The Types of Long Term Disability Claims We Handle
Disability claimants apply for benefits for the following types of injury or illness:
- Physical injuries, such as traumatic brain injuries (TBIs), spinal cord injuries, and injuries that lead to chronic pain
- Medical conditions, such as autoimmune disorders like rheumatoid arthritis, irritable bowel disease and lupus
- Chronic illnesses such as multiple sclerosis, Type 1 diabetes, fibromyalgia, and chronic fatigue syndrome
- Mental health conditions, such as post traumatic stress disorder (PTSD), depression, and anxiety disorders
Any one of these or other illnesses can interfere with your ability to do your job, having a serious impact on your finances.
Requirements for Long Term Disability Benefits
In order for your condition to qualify for long term disability benefits, you must have suffered an illness or injury causing a disability that leaves you unable to work for a significant stretch of time. Qualifying factors include the degree to which you’ve been functionally impaired –which refers to how significantly your ability to perform your job duties has been affected – as well as the severity of your condition and your policy’s language.
LTD policies have different elimination periods, which are also known as qualifying periods and refer to the waiting period from the date you suffered the disability to the date that your benefits are paid.
How the Application for Disability Benefits Works
In order to apply for long term disability benefits, you’ll begin by making a claimant’s statement – for private policies– or an employee statement if your policy comes through your employer.
Your Employee Statement/Claimant’s Statement
Your statement is your opportunity to provide the insurance company with information about the extent of your disability and the impact on your ability to work. Your statement should include a thorough medical history and description of your symptoms.
The Employer Statement/Occupation Statement
Your employer will be required to provide the insurance company with specific information in the form of an employer statement. This document will provide financial information to calculate the monthly benefit you’re entitled to receive. The employer statement will describe the essential duties of your occupation.
If you are self employed, you will provide an occupation statement which sets out the work you perform for your business and thoroughly describes all aspects of your responsibilities and tasks.
The Attending Physician Statement
An attending physician statement is another piece in the puzzle, and it refers to the report your treating doctor makes. This report helps your insurance provider understand the nature of your diagnosis and disability, and it should include copies of all related test results, imaging, and supportive reports from medical specialists.
The better documented your disability is, the smoother the claims process is likely to be. It’s important to note, however, that doctors are busy medical professionals who aren’t always as thorough of detail as the insurer requires. Your physician’s statement and documentation is a key component of your claim, which makes putting additional effort into getting it right worth it.
The Interview with the Case Manager Assigned to You
About 10 days after you submit your LTD benefits application, you can expect to hear from the disability claims adjuster who is assigned to your case. They will contact you in order to obtain any additional information needed to round out your claim.
Each step in the application process is important to the outcome of your LTD benefits claim. It in your best interest to work closely with an expert long term disability lawyer throughout.
If Your LTD Claim Is Denied
Disability law is complex, and long term disability claims can be denied. If yours is, however, it’s important to know that you don’t need to give up. There is an appeals process in which your experienced disability lawyer will skillfully advocate for a fair resolution that honors your legal rights and provides financial support according to your disability insurance policy terms.
In short, if your LTD claim is denied – and you haven’t done so already – it’s time to reach out for the skilled legal guidance of a long term disability lawyer.
Denial of Long Term Disability Claim
If you receive an LTD denial letter, there are several important steps that you should take in conjunction with your disability lawyer.
Reviewing the Denial Letter
To begin, you’ll review the denial letter to better understand the reasoning behind it, which will guide your next steps. From here, you’re advised to request a copy of your policy and claim file from the insurance provider.
Strengthening Your Claim
Moving forward, your lawyer will focus on strengthening your claim, which often means updating medical documentation. You’re also well advised to carefully follow your medical team’s instructions and advice . Your lawyer will assess your original application to ensure that it clearly defines the impact that your condition has had on your ability to work. The success of your claim will hinge on your ability to succinctly define your functional limitations.
Your Legal Options: Appealing the Denial or Starting a Lawsuit
From here, you may choose to proceed with an appeal. This includes taking the steps necessary to clearly demonstrate the medical evidence supporting your disability. If your appeal is denied, your lawyer will file a lawsuit on your behalf.
The Role of a Disability Lawyer
Your LTD lawyer will play a critical role in the outcome of your claim, and will ably take on each of the following key tasks:
- Guiding you seamlessly through the claims process, which includes ensuring that you know what to expect as you proceed
- Helping you avoid the missteps that can lead to claim denial
- Building a solid claim that is difficult for the insurance company to effectively refute
- Skillfully negotiating a settlement that provides you with the compensation you deserve
- Effectively taking your case to trial if the insurance provider won’t pay a reasonable amount
Turn to Our Brantford Long Term Disability Lawyer for Help
If a disabling condition keeps you off the job, the impact on your ability to meet your expenses and support yourself can be immense. The right lawyer for you is at Burn Tucker Lachaîne – proudly serving Brantford, Ontario. We will use the full scope of our experience and drive in pursuit of a settlement or court award that reflects your case. We act for clients on a contingency fee basis or an hourly retainer. We are on your side and here to help – so please don’t put off reaching out and contacting or calling us at 519-340-0816 to schedule a free consultation today.