If you’ve been wrongfully denied or terminated from your long-term disability benefits, you are not alone. Our Ontario disability lawyers have seen it time and time again. You’ve paid some or all of your premiums on every paycheck – and now – your disability insurance company refuses to pay your monthly disability benefits. They’ve told you you can return to work and “do something.” They say that your condition has improved. They say you no longer “qualify” for long-term disability benefits because you do not meet the company’s definition of total disability. They insist that you can do “some type of work,” but this is not how disability benefits work.
If you’ve been on disability benefits for two years – your disability insurance company might be telling you that you do not meet the change of definition. A typical scenario seen by our Ontario disability lawyers is when you reach the two-year mark of receiving benefits, and your insurer informs you that you no longer meet the definition of disability, as it’s now changed. Even worse, your disability insurer might be ignoring your doctor’s clinical advice that you remain off work. They say that if you want your disability denial overturned, you have 30 days to file an “internal appeal” with their appeals committee.
Because your disability insurance company has denied or abruptly terminated your long-term disability benefits, you’re left without a monthly income. This makes it harder to pay your bills, pay your insurance, pay your mortgage, and simply survive. You’re frustrated and left in a state of confusion and financial despair, still suffering from your disability and left without income in a time of need.
Long-term disability is supposed to protect individuals and their families financially when work is impossible due to a debilitating injury or illness. Unfortunately, many are let down by the very company that promised to help them. When claimants’ disability benefits are terminated, most do not know they are fully entitled to hire a disability lawyer to protect and represent them.
The reality is that most policyholders do not know where to turn when they’ve been denied long-term disability benefits. Most claimants get so exhausted and frustrated dealing with endless requests for paperwork and medical documentation – all while suffering from a disability – that they simply give up.
If your long-term disability benefits have been wrongfully denied or terminated, contact us today to set up your free consultation. Call us no matter where you are in Canada at 1-844-4-DISABILITY or send us a confidential email ,and our intake specialist will be happy to set up your free consultation today. We are happy to meet at one of our locations or via Zoom or Teams video conferencing.
If you’ve been denied long-term disability benefits, we can help you get things back on track without any upfront fees. Our Ontario disability lawyers understand the tough financial situations many claimants are in, so we offer a free consultation to everyone.
Matt Lalande is an Ontario Long-Term Disability lawyer who has fought for the disabled since 2003. As a disability lawyer, he is the co-author of the third edition of “Disability Law in Canada,” a disability publication often referred to by lawyers and judges across Canada.
Since Matt became a lawyer, he has helped disabled individuals obtain the long-term disability benefits that they deserve. He has recovered millions in wrongfully denied long-term disability benefits and has the experience to handle any disability case in Ontario and throughout Canada.
Ontario Disability lawyer Art Camporese has been recognized as one of the best lawyers in Canada. He is an experienced trial lawyer who has tried countless bench and jury trials to reach verdicts. Since 1984, Art Camporese has handled hundreds of disability cases and has recovered millions for disabled individuals all over Ontario. Art handles short-term disability cases, long-term disability cases, critical illness cases, and life insurance cases. He has litigated against every major disability insurance carrier in Ontario.
Our Ontario disability lawyers regularly assist claimants with cancer disability claims, mental health disability claims, chronic illness disability claims and injury disability claims – the following of which are set out below:
Online reviews can be essential to your research for an Ontario Disability Lawyer. While personal recommendations carry significant weight, online reviews provide additional viewpoints and insights that can assist you in making a well-informed decision.
Consider the following when consulting with various Ontario disability lawyers.
Comprehensive Outlook: Online reviews offer a broader spectrum of experiences and opinions from previous clients. This can give you a more thorough understanding of the lawyer’s strengths and potential weaknesses.
Recognizing Trends: If you observe recurring themes in the reviews, whether positive or negative, it can suggest a pattern in the lawyer’s service. For instance, if several reviews highlight the lawyer’s responsiveness in communication, it’s likely a consistent strength.
