Individuals who experience severe mental illness often have difficulty holding down a job. A lot of this comes down to inconsistent performance as well as periods of heightened anxiety and depression. All of this can compound over time, making it difficult to keep up with social interactions as well as making it hard to focus during the day. Even if you do seek treatment, you have the risk of medication side effects. These can hinder your workability by making you drowsy, so even if you are trying your best, and working hard, you still have the odds stacked against you. Eventually, you may come to the conclusion that you are simply unable to sustain employment and that your current job is no longer sustainable. If you have gotten to this point and you feel as though you need to make a change then this guide should tell you everything you need to know.
If you’re grappling with the tough realization that your disability has reached a point where continuing work is no longer feasible, know that you’re not alone in this journey. The decision to apply for long-term disability benefits is often accompanied by a mix of emotions – frustration, sadness, but also relief at acknowledging the need for support. It’s a decision that signifies strength and self-awareness, not defeat.
As you begin this process, understand that while it may seem daunting, there are resources and people ready to help you navigate through. You’re taking a necessary step towards prioritizing your health and well-being, ensuring that your needs are met in a manner that respects your circumstances. Remember, applying for long-term disability is a way of adapting to a new phase of life, and it’s okay to seek assistance and guidance as you make this transition.
Facing the setback of being denied long-term disability benefits can feel disheartening, but it’s important to remember that this isn’t the end of the road. There are two primary avenues you can explore.
The first option is to file an internal appeal with the insurance company. This process involves gathering additional evidence and “new” medical records to support your disability claim, presenting a detailed case to challenge the denial. It’s a step that demands thorough preparation, but it offers a chance to overturn the decision without entering a courtroom. Do internal appeals often succeed? No. At least not without the assistance of counsel and the presentation of new medical information which your disability carrier may not have had when they made their original decision.
The second path is to hire a disability lawyer and consider legal action. This route often involves suing the insurance company, a process that can be more complex and may take longer, but it also potentially brings the expertise and advocacy of a legal professional to your case.
Each option has its own set of challenges and benefits, and the choice depends on your specific situation, resources, and how you wish to proceed. Whichever path you choose, remember that it’s about asserting your rights and seeking the support you are entitled to.
Firstly, it’s important that your disability carrier convey to you what the limitation is to file and internal appeal. In most cases, the disability insurer will give you 60 to 90 days to file an internal appeal. During this time you will have no access to monthly benefits and be without income. Then, the problem becomes the time it takes for the insurer to provide an answer to your appeal.
While you are to strictly adhere to their time limitations to file an appeal, the disability insurance carrier is not under mandate to provide you with a response within a certain amount of time – leaving you without continued benefits for an indeterminably amount of time. For example, Canada Life’s publication “How to submit a claim and what happens after” reports that for a LEVEL 1 and LEVEL 2 Appeals “communication will be made within 7 calendar days for short-term disability benefits and 14 calendar days for long-term disability benefits.” With LEVEL 3 appeals, Canada Life will “communicate with the claimant within 10 calendar days for both short-term disability and long-term disability benefits.” The insurer is using the word “communicate” and not render a decision. Remember, the claimant is without any income during this period of time.
Yes – you have the right to hire a disability lawyer to help you with the process. In Canada, individuals who have had their disability benefits terminated have the right to seek legal representation and are not limited to just filing an internal appeal with their insurance company.
This means a disability claimant can choose to hire a disability lawyer to advocate on their behalf, rather than solely relying on the insurer’s internal review process. Engaging a disability lawyer can offer several advantages.
Firstly, it provides the claimant with professional legal guidance and representation, which can be crucial in navigating the complex legal and procedural aspects of disability law. A disability lawyer can help in gathering and presenting evidence, negotiating with the insurance company, and representing the claimant’s interests in a more formal legal setting, if necessary.
