Disability Benefits: Eligibility Criteria
In order to receive disability benefits, you must satisfy the policy’s eligibility requirements. You must have long term disability coverage through employment and have been enrolled in the benefit plan through your employer. There is generally a requirement that your position involved working a minimum weekly number of hours to be entitled to benefits.
Alternatively, you may have purchased a private disability income policy. Individual and private insurance contracts are complex and you need to hire a lawyer who understands these insurance policies and how they are interpreted.
In order to receive disability benefits, you must satisfy the insurance contract’s definition of disability throughout a specified waiting period. After the waiting period, if the insurer accepts your claim, LTD benefits will be payable to you.
Both group and private insurance policies provide that you need to complete specific forms and submit them to the insurance company by a deadline. If you fail to meet the deadline you may lose your right to disability insurance. It is valuable to get legal advice about the claim process and forms.
Your long term disability claim needs to be supported by medical evidence. Your treating doctor will need to provide detailed information about your disabling condition and why it prevents you from performing the essential tasks of your occupation. The disability insurer will assess your application and if it does not agree that your LTD claim forms prove that you satisfy the definition of disability, your application will be denied.
All disability policies provide a maximum benefit period or expiry date for benefits. Some policies provide that the insurer will only pay you benefits for a specified number of years (for example for 5 or 10 years) after which time your benefits will end. Other policies may provide that the insurer could pay LTD benefits until age 65 if you continue to satisfy the policy definition of disability.
The experienced lawyers at Burn Tucker Lachaîne will review the policy and provide you with advice about the payments to which you are entitled and how to deal with the insurance company. We will provide you with a review of the essential terms of your disability insurance policy and requirements.
Types of Disability Claims We Can Handle
At Burn Tucker Lachaîne, we have assisted clients in receiving payment for their denied claims for disabilities involving:
- Traumatic brain injuries and post concussion symptoms
- Neurological illnesses
- Rheumatological conditions
- Cancer and continuing disability caused by cancer treatment
- Chronic pain
- Post Traumatic Stress Disorder, Anxiety, Depression and other Mental Health Conditions
Common Reasons for Disability Claim Denial
Insurance companies will closely scrutinize your application for LTD benefits and deny payment if your medical evidence does not persuade it that you satisfy the definition of disability. It’s important to keep in mind that your denied application can be challenged. An experienced disability lawyer in Kingston will fight to ensure that your legal rights are protected and assist you in obtaining a fair payment.
The most common reasons for disability claim denials include:
- Filing issues, such as failing to file within the allotted timeframe
- Issues related to pre-existing conditions
- Issues related to not adequately following your medical doctor’s advice or complying with treatment
- Insufficient medical evidence
- The insurer does not accept your doctor’s opinion on your ability to work and your disability
The Claims Process
The claims process for long term disability benefits can be confusing. Generally the process includes properly describing your medical condition and symptoms, gathering the supporting medical evidence you need from your treating doctor or nurse practitioner, carefully completing the application form, and filing a claim that meets all administrative requirements, including the set time limit.
It’s a challenging process that is made more difficult by the fact that you are suffering from a disability. The best plan is to contact a lawyer to obtain advice about how to submit a claim which qualifies for payment.
Benefits of Hiring a Long Term Disability Lawyer
Your disability lawyer has the experience, legal insight, and skill to assist you in submitting a thorough application for benefits. Retaining a lawyer early will provide you the advantage of ensuring that your claim is solid, is backed up by strong evidence, and is filed correctly. Additionally, you’ll have skilled legal representation in the event the insurance company denies your claim. While few cases will proceed to court, you need to have vigorous legal advocacy at each stage of your case.
Why Choose Our Kingston Long Term Disability Lawyers
If you have suffered an illness or injury that keeps you from working, contact the formidable long term disability lawyers at Burn Tucker Lachaîne – proudly serving Kingston. We will pursue a fair resolution and be by your side every step of the way. Your claim’s outcome is important to you and your family’s future, so please don’t delay reaching out and contacting or calling us at 613-917-0909 to schedule a free consultation and learn more about what we can do to help you today.
March 6, 2025 