Insight into Client Journey: Reviews frequently detail the client’s experience, from the initial consultation to the case resolution. This can give you an idea of what to anticipate if you decide to work with that lawyer.
Warning Signs: Negative reviews can raise awareness of potential problems, such as poor communication, unprofessional conduct, or unsatisfactory case outcomes.
However, it’s crucial to approach online reviews with a discerning eye and consider the various factors that may influence what’s shared:
Genuineness: Not all reviews are authentic. Some may be authored by the lawyer’s acquaintances or family members, while others may be posted by competitors attempting to damage their reputation. Our reviews are 100% genuine and authentic – that is a guarantee.
Polarized Viewpoints: People are more inclined to write reviews if they had an exceptionally positive or negative experience. This can result in extreme opinions that may not reflect the typical client’s experience.
Insufficient Context: Reviews often lack the complete context of the case. An unfavourable outcome might be due to factors beyond the lawyer’s control, but this context could be absent from the review.
Outdated Information: Laws, practices, and even lawyers can evolve. An old review may not accurately represent the current situation.
Despite these limitations, online reviews remain a helpful tool in your research. Look for patterns and use the insights gained to guide your questions when meeting prospective lawyers.
While online reviews should not be the sole basis for your decision, they can offer valuable information to complement personal recommendations and your research. Approach them critically, but don’t disregard them entirely. They are another part of finding the right Ontario disability lawyer for your needs.
Yes, consultations with our Ontario disability lawyers are entirely free. Regardless of what stage of the disability claims process you are currently in, the Ontario disability lawyers of Camporese Lalande can help. If your long-term disability benefits have been terminated, it’s essential that you consult a disability lawyer and carefully go through all of your legal options so you are fully informed.
Our Ontario disability lawyers can help with any claim in Ontario and throughout Canada, and we encourage you to contact us to discuss your case in detail. We will take as much time as you need to discuss your disability matter and explain your legal rights.
We understand that you’re going through a painful and challenging time, so we never charge anyone to talk about what they are going through with their long-term disability insurance company.
Our Ontario disability law firm is one of the only law firms in Canada specializing in long-term disability insurance denials. Since 1984, we have represented thousands of disabled individuals who have been wrongfully terminated or denied long-term disability benefits. A disability claim is a medical-legal case, which can be highly complex. The many nuances and moving parts make it crucial to hire an experienced Ontario disability lawyer to help ensure everything is done correctly.
Our lawyers will explain how the disability process works, evaluate the strength of your case and help you understand your options within the disability laws in Ontario. If we decide to work together, we will gather all relevant medical records and file a claim against your disability insurance carrier immediately.
We will pursue a swift reinstatement of benefits so you can bring your life back into balance. We work with the best experts in Ontario to ensure that your burden of proving total disability is discharged and you are paid the monthly benefits you deserve. We will also help prepare your care, prepare you to provide testimony if required, and represent you through the entire process, including trial or settlement.
You do have the option of representing yourself throughout the internal appeals process. However, it is not recommended that you do so, as many disability carriers have strong representation of their own and facing them alone will be challenging.
The entire process will be complex and challenging for anyone without experience. Most claimants do not understand the unique and intricate elements of disability law and litigation against disability insurance. Our Ontario disability lawyers have extensive experience handling every element of a long-term disability case, and we recommend that you call us before doing anything else.
The only recourse for disability claimants who have been denied their long-term disability benefits is to hire a lawyer with experience in disability insurance litigation and the resources to handle it. Disability insurance law, however, is very expensive to litigate – and the longer the case lasts, the more expensive it gets.
Due to financial constraints, obtaining legal services is often difficult, if not impossible, for many lower-income and disadvantaged individuals. As a result, many individuals are left without access to a proper solution. Average hourly legal fees can amount to hundreds of dollars, and trials can cost upwards of tens of thousands of dollars per week. This is prohibitive for most, leaving many individuals with no help and no choice but to accept the insurers’ decision.