Additionally, a lawyer can assess the merits of the case, advise on the best course of action, whether it’s negotiating a settlement or proceeding to litigation, and ensure that the claimant’s rights are protected throughout the process. This approach can often lead to more favorable outcomes for the claimant, as opposed to going through the insurer’s internal appeal process, which may not always be impartial. Therefore, hiring a disability lawyer offers a viable and potentially more effective alternative for those seeking to challenge the termination of their disability benefits in Canada.
The answer is quite unpredictable. When you commence a claim against your long-term disability carrier, you are seeking to have a judge “declare” you are disabled pursuant to your policy definition. Here’s how the process works ina nutshell – with all times being estimates only based on our experience as litigation lawyers:
Month 1 to 4
First, it may take you a bit of time to search for the right disability with the experience you need. Then, after you hire the disability lawyer with whom you feel most comfortable – a lawsuit will be filed and “pleadings” – will be exchanged – which are the lawsuit documents between you and your disability insurance company’s legal department.
Month 4 to 6
Normally in months four to 6 there examination for discoveries scheduled. This is a period of questioning. One of our lawyers gets to examine a disability insurance company employee – namely your adjuster, and you also will be questioned by the disability insurance company lawyer.
Month 4 to 12
Discoveries should happen during this part of the timeline. You should also be scheduled to see experts hired by your lawyers, who will provide independent medical legal opinions.
The case could also go to a mediation at any point throughout the process, depending on the insurer’s view on risk assessment. A mediation is a formal settlement meeting.
Month 12 to 24
If your case does not settle, then you will most likely attend a pre-trial and the trial of your case during this part of the timeline.
Ther are man factors which can affect the progress of your lawsuit, such as the schedules of the lawyers involved, the gathering of medical evidence, communication problems with the insurer, backlog and scheduling in the legal system, backlogs and delays in the Courts and at times, the plaintiff’s willingness to settle. The plaintiff’s own decisions regarding settlement offers can also affect the timeline. A willingness to accept a reasonable offer early in the process can shorten the duration, while holding out for a larger settlement or a trial can extend it. Understanding these factors can be crucial for individuals involved in LTD lawsuits, as they can impact both the strategy and expectations regarding the duration of the legal process. Experience disability legal counsel can provide guidance tailored to the specifics of each case.
For nearly four decades, our team of experienced long-term disability lawyers have been dedicated to advocating for claimants at every stage of their disability claims. We recognize the physical, emotional, and financial toll that can arise from the cessation of disability benefits. Our team is acutely aware of the stress and challenges you may be experiencing in your interactions with insurance adjusters, and we understand the distress caused by feeling pressured to return to work prematurely.
Our goal is to assist you in obtaining the long-term disability benefits you rightfully deserve, enabling you to concentrate on your health and recovery without the worry of financial hardship. If you or someone you know is battling colon cancer and has faced denial or wrongful termination of long-term disability insurance benefits, we are here to support you. Our services are designed to ensure that you receive the benefits you need, alleviating additional financial concerns during your recovery period.
Based in Hamilton, Ontario, our firm represents disability claimants across the nation.
We offer free consultations to anyone in Ontario or across the country. You can reach us toll-free at 1-844-4-DISABILITY. For confidential inquiries, feel free to email us via our website. We are more than willing to discuss your long-term disability rights and legal options at no charge.
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“Matt Lalande halped get my long-term disability benefits back. It was a longer fight than expected, but he managed to help make things right again. Would recommend A+++++ Thank you Matt.”
Patricia Williamson
Long-Term Disability
“Matt Lalande helped me attain my long-term disability benefits. The denial of benefits caused me substantial stress on top of my existing condition. Matt Lalande and his team were very understanding and explained the whole process clearly. They were confident that we would be successful. Dealing ...
Cheryl Oddie
Long-Term Disability
My experience with Mr. Matt Lalande and his team was exceptional. Matt is a very impressive professional when involved in a long-term disability benefits denial. Matt and Heather responded to all my emails and phone calls in a prompt and efficient manner. Matt is a great and honest lawyer. I highly reco...
Payne Momich
Long-Term Disability
