If you’ve been wrongfully denied or cut-off from your long-term disability benefits, you are not alone. Our disability lawyers have seen it time and time again. You’ve paid some or all of your premiums on every single paycheck – and now – your disability insurance company refuses to pay your monthly disability benefits. They’ve told you that you can go back to work and “do something.” They say that your condition has improved. They say that you no longer “qualify” for long-term disability benefits because you do not meet the company’s definition of total disability. They say that you are fine to get back to work and “do something” – when this is not how disability law works.
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. 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 cut off your long-term disability benefits, you’re left without a monthly income to pay your bills, pay your insurance, pay your mortgage, or simply survive. You’re frustrated and left in a state of both 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 families financially during a time of need – during a time that one could no longer work because of an debilitating injury or illness. Unfortunately this is often not the case – and when claimants are cut-off from their disability benefits, most do not know that they are fully entitled to hire their own disability lawyer.
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 you’ve been wrongfully cut-off or denied yoru long-term disability benefits, contact us today to set up your free consultation. Call us not 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 by way of ZOOM or TEAMS video conferencing.
If you’ve been denied your long-term disability benefits we can help get things back on track – and the fee is free. We understand the financial position you are in – and we NEVER ask clients for any money upfront, ever.
Matt Lalande is an Ontario Long-Term Disability lawyer who has been fighting 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 that is often referred to by lawyers and judges across Canada. Since Matt became a lawyer, he has helped the disabled and disadvantaged 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 trials and jury trials to verdict. Since 1984, Art Camporese has handled hundreds of disability cases and has recovered millions for disabled individuals from 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.
If you have been wrongfully denied or cut-off your long-term disability benefits, the answer is yes, you can, and you should hire an experienced Ontario long-term disability lawyer. You have enough to worry about in terms of taking care of your health and medical treatment. Long-Term disability litigation is complex medical-legal litigation – and the last thing you need while suffering is the pressure of dealing with a faceless company that has no interest in helping you. Your disability insurance company does not care about what you’re going through in your life, about your finances, that you no longer have money to pay your bills or that you are struggling with your disability. Many, if not most, claimants have their claims denied outright and do not know how to navigate the additional complexities of the appeals process. Experienced long-term disability insurance lawyers can provide invaluable assistance at all stages of the claims process.
If your disability insurance benefits have been terminated, our team of Ontario long-term disability lawyers can help you. We have helped hundreds of people who have been denied their long-term disability benefits. You need an experienced disability law firm on your side because the litigation rules can get very complicated very quickly. When you hire our disability lawyers, we file your case immediately and fight to get your benefits back on track.
It is 100% 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 important that you consult a disability lawyer and carefully go through all of your legal options so that you are fully informed.
Our Ontario disability lawyers are available to help you with any claim in Ontario and throughout Canada, and we encourage you to contact us to discuss your case with us. Our consultations are 100% free, and we will take as much time as you need to discuss your disability matter and explain your legal rights to you.
We understand that you’re going through a time of need – which is why 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 that specializes in fighting long-term disability insurance denials. Since 1984, we have represented thousands of disabled people who have been cut off or denied long-term disability benefits. A disability claim is a medical-legal case which can be very complicated, so it’s important to have an experienced Ontario disability lawyer on your side.
Our lawyers will review your case for free, explain how the disability process works, evaluate the strength of your case and help you understand your options and the disability laws in Ontario. If we decide to work together, we will gather all of your relevant medical records and file a claim against your disability insurance carrier without delay to start the legal process. We will fight to reinstate your long-term disability benefits so you can re-balance financially. We work with the best experts in Ontario to ensure that your burden of proving total disability is discharged and that you are paid the monthly benefits you deserve. We will prepare your care, prepare you to provide testimony if required and represent you through to settlement or trial.
You can decide to represent yourself throughout the internal appeals process – however, it is never recommended that you represent yourself regarding any litigation against the disability carrier. Disability cases are complex, filing the lawsuit is complex, and preparing the file and attending discoveries is not an easy process. In the end, most claimants do not know about offsets, subrogation rights and present value discounts. We have extensive experience representing disability claimants, and we recommend you call us to discuss your case.