However, Our Ontario disability lawyers understand that disability claimants denied or terminated from their long-term disability benefits do not have the funds to retain a lawyer. In many cases, the disability payment is their only source of income. This is why we work on a contingency basis instead, meaning we only get paid if we win your case.
With our disability law firm you will neer pay anything up front – no matter what the circumstance. We work at no cost until the case is won, at which time we will retain a portion of the settlement as our fee. If we do not win your case, you owe us nothing.
Matt Lalande – Lalande Disability Lawyers
Upon denial of your long-term disability claim, your disability insurance company may offer you the chance to appeal the denial. They may advise you that they have an efficient and streamlined appeals process and their disability appeals team will review any new documentation you submit.
They may make it sound simple, but the question is – do internal appeals work? Is it worth the effort? Unfortunately, the internal “appeal committees” are not independent bodies. The committee comprises employees paid by the same insurance company who initially declined your long-term disability claim. Regardless of what they claim, this appeals team is not impartial.
Most disability insurance companies say the appeal process can take up to three months. Whether or not they accept your appeal, this is three more months without income, and you’re delayed in starting any legal process.
Long-term disability insurance is supposed to protect you financially. The promise is that they will provide you with a monthly income replacement benefit when you can no longer work. Over the past 20 years, we can count the number of successful internal appeals seen by our Ontario disability lawyers on the one hand. Remember, the longer you wait to hire an Ontario disability lawyer, the longer you wait to get your benefits back on track.
Qualifying for long-term disability benefits can be a complex and frustrating process. With most Canadian long-term disability policies, the claimant must first show that they cannot perform the substantial duties of their “own occupation.” This means that you must be unable to do the work you were doing at the time of the onset of your disability.
It does not matter what you are suffering from – whether it is a chronic illness, a chronic disease, a chronic injury, a mental health issue, a psychological problem, a trauma or an auto-immune disorder – you have the burden of proving that you suffer from a total disability as it is defined within your individual or group policy. If you are deemed to meet this definition, it will apply for two years.
After 24 months, most long-term disability policies incorporate a “change of definition (COD).” This means that the definition of total disability changes from being unable to perform the substantial duties of your “own occupation” to being unable to perform the substantial duties of “any occupation” you might be suited for based on your education, training or experience.
As the claimant, you must prove your inability to work in both your own occupation and any occupation to remain eligible for total disability.
If you can only perform the duties of a menial occupation that does not measure up to your previous employment, you may still qualify for long-term disability benefits. This theory was set out in a case called Labelle v. Great West Life, where Judge Proudfoot J. construed an “any occupation” definition of total disability as “notwithstanding this all-embracing definition, this does not mean that the person is not entitled to the benefit if he is so sick that he can take on only trivial or inconsequential work, or work for which he is over-qualified, or work for which he is completely unsuited by background.“
An old case called Paul Revere is often cited when trying to determine if a claimant is, indeed, totally disabled. In this case, the Court stated that the test of total disability is whether a reasonable person would recognize that they should not engage in certain activities even though they are not physically unable to do so.
In other words, total disability does not mean that you are physically unable to do every task related to your job. What total disability means is that you cannot do the essential duties of your job.
In our experience, many disability insurance companies, including Canada Life, Manulife, Sunlife, Beneva (formerly La Capitale), Empire Life and RBC, to name a few, tend to terminate long-term disability benefits at the “change of definition” after two years.
Generally, it’s a little easier to prove that you cannot perform the duties of your own occupation, especially if you are newly injured or disabled. However, once two years pass and the definition changes, many disability insurance companies take advantage of how challenging it can be to prove “total disability” under the new definition. They often override a claimant’s own doctor’s conclusion and insist they can do “some type of work” and, therefore, do not need benefits.
Most of the time, the claimant is still unable to work, but the insurer is not sympathetic. It’s at this point that many individuals require the help of an Ontario disability lawyer to set things straight.
