Long Term Disability Lawyer Milton

Types of Disability Benefits You May Be Entitled To

There are a number of types of disability benefits including:

• short term disability benefits which cover the initial period that you are absent form work
• salary continuance which refers to a period that your employer continues to pay all or part of your income while you are absent due to disability
• long term disability benefits which pay a portion of your pre disability income if you satisfy the definition of disability in your policy
• waiver of premium on life insurance, critical illness or accidental death & dismemberment coverage – this means that if the insurer accepts your disability claim, you do not have to pay for this coverage and it will remain in place while you are absent from work
• private disability or disability income coverage pursuant to an insurance policy which you purchased from a broker or agent
• loan or creditor disability insurance coverage which pays your mortgage or loan payments while you are disabled

Eligibility Criteria for Long Term Disability Benefits

Long term disability insurance is provided as a result of the terms of the disability policy or coverage. The claims process involves an employee of the insurer (a case manager) reviewing supporting documents such as a report completed by your medical professional, a form completed by your employer and your claim form. The amount of disability benefits depends on the amount of insurance that you purchased in a private disability policy or that your employer arranged for you in a group insurance policy.

The definition of disability will be set out in your policy and if the insurance provider will only accept your disability claim if your medical records establish that you are suffering from a medical condition that satisfies the definition of disability. The claims process is dependent on the claims adjudicator’s personal assessment of your claim and therefore you may be unfairly denied your benefits simply based on the personal views of that insurance employee in reviewing your claim.

Common Reasons LTD Claims Are Denied

Insured employees and claimants are denied benefits for all of the following, among other reasons:

• missed deadlines
• insufficient medical evidence of disability
• the insurer believes that there is inadequate treatment – this regularly happens for mental health conditions or chronic pain where there is no specialist referral or the insurer believes the medication is not appropriate or sufficient
• many disability cases arise when insured have their benefits cut off on the definition change date
• the absence is caused by a pre-existing condition and the insurer takes the position that there is no disability coverage

How to Appeal a Denied Disability Claim

An LTD lawyer can advise you whether you should access the insurance provider’s appeals process or start a legal action. While there are times that an appeal is advisable such as when there is new information that the insurance provider did not have at the time that it made the decision to deny benefits. There are also times where the insurance policy stipulated that you must submit an appeal in order to start a law suit.

If you are simply asking the insurer to reconsider its decision on the same medical evidence you will likely receive the same outcome on appeal as you did upon the initial application. Submitting the appeal can simply delay your efforts to obtain the benefits to which you are rightfully entitled. It is essential to hire lawyer with detailed knowledge of disability law in order to appropriately assess the best course.

The Role of a Long Term Disability Lawyer in Milton

Our law firm acts for clients throughout Ontario including Milton and the surrounding areas. We have handled hundreds of disability claims and have a deep knowledge of disability law and all the benefits you are entitled to. We will review your long term disability claim and obtain a copy of the insurance company’s claim file in order to determine what the insurer considered when it denied your claim. We can determine if the insurer was missing essential information when they issued the LTD denial.

Your Milton disability lawyer will gather medical evidence, review your insurance policy to make sure that the correct benefit has been calculated and will work to secure a fair resolution of your claim whether that involves a lump sum payment or monthly disability benefits.

Schedule a Free Consultation with Our Milton Disability Lawyer

Schedule a free initial consultation with one of our LTD lawyers today. In most cases we can provide legal representation on a contingency fee basis which means that you do not have to incur any upfront legal fees. We will be paid when you are.