The only recourse for disability claimants who have been denied their long-term disability benefits is to hire a plaintiff 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. For many lower-income and disadvantaged groups, obtaining legal services is often difficult, if not impossible, because of the lack of economic resources. As a result, many plaintiffs are left without viable access to a real remedy. The problem is that the legal profession, in a sense, has priced itself beyond the majority of society. Average hourly legal fees can amount to hundreds of dollars. Trials can cost upwards of tens of thousands of dollars per week.
Our Ontario disability lawyers understand that disability claimants who are denied or cut off their long-term disability benefits do not have the funds to pay a lawyer. In many cases, the disability payment is their only source of income. Thankfully, meaningful access to justice can be obtained for disability claimants by way of contingency fees – meaning that legal fees are paid only when the case is concluded and if the claim is successful.
With our disability law firm you NEVER pay anything up front – no matter what the circumstance. The fee is always free – you only pay if we win your case.
Matt Lalande – Camporese Lalande Disability Lawyers
Once your long-term disability claim has been denied, your disability insurance company may offer you the chance to appeal the denial of your long-term disability benefits. They may advise you that they have a “streamlined” or “fast-tracked” appeals process that is efficient and that their disability appeals team will promise to review any new supporting documentation you choose to submit.
The question is – do internal appeals really work? Is it worth the effort? The reality is that internal “appeal committees” are not independent bodies. The committee is made up of employees who are paid by the same insurance company that originally declined your long-term disability claim. There are no impartial deciders – no matter what they say.
Most disability insurance companies say that the appeal process can take up to 3 months – and then, when the appeal is denied, you are not only 3 more months without income – but your potential legal claim for the wrongful denial of benefits is now simply further delayed. Remember, long-term disability insurance is supposed to protect you financially by providing you with a monthly income replacement benefit during a time when you can no longer work. Over the past 20 years, we can count the number of successful internal appeals 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, you, as the claimant, must first show that you are unable to perform the substantial duties of your 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 issue, 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.
After 24 months, most long-term disability policies incorporate what is called a “change of definition (COD)” which means that the definition of total disability changes from not being able to perform the substantial duties of your “own occupation” to not being able 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 prove you are eligible for total disability. 1MacDonald v. Mutual of Omaha Insurance Co. (1987), 36 D.L.R. (4th) 492 (N.S.C.A.). (at para. 26)
If you are able to perform the duties of a menial occupation, 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.“
The most often cited test to determine whether an individual is totally disabled was stated in an old case called Paul Revere where the Court stated that the test of total disability is if a reasonable person would recognize that he or she should not engage in certain activities even though he is literally not physically unable to do so.
In other words, total disability does not mean that you are physically unable to do every task that is related to your job. What total disability does mean is that you are not able to do the essential duties of your job.
In our experience, many, if not most, 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 two-year mark or what is otherwise known as the “change of definition.” Typically, in most disability policies, for the first 24 months of disability, a claimant must be unable to complete the substantial duties of his or her own job – otherwise known as a total disability in terms of a claimant’s “own occupation.”
Then, after 24 months, the definition of total disability changes (change of definition). A claimant, after 24 months, must be unable to complete the duties of any occupation for which he or she is suited by education, training or experience – otherwise known as a total disability in terms of “any occupation.”
Disability insurance companies tend to terminate long-term disability benefits at this juncture in the claim, often overriding the claimant’s own doctors and coming to the conclusion that the claimant can do “some type of work,” which often is not the case. If this happens, it is vital that you speak to a long-term disability lawyer immediately to assess your legal options.
Suffering from a serious mental or physical disability cannot only be life-altering, but it can be financially devastating if you are not able to work. Time and time again, our long-term disability lawyers have seen individuals struggle with mental and physical impairments that interfere with the ability to hold down a job – the most common of which we see are listed at the bottom of this page.
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 trouble, we’ve highlighted some common causes of why disability benefits are 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 may deny your claim for benefits. 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.
Your disability insurer may not have sufficient medical evidence: remember – you are the one that must prove your disability. This is why it is always better to hire a disability lawyer to help with this burden. Our long-term disability lawyers will contact and request medical records of all of your doctors, hospitals, clinics, rehab clinics, therapists, psychologists, psychiatrists, social workers and anyone else who has been involved in your care as far back as possible. It is important that we obtain all relevant documentation to tell your story – and prove your disability.
