow your treatment plan. With Ontario’s healthcare system, there can be delays in seeing a specialist, and you may have trouble getting in to see your doctor quickly. It’s still important that you persist and follow everything to the letter. It not only creates documentation about your medical condition and symptoms, which can strengthen your claim, but it means you have the best chance possible to heal.

Of course, you can do everything right and still find your claim denied. If this happens to you, reach out to Derek Wilson, Injury and Disability Law, for a free consultation with an Oakville disability lawyer.

Contact Us for a Free Consultation

At Derek Wilson Injury and Disability Law, your first consultation is always free and comes with no obligation. If you have received a denial letter or are having trouble getting your rightful benefits, contact us.

It costs you nothing to get the founder of the firm to look at your claim, your policy, and your denial letter and give you his honest assessment of the situation — and what you may be able to do.