HAVE YOU BEEN DENIED LONG TERM DISABILITY BENEFITS?
The essence of long term disability is that an insurer will pay monthly pre-determined benefits (either fixed or a percentage of your salary) to an insured person, you, provided that you meet the applicable policy definition of “total disability”. Most long term disability polices in Canada define “total disability”, within the first two years, as being established when you are unable to perform the important duties of your own job, even though you may be capable of performing another job. This is what we normally refer to as “own occupation” disability. After two years, long-term disability policies typically switch to a disability definition of “any occupation”, which means that you must be unable to perform the activities of any occupation for which you are reasonably suited by your education, training and experience.
Most long-term disability insurance companies deny long-term disability benefits after the two year mark, when the policy makes the “switch” to the new policy definition from “own occupation” to “any occupation”. It is at this point that you would bear the ultimate burden of proof, meaning that you must prove that you are totally disabled and unable to perform any occupation which you are reasonably suited by means of your education, training and experience. It is at this point that you would need the assistant of an experienced long-term disability lawyer.
WHAT CAN A LONG TERM DISABILITY LAWYER DO FOR ME?
First and foremost, you need to find a long term disability lawyer to help you. Your lawyer would then file a claim declaring that you are entitled to recover your long-term disability benefits from your long term disability carrier as long as you satisfy the definition of total disability within the meaning of your long term disability policy. This is called “reinstatement.”
Your lawyer would then try to ensure that your long-term disability benefits would continue for your maximum period of benefit recovery which would normally be until the age of 65. Your long term disability lawyer would also try to ensure that you are provided payment of all past long term disability benefits that are owed to you to the date of your settlement or trial. Lump sum awards for future benefits can be negotiated during a long term disability settlement but should never be considered when deciding to start a case against your long-term disability benefit carrier. Paying a lump sum for future benefit ignores the fact that you can die tomorrow and thus be disentitled to any future long term disability awards. Your mind should turn towards protecting your monthly income to support yourself and your family.
Extra contractual damages such as aggravated damages can be awarded against your long term disability insurer if your disability benefits have been unreasonably denied or delayed and have caused you any serious mental distress or aggravation. Often times injured or sick people rely on the payment of disability benefits and the refusal to pay those long term disability benefits can cause total financial collapse of a family unit which in turn, can cause serious psychological distress. We understand that denying or delaying benefits that you are entitled to can cause you increased stress and psychological impairment.