Long-Term Disability Lawyer Hamilton
A personal injury can happen anywhere and anytime with a range in severity from mild to catastrophic. If you’ve suffered a personal injury, you know the extent to which it can affect your quality of life for you and your family and impact your financial freedom.
It is tough when you’re dealing with an injury to think about a lawsuit, and you may be asking, “Can I sue?” As an experienced personal injury lawyer I will guide you with what’s possible and the relevant deadlines for filing critical information. Filing a lawsuit or a personal injury claim is a complex process and I’ll simplify everything for you and explain what you need to know.
The bottom line is that, if you’ve been injured, there may be compensation available to help you cope. My job is to see your case through to the end. Let me fight for you and handle the stressful details so that you can focus on what’s most important: your recovery and your family.
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Have you been denied your LTD benefits claim? Derek Wilson is an experienced lawyer assisting disability claimants across southern Ontario.
A disability, whether sudden, or degenerative, can leave you with lost income and unable to pay for your living expenses. It’s a scary and often frustrating position to be in, and most people, if they have insurance, look to their disability insurance policies. Making an insurance claim may seem straightforward, but unfortunately, both long term disability claims and even short term disability claims are often unfairly denied by the insurance company on simple technicalities.
It could be that the claim did not include proper medical documentation that was required by the policy or the injury/illness didn’t meet certain policy requirements. There are even times when claims are denied because the claimant may have missed a deadline. Let’s face it, the application process for disability benefits can be an extremely complex and time consuming process.
Long Term Disability Benefits
If you have an LTD policy, either through your work or a private policy that you’ve purchased because you’re self-employed, there are a few things you should review in your insurance contract to make sure that you have a policy that will give you and your family good coverage.
The definition of disability is the first thing to review. It is not the same on every policy. Contrary to the Accident Benefits definitions that are part of your car insurance policy and are decided by the government, the definition of disability for LTD coverage varies from company to company, and even from policy to policy within the same company. However, it’s a critical piece of information as it is what the insurance company will use to decide if you’re eligible for receiving disability benefits.
LTD Eligibility Tests explained
Your policy will have one of several ‘tests’ to determine eligibility for disability insurance coverage:
- “Own Occupation” test — this definition basically states that you are eligible for benefits if you are not able to return to the exact job you had before your accident or the onset of your disability. A policy with this test and no time limit as to how long it applies for is probably the costliest but think about what you do for a living. If it’s a specialized job where you would end up taking a major pay cut if you ended up having to work in another field, it’s worth considering.
- Percentage test — this definition outlines a specific percentage of your duties that you cannot do to qualify as being disabled. For example, if you cannot do 65% of your prior duties, you would be considered as being disabled.
- “Any Occupation” test — this definition is the most difficult to gain eligibility under. It asks whether you are disabled for ANY job for which you may be reasonably suited, taking into account your work experience, education, training and previous salary.
- Some definitions will have multiple tests, separated by a ‘change of definition’ date. For example, the test in the first 12-24 months of your disability might be ‘own occupation’, but after the two year mark, the test might change to ‘any occupation’.
What Are Some Other Aspects of LTD Policies You Need To Know?
- Qualifying Period: there will likely be a qualifying period before you are eligible to get benefits. That period can range from 90 to 180 days. Very often, there are other benefits to be exhausted prior to the start of LTD benefits, such as STD benefits through your policy or employer or EI Sick Benefits you would get prior to going on LTD. In terms of coverage, policies vary, providing anywhere from 60 to 85% of your previous salary. You need to consider what you could live on if you were unable to work for years at a time. Under some LTD policies the insurer will require that you apply for CPP Disability benefits.
- Medical Evidence: most insurance companies are going to ask for objective evidence in order to determine eligibility of your disability case. Your insurance company may base their decision on other examinations, independent tests and other results.
- Internal Appeal Process: When the insurer denies your LTD benefits they often invite you to make an appeal.
- Two-year time limit: You have up to 2 years to file a lawsuit against your insurance company after the first denial, and if you miss this deadline the insurer can deny your benefits.
Why was my Long Term Disability Claim denied?
Denied disability insurance benefits are very common in the insurance industry. If you received a denial for your long term disability insurance, here’s what you should do:
- Put your denial letter or termination letter in a safe place. This is an important document because it will include the date of the letter (in Ontario this is the date from which the 2-year limitation period to sue starts to run). It also includes your definition of “disability” as per your policy, the provisions of your policy, the insurer’s reasons for denying your benefits and in some cases the last day of your long term disability payments.
- Skip the internal appeal process, it’s very difficult to win because essentially someone from the same company is reviewing a co-workers previous decision. Unless you have brand new information or medical reports to present containing information the insurer did not already have, it can be very difficult to win the appeal. It does happen but it’s very difficult which is why many people choose to retain a disability lawyer.
- Keep seeing your doctor and have them update your medical information. You will need the medical records to support your disability claim and they will also refer you to specialists who can help diagnose and treat your condition, as well as provide treatment options.
- Call a disability lawyer. The moment you receive your denial letter is the time to call a personal injury lawyer who has experience in long term disability insurance in Ontario. When you suffer an illness or an injury, it’s about getting your life back together and providing for yourself and your family.
Call today for a Free Consultation
For an initial consultation with an experienced long term disability lawyer in the Hamilton area call us at 855-769-0418 or fill out a free consultation form. My firm focuses only on personal injuries and represent clients with their long term disability claim. We provide fair and honest legal advice with a focus to help you, your loved one and family recover fair compensation with no upfront fees.
I will always have your best interest in mind. We will respond in a timely manner so you and your family members can receive the help you need. Our practice areas focus only on your injury claim; such as Disability Insurance Claims, Slip and Falls, Car Accidents including Accident Benefits, Brain Injury, Concussions, Spinal Cord Injuries, Wrongful Death, Product Liability, Pedestrian MVA and Personal Injuries.
At my law firm, I can help you navigate your long term disability benefits case and the insurance companies because it’s all we do. Our personal injury practice truly cares about your well-being and we understand that the road to recovery is often long and filled with pain and suffering. Insurance companies and long term disability policies in Canada can be complex to navigate on your own, which is why our team is prepared to take all reasonable steps to proceed with your claim and get you the compensation you deserve. We are passionate legal professionals and have assisted many individuals across Ontario in recovering fair settlements. Don’t suffer in silence – contact our office today for your free consultation and discuss your particular case with a qualified disability lawyer.