Challenging a major insurance company alone is next to impossible as they have nearly endless spending power and access to high-profile, expensive lawyers. We’re here to help you navigate this part of the process, ensuring your representation matches theirs, and you get the result you deserve.
Our team at Camporese Lalande Disability Lawyers wants to ensure that you face as few obstacles as possible when seeking benefits. To help you understand what might lead to wrongful denial, we’ve highlighted some common reasons why long-term disability benefits may be denied or terminated:
You do not meet the definition of total disability. If your injury or illness is not severe enough to prevent you from performing the essential duties of your job, your disability claims adjuster can deny your claim. Remember, for the first 24 months of disability, you must be unable to complete the substantial duties of your own job. After 24 months, the definition of total disability changes.
At this point, a total disability means that you can’t complete the duties of any job for which you are reasonably suited by education, training or experience. While your injury or illness not being severe enough is grounds for denial, claimants and their doctors often have a different definition than the insurers of how severe your injury is. If they deny you on these grounds but you truly cannot work, that is a good time to contact an Ontario disability lawyer.
Your disability insurer may not have sufficient medical evidence. Remember – the onus is on you to prove your disability. This is why it’s helpful to hire a disability lawyer for this part of the process. Our long-term disability lawyers will contact and request medical records from your doctors, hospitals, clinics, rehab clinics, therapists, psychologists, psychiatrists, social workers and anyone else involved in your care as far back as possible.
We must obtain all relevant documentation to tell your story – and prove your disability. Our Ontario disability lawyers know precisely what medical evidence is necessary and they will be as thorough as possible to ensure we present a strong case.
Social media has undermined your claim. With the advent of social media, insurance companies have had to adapt their policies and procedures. In the past, insurance companies would hire private detectives to surveil policyholders suspected of fraud or other wrongdoing. Now, the cheapest and often most effective option is social media investigation.
During a social media investigation, a disability insurance company will collect evidence from a policyholder’s social media accounts to identify any fraud on their part. This can include images and videos of the claimant performing physical activities they claimed they could not do due to their disability.
If you are genuinely disabled and being honest in your claim, you have nothing to hide. However, insurers are liable to take things out of context, so our disability lawyers still advise clients to avoid posting on social media or discussing their case publically while their case is active.
You are not following a treatment plan. Most disability policies provide that a claimant who is on long-term disability must follow a treatment plan to mitigate their disabilities. If you are not participating in a treatment plan, the disability insurer can deduce you are not complying with the terms of the long-term disability policy and are not trying to get better. As such, you are not entitled to long-term disability benefits.
An insurer conducts an “independent medical exam.” When a disability insurance company needs to evaluate a disability claimant’s injuries, they often schedule an independent medical exam, or IME. The insurance company chooses and pays the doctor who performs the IME, which raises the question of whether or not these doctors are impartial.
In many cases, insurance company-paid doctors are biased in their assessments. Often, this bias is present in the doctor’s opinion of the severity of the claimant’s injuries. These doctors often downplay the seriousness of claimants’ disability, which can lead to the termination of benefits, especially at the two-year mark. Another common cause of concern is when a disability insurance company doctor is not competent in the field of medicine in which the claimant suffers.
Substance abuse is “not a disability.” Substance abuse is almost always a contentious issue to deal with. Disability insurance companies often deny disability benefits to claimants who suffer from alcohol or drug abuse when the reality is substance abuse is almost always caused by an underlying mental illness. For years, the medical community has published medical journals on the co-morbidities between mental health and substance abuse.
Even more importantly, they have repeatedly written that Integrated treatment for comorbid drug use disorder and mental illness is consistently superior compared with separate treatment of each diagnosis.
Yet, disability insurance companies will still deny a claimant suffering from drug and alcohol abuse and not participating in an approved treatment program. They will deny disability benefits without examining the underlying mental health issues. If you have questions about this unique situation, our disability lawyers in Ontario can explain more.
