NOVA SCOTIA LONG TERM DISABILITY LAWYERS
Cut off or Denied Long Term Disability Benefits?
We fight for the rights of disabled workers
Insurance exists as a safety net for the worst case scenario. It is meant to provide you with financial security in the short term while you recover, and for the long term if you remain disabled. If all people with a valid claim were paid benefits owed to them, there would be no need for plaintiff disability lawyers. As you may suspect, we assist disability client’s on a consistent basis.
Disability policies take many shapes and sizes, but the core feature of most policies considers the extent of your disability. A Short-Term Disability benefits may exist through a group plan through your work, or via a private plan. Short-term policies are meant to provide a bridge to your recovery. Long-Term Disability insurance generally activates after the expiry of the short-term disability period.
The vast majority of our work starts because of two events which occur all too often:
1. the injured person’s application for benefits is rejected by the insurance company
2. the injured person’s benefits are cut-off
Disability law is complex. Policy wording is complicated, and the requirements for accessing the benefits are often lengthy. Sometimes, an application is rejected simply because an insufficient amount of medical information was provided. In other cases, the application form was simply incomplete.
The second event occurs at the so-called ‘change of definition’ date. Many policies have a definition change clause within the terms of the policy, allowing the insurer to end monthly benefit payments to an injured person if they are found to not have a disability severe enough for benefits. Commonly, the definition of benefits changes from an ‘own-occupation’ standard to an ‘any-occupation’ standard. In short, if you can do some job that you would be reasonably able and qualified to do, the insurance company will terminate benefits.
Benefit cut-offs are often unfair. Decisions are generally made by medical consultants working for the insurance company. Appeals are possible, but the review will be done by the insurance company.
Our work begins with an assessment of your medical file. Following a detailed review of your health and the insurance policy, we develop a strategy to demonstrate your level of disability to the insurer. A properly developed claim will result in one of three main possibilities:
Your health has improved such that you are able to work.
Your benefits are reactivated – you return to being “on claim”.
You receive a lump-sum payment to give up your policy.
Enforcing your contractual benefits is often challenging and discouraging. We help take this burden from our clients through our management of your claim. We are committed to fighting for your health and recovery.
We encourage you to speak to us about your disability benefits claim. We will review the policy with you and provide our opinion on your likelihood of success. We look forward to your call.
What is long term disability?
Long-term disability insurance benefits generally begin when the following benefits end:
- 1. short-term disability insurance
- 2. sick leave benefits from your employer
- 3. EI benefits
Most long-term disability plans will replace 60% to 70% of your normal income. Each disability plan is different. Some may provide disability benefits for up to two years if you’re unable to return to the job you had before becoming disabled. After two years, you may continue to receive benefits only if you’re unable to work at any job.
Am I Still employed while on long term disability?
You are employed as long as your employer does not terminate your employment.
With some exceptions, employers can terminate an employee whenever they want, as long as the termination is not for a discriminatory purpose.
Usually employers will not immediately terminate an employee who is on long-term disability. While they have the right to do so, it can be difficult for them to prove that the termination is not related to discrimination based on disability. Most employers will therefore allow the claimant to remain employed on an approved sick leave for up to two years.
After two years, if the employee is permanently incapable of returning to work in any capacity, many employers will move to terminate.
When faced with a termination of employment, always get legal advice.
How much does a disability lawyer cost?
Depending on what you need done, hiring a disability lawyer can cost as little as $50 or as much as $100,000 in extreme situations. You can hire disability lawyers under different fee arrangements, such as hourly rate, fixed fees, or contingency (no-win, no fee). Generally speaking, the amount you will pay will depend on two factors: 1) The amount of financial risk to the lawyer and 2) the scope of the work you need done.
How long before Long term disability starts?
Long term disability benefits start after you have been continuously disabled for the required waiting period. Depending on your policy, this waiting period is usually three to six months. It is common for people to receive short-term disability benefits or EI sickness benefits during the waiting period.
Are long term disability Benefits taxable?
Generally, if you pay the entire amount of the disability premium yourself, your disability benefits will be tax-free. This may bring your income while on disability closer to your current take-home pay.
If your employer pays all or part of the disability premium, your disability benefits will be subject to income taxes.
What to do if your ltd benefits are denied or cut off
It is a bad day for any disabled worker when they receive a denial letter or termination letter but there is still hope. The first thing you should do when receiving one of these letters is to photocopy it and store it in a safe place, as it will be a valuable asset in any appeal.
A denial letter indicates that your LTD claim was unsuccessful. The denial will typically mention that you may suffer some restrictions, but that your disability does not rise to the level of a “total disability”.
These letters are a threat to your LTD benefits and must be taken seriously. Once you have sorted out why you were denied, you can then determine what you can do to attempt to overturn the unfavourable decision. There are ways to appeal both a denial and a termination letter. Although this can be a complex matter and it is recommended that you seek out a disability lawyer, “The Must-Read Guide to Winning Disability Insurance Benefits” lays out a step by step guide (along with tips) to successfully appeal a denial or termination and get your LTD benefits back.