Social Media has undermined your claim: with the advent of social media, surveillance and investigation, insurance companies have had to adapt their policies and procedures. In the past, insurance companies would hire private detectives to conduct surveillance on policyholders suspected of fraud or other wrongdoing. Now, the most effective and cheapest option is social media investigation. During a social media investigation, an disability insurance company will collect data from a policyholder’s social media accounts to identify any potential red flags that prove a claimant is not being truthful about their claims history or personal information – or is contrary to evidence that he or she provided under oath. We always advise our clients that social media can be a case killer.
You are not following a treatment plan: most, if not all, disability policies provide that a claimant who is on long-term disability must be following a treatment plan in order to mitigate their disabilities. Mitigation means the action of reducing the severity, seriousness, or painfulness of something. If you are not participating in a treatment plan – the disability insurer may take the position that you are not complying with the terms of the long-term disability policy, and as such, you are not entitled to long-term disability benefits.
An insurer “independent medical exam”: When a disability insurance company needs to evaluate a disability claimant’s injuries, they will often schedule what is called an independent medical exam, or IME. The insurance company will choose and pay 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 will be biased in their assessments. A common way this bias manifests is in the doctor’s opinion of the severity of the claimant’s injuries. Disability insurance company-paid 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. If your disability benefits have been cut off, it’s vital that you seek the services of a disability lawyer to understand your legal options.
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, and even more importantly, have repeatedly written that Integrated treatment for comorbid drug use disorder and mental illness has been found to be 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 his or her disability benefits without examining the underlying mental health issues. If you have any questions, our disability lawyers in Ontario can explain more.
You can – but a disability insurance company is not mandated to settle with you or “lump out” your disability benefits with you. A disability policy is a contract between an insurer and an individual (or employer) that outlines the terms of coverage and the benefits that will 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 but the monthly premium. However, in some circumstances where a disability insurance company needs to respond to a lawsuit, they may choose to weigh the risk of the claim and the extra-contractual damages (meaning aggravated and punitive damages) and decide to come to an agreement with the claimant’s disability lawyer to settle the entire disability benefit full in exchange for you signing a release – or in other words, giving up all claims you have in exchange for a settlement or payment. When you hire a disability lawyer, however, the expectation should be that you are seeking to have your monthly benefits “reinstated” as they were before the payments were terminated. Even more important is the calculation of settlement – never try to negotiate your own disability settlement. There are NUMEROUS factors that come into the calculation that only an experienced disability lawyer and actuary/ accountant may understand.
CPP, or the Canada Pension Plan, is a Canadian social program that provides financial assistance to eligible individuals who are unable to 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 who are unable to work at any job on a regular basis 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, but most, if not all long-term disability policies in Canada mandate that disability claimants are required to apply for CPP disability – and if approved, the LTD payment is offset by the amount of CPP a claimant receives. For example, if you receive $4000.00 in long-term disability benefits and are approved for CPP and paid $1000 a month, your LTD will be reduced to $3000 a month.
If you’ve been denied long-term disability, you may wonder whether you should hire a disability lawyer to fight for you. An experienced disability lawyer can help you navigate the legal system, gather evidence, and build a case to help discharge your burden or prove total disability. If you are considering hiring a disability lawyer, ask for referrals from friends, family members, or even your doctor. A referral is the best way to hire a disability lawyer – and a much better way than calling someone you saw on a billboard or television.
If you meet a disability lawyer, make sure that he or she devotes all or more of their practice to long-term disability law. The disability lawyer’s experience winning cases like yours is essential to providing you with peace of mind during a difficult time. If they cannot provide you with a history of winning cases like yours, they may not be the best disability lawyer for your situation.
Once you have compiled a list of potential lawyers, arrange consultations to discuss your case and get a sense of how that disability lawyer would handle your claim. Our advice is to hire a disability lawyer that you feel most comfortable with – an Ontario Disability lawyer who answers all of your questions, makes you feel at ease, and with whom you feel 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 become unable to work because of an illness or injury, you may have already found that dealing with your long term disability insurance company can be an extremely frustrating and complicated process. In fact, it is not uncommon for claimants to complain 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 with experience will not only help you navigate the process better, but it will increase your chances of getting your monthly payment back on track faster or recovering the most amount possible in a settlement situation – if that option becomes available.
We are a boutique disability law firm, focusing on helping claimants with their disability insurance issues in Ontario and across Canada. Our team has extensive experience in 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 stopped, call us today, not 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.