“Lumping out” your benefits means that instead of reinstating your benefits and continuing the monthly payments, the insurer decides to settle the lawsuit by paying your entire benefit in a lump sum, instead. Upon doing so, you’ll sign a release agreeing that you accept this in leui of continued benefits.
Although this is a fairly common occurrence, no insurer is mandated to do this. A disability policy is a contract between an insurer and an individual (or employer) that outlines the terms of coverage and the benefits to be paid in the event of a disability.
The policy may also include provisions for how long the benefits will be paid and what types of disabilities are covered. Given that the policy is a contract, there is no requirement for the disability insurer to pay you anything except the monthly premium.
However, in some circumstances where a disability insurance company must respond to a lawsuit, they may choose to come to an agreement with the claimant and their lawyer to settle the entire benefit in full. They often consider this decision to avoid extra-contractual damages such as aggravated and punitive damages that would accompany further litigation.
Even once an insurer and a disability lawyer come to this agreement, however, it’s still not over. The next step is to calculate the settlement. Our ontario disability lawyers will also help you navigate this part of the process to ensure you get the maximum settlement you’re entitled to. There are many facets to the calculation of a settlement, including many things that claimants will not consider but an experienced disability lawyer is familiar with.
CPP, or the Canada Pension Plan, is a Canadian social program that provides financial assistance to eligible individuals who cannot work due to a disability. The program is jointly managed by the federal and provincial governments and is funded by mandatory contributions from workers and employers. CPP Disability Benefits are available to eligible applicants who have made enough contributions to the CPP and are unable to work due to a severe and prolonged disability. Benefits are paid monthly and are based on the applicant’s previous earnings.
Many disability claimants are unaware that most long-term disability policies in Canada require disability claimants to apply for CPP disability. This is because if they are approved, the LTD payment is offset by the amount of CPP a claimant receives.
For example suppose you recieve $4000 monthly in long-term disability benefits. If you are approved for $1000 monthly through CPP, your LTD will be reduced to $3000 a month. Insurers require this as it saves them money. You don’t have to necessarily be approved, but they will require you to apply.
Those not familiar with the long-term disability landscape may wonder if an Ontario disability lawyer is necessary. The answer is almost always yes. The process involves many complexities and the insurance companies will be actively working against you, trying to pay out as little money as possible.
An experienced disability lawyer can help you navigate the legal system, gather thorough evidence, and build the strongest case possible to render your disability undeniable. If you are considering hiring a disability lawyer, there are a few things you can do to locate the best one:
Once you have compiled a list of potential lawyers, arrange consultations to discuss your case and understand how that disability lawyer would handle your claim. Our advice is to hire a disability lawyer you feel most comfortable with and who answers all of your questions honestly and transparently.
The lawyer should make you feel at ease and that you can trust your case. Remember, you only get one shot in a disability case, so having the right Ontario Disability Lawyer by your side is crucial. With careful research and guidance, hiring an Ontario disability lawyer can help you get the compensation you deserve.
If you are unable to work because of an illness or injury, you may already be frustrated with how complicated and challenging it is to deal with the insurance company. In fact, many have complained that dealing with their disability insurance company has exacerbated their mental health condition and made things worse.
Remember, you only have one shot at fighting the wrongful denial of your disability benefits. Hiring the right Ontario long-term disability lawyers will help you navigate the process more effectively and increase your chances of getting your monthly payment reinstated or recovering the maximum possible settlement.
We are an experienced, family-oriented disability law firm. We focus on on helping claimants with their disability insurance issues in Ontario and across Canada. Our team has extensive experience handling long-term disability claims, appeals, and lawsuits.
The dedicated long-term disability insurance lawyers and professionals at Camporese Lalande have helped hundreds of people fight wrongful denials by insurance companies since 1984 and have recovered millions in wrongfully denied long-term disability benefits.
If your long-term disability insurance claim has been denied or your long-term disability benefits have been terminated, call us today, no matter where you are in Ontario at 1-844-4-DISABILITY or in the alternative, send us a confidential email to set up your free consultation today.
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