Nova Scotia Public Service LTD: Final Appeal

How do I do my Final Appeal to the LTD Plan

Once the second appeal decision has been made, Manulife will provide a written decision to the claimant. If the decision reverses their prior decision to deny benefits – excellent, you will get your benefits! If not, you must then continue to the final appeal stage.

The final appeal is with the Appeal Board run by the Nova Scotia Public Service Plan itself, rather than Manulife. You can consider the Appeal Board to be the last chance to obtain benefits because there is no right to sue for an unfair denial of benefits.

Importantly, the appeal will only consider evidence that was filed as part of appeal process with Manulife. This means that it is essential that all evidence you seek to rely upon at the appeal has been provided before the second appeal to Manulife.

Once the second denial decision has been made, you will be advised of the Appeal Board option. It is critical that you provide notice of your intent to appeal within 15 days. To do so, you must write to the Chief Executive Officer at the LTD Plan office.

When will the Final Appeal be heard?

You will then hear from the Plan office with respect to the setting of the appeal hearing date. While it is possible that the Plan can overturn Manulife’s decision without an appeal, one should not rely on this because it is the Plan that has hired Manulife to do the proper job in the first place. If the CEO does not request Manulife to review its decision, an appeal hearing will be scheduled.

The appeal is typically heard at the Plan office, located on Spring Garden Road in Halifax. The appeal is to be held within six months of the filing of notice to appeal. The delay is due in part to the review processes which occur and do to scheduling matters.

A physician knowledgeable about the process and procedures will sit as the Appeal Board Chair. This physician is the judge. It is your job to convince the physician that you are entitled to the benefit.

In advance of the hearing, you will be provided with a binder containing all the evidence that can be referenced at the appeal. Given the rules for the appeal, the binder will only contain information included in Manulife’s file, and information that you have submitted during the course of appealing the original denial decision.

How does the Final Appeal work?

At the appeal, you will be seated at a table with the Manulife representative and the Plan representative on the other side. The Appeal Board Chair will be at the head of the table. The proceeding is must less formal than a courtroom. The Chair will start by explaining the process of the appeal and will ask if you have any questions. Manulife will then present its case to the Chair. Manulife’s presentation will be mostly a summary of their past decision making with reference made to key medical documents and investigations. You will then have an opportunity to comment on Manulife’s presentation. It is then your opportunity to present your case. Most presentations are made with a written submission to the Chair. You then address your written content in oral submissions. There is no formal time limit for your submissions. The Chair may ask you questions regarding your submissions. Manulife will have an opportunity to comment on your presentation to the Chair. The Chair may have further questions for Manulife based o your presentation. Once the questioning is complete, the Chair will call an end to the meeting.

The Chair will send the decision to you and the Plan within 14 days.

Why Hire A Lawyer for your Final Appeal

We know how to win an appeal before this Board. There are two main ways to win your appeal for Long Term Disability Benefits:

  1. Submit the right information before the second Manulife appeal take place, and
  2. Make the right arguments at the hearing of the final appeal.

Be sure to contact us right away for a free case review. Ideally, we are providing you with our opinion before the second appeal to Manulife. If this appeal has already happened in your case, please be sure to let us know right away. Time limits apply to your claim and timely notice to complete the final appeal must be made. Jeff Mitchell is an experienced Long Term Disability Benefits Lawyer who has successfully advanced his client’s interests before the Nova Scotia Public Service Trust Fund. To book your free consultation, call toll-free: 1-855-670-1345 or 902-702-3452. Prefer to email?  Email Jeff at jeff@novainjurylaw.com.

Leave a Comment