Types of Disability Claims We Can Handle
At Burn Tucker Lachaîne, we have many years of experience successfully handling all kinds of LTD claims whether they are pursuant to individual/private income replacement policies or group long term disability insurance.
Individual Disability Income Insurance
Individual policies are often purchased by self-employed workers and by employees who work for smaller companies that don’t offer long term disability coverage. These private insurance plans allow you to purchase coverage according to your needs, and the premiums reflect the amount of coverage chosen.
Individual LTD policies tend to be pricier, but they also offer more flexible terms and generally include own occupation coverage. This means that the test for LTD eligibility used will be based on whether or not you’re able to perform the duties required by the job you have.
Group Long Term Disability Insurance
Many employers offer group long term disability coverage as part of their employee benefits package. These policies typically pay out a specific percentage of the employee’s monthly earnings at the time they became disabled. The level of coverage is determined by the insurance policy the employer has negotiated. Since the associated risk is spread out across a group of people, the overall cost of insurance is generally lower.
Special Purpose Long Term Disability Insurance
Special purpose LTD policies address specific needs, such as coverage for professionals like doctors or lawyers. Other special purposes include high-limit coverage for those with high incomes as well as critical illness coverage, which makes lump-sum payouts for critical illness diagnoses.
What Conditions Qualify for Disability Claims
Every disability claim is unique, but the kinds of conditions that tend to qualify break down into several basic categories.
Physical Injuries
A serious physical injury can leave you unable to work for a long time – or permanently – and when it does, it may qualify as an LTD. The kinds of physical injuries that often support eligibility for LTD benefits include traumatic brain injuries (TBIs), spinal cord injuries, broken bones, serious burns, injuries that require amputation, limb loss, and injuries that cause hearing or vision impairments.
Physical Illnesses
Serious illnesses can also support long term disability benefits, and common examples include all the following:
- Illnesses that cause chronic pain, fatigue, or both, including chronic fatigue syndrome and fibromyalgia
- Cancer and post-cancer treatment symptoms/side effects
- Diabetes
- Heart diseases and stroke
- Multiple Sclerosis
- Rheumatoid Arthritis
- Respiratory conditions, such as chronic obstructive pulmonary disease and severe asthma
Mental Health Conditions
Mental health concerns can also have a profound effect on your ability to do your job, and LTD claims are often based on these serious health challenges, including:
- Depression
- Anxiety
- Borderline personality disorder
- Bipolar disorder
- Post Traumatic Stress Disorder (PTSD)
When an injury or illness is severe enough to impede your ability to work for an extensive period of time, it may be classified as a long term disability, and if that’s the case, it’s time to reach out to a reputable LTD law firm serving Markham for the skilled legal guidance you need.
Long Term Disability Insurance
LTD disability insurance affords income replacement in the event that a serious illness or injury stops you from working for a significant amount of time, which is often defined as three months but policies vary. LTD benefits generally pay out in monthly installments that replace a specific percentage of your lost work income.
The Terms of Your Coverage
The terms of your coverage and the compensation you receive will be determined by factors such the policy purchased, the option of coverage chosen, if applicable, and your income at the time of disability.
The Requirements Involved
An important point to make about the LTD claims process is that the path forward is challenging and that there are a range of requirements that apply, including:
- If your policy is employment-based, you must have worked at the company for the period of time required to qualify.
- You must have a serious injury or illness that prevents you from working long-term and that meets your policy’s definition of a long term disability.
- You must file an application package that meets the insurance company’s requirements and that clearly identifies the degree to which you’ve been disabled by your long-term injury or illness.
A Denied LTD Claim: Your Further Steps
Because the LTD claim process is demanding, claims are sometimes denied, and while it represents a setback, it doesn’t mean that you’re out of options. If you receive a denial letter and you’re not already working with a savvy LTD lawyer, it’s time to schedule a free consultation.
There are many reasons why long term disability claims are denied, and while each situation is unique, most denials are based on providing insufficient medical records and reports. A proactive LTD lawyer has the skill and dedication to gather the medical documentation necessary to help establish that you qualify for benefits.
Other common reasons for claim denials include having a pre-existing condition as defined by the policy, failing to follow up the treatment plan recommended by your medical team, making statements to the insurance company that contradict one another, missing filing deadlines, or making administrative errors like submitting incomplete forms.
If your insurance company denies your claim, the reason should be outlined in your denial letter, and your knowledgeable disability lawyer will leave no stone unturned in their focused efforts to strengthen your application. This often means obtaining updated medical records, correcting any errors or omissions in the application, and communicating on your behalf to answer the insurer’s questions.
Regardless of why your claim was denied, you have the right to avail yourself of the appeals process. If you choose to appeal, it’s wise to get the assistance of a lawyer who has years of advancing cases of total disability. If an appeal is unsuccessful, your lawyer will be poised to take legal action.
How a Long Term Disability Lawyer Can Help with Your LTD Case
If you’re unable to work as a result of a long term disability, having a lawyer with a strong knowledge of disability law can make a serious difference to the outcome of your claim. Your lawyer’s role includes building a solid claim that is bolstered by the documentation necessary to convince the insurance company that you satisfy the definition of long term disability.
From here, your lawyer will help you better understand the claims process in order to guide you effectively and efficiently toward a favourable resolution. Your lawyer can help avoid the kinds of errors that can cause a claim denial. For example, they will likely advise you to take a break from social media while your claim is pending. It’s far too easy to send mixed online messages that may not align with the statements you’ve made to the insurance company.
Finally, after filing a lawsuit, your disability lawyer will skillfully negotiate with the involved insurance company on your behalf. And if a mutually acceptable settlement can’t be reached, the Ontario disability lawyers at Burn Tucker Lachaîne have a proven track record of trying cases and holding insurance providers to account.
Speak to an Experienced Long Term Disability Lawyer Serving Markham
If you can’t work for a protracted period, a long term disability claim can help you maintain your family’s financial stability. While disability law is complex, the reliable Markham long term disability lawyers at Burn Tucker Lachaîne dedicate our imposing skills to helping our valued clients obtain just settlements that accurately reflect their level of disability . We are here for you too, and we welcome the opportunity to help. Your claim is important to your future, so please don’t hesitate to reach out and contact or call us at 416-365-1223 and schedule a free consultation today.
March 6, 2025 
