Why an insurer may ignore a treating doctor’s opinion.
Many people, as well as their doctors, believe that when they file a claim for disability benefits their disability insurance company has to accept the medical professional’s opinion that they are disabled. Common sense suggests this is a reasonable assumption – but it couldn’t be further from the truth. Why? Because many insurers simply do not want to pay disability claims and, when armed with discretionary language in the policy, the insurer has the final say as to who is “disabled”, not the treating doctor. Making matters worse is the fact that the insurance company is...
read moreReducing work hours may imperil disability coverage.
Many people who are struggling to work due to an acute unexpected medical condition do not have the opportunity to prepare or plan for filing a short and or long term disability claim. My experience is that most people who eventually file disability claims have chronic medical conditions which have been ongoing for months and even years. During this difficult period disabled people often find themselves engaged in an heroic effort to continue working. People engage in this long battle for many reasons, one is often financial, and the other is simply their own credibility – they like...
read moreShort term disability approved, but long term disability denied.
One issue I see all too frequently in my practice is the situation where an insurance company approves a short term disability claim for a period of time (perhaps the maximum time frame, usually no more than 180 days) but then turns around and denies the long term disability claim. Most individuals do not understand how the same insurance company, reviewing essentially the same evidence, and using what is frequently the same definition of disability, can make such contradictory findings. After reviewing hundred of disputed disability claims my experience is that most insureds are simply not...
read moreAlways apply for CPP disability benefits.
If you have been receiving long-term disability (“LTD”) benefits for over a year your insurance company will likely require you to apply for Canada Pension Plan (“CPP”) disability benefits. This seems like a no-brainer at first, until you realize that if you win CPP disability your insurance company basically gets to keep all the money. You will have to give the insurance company the retroactive payment you get from the CPP, your overall monthly income may go down slightly. and, you might get an unexpected tax bill for the retroactive payment, even though...
read moreLong Term Disability Insurance – common questions.
Q.What is long-term disability insurance? A. Long-term disability (LTD) insurance is designed to provide replacement income should you become disabled from work. Often, LTD coverage is bundled together with short-term disability coverage (which may cover, for example, only the first six months of disability) under a group insurance plan provided through your employer. If you have a private life or accident and sickness policy, you may have LTD coverage as well. Q. What types of disability are covered? A. Coverage varies from policy to policy, but generally speaking, LTD policies cover any...
read moreWhat to do if you have a disability claim.
Disability insurance policies are ‘peace of mind’ contracts that pay you a portion of your lost income if you become “disabled” from working as a result of illness or injury. These can be individual/private plans or policies (paid for privately by the person wishing to be insured) or group plans or policies (paid as part of your employment package). The contract or policy will set out the definition of disability. Contractual definitions are always open to interpretation. Generally you will qualify for benefits if you are not able to do all, or substantially all, of the duties of your...
read more
