Filing a long-term disability (LTD) claim can feel overwhelming, especially when you’re dealing with a serious health condition. At Kotak Law, we understand the challenges faced by individuals seeking disability benefits. If you’ve been denied short-term or long-term disability in Toronto, our experienced team is here to guide you every step of the way.
Whether you’re preparing to file a claim or fighting an unjust denial, having the right information and support can make all the difference. Below, we outline the critical aspects of long-term disability claims, including the documents you’ll need, qualifying conditions, and common reasons claims are denied.
Documents Needed to File a Long-Term Disability Claim
Submitting a comprehensive and well-documented claim significantly increases your chances of approval. Insurance companies are meticulous, so it’s crucial to provide accurate and complete paperwork. Here’s what you’ll typically need for an LTD claim in Toronto:
- Claim Forms : This includes both the claimant’s statement (completed by you) and the attending physician’s statement (completed by your doctor). These forms detail your medical condition, symptoms, and limitations.
- Medical Records : Comprehensive medical documentation, such as test results, imaging reports, specialist opinions, and treatment history, is essential to demonstrate the severity of your condition.
- Employer Statement : Your employer must provide details about your job duties, salary, and work history. This helps insurance companies determine whether you can perform the essential duties of your occupation.
- Proof of Earnings : You’ll need to submit pay stubs, tax returns, or other financial documentation to establish your income prior to disability.
- Correspondence with Insurer : Keep records of all communications with your insurance company, including emails and letters, as they may be important if your claim is denied.
Providing a complete and cohesive package to your insurer can help avoid unnecessary delays or denials in your claim process.
What Conditions Qualify for Long-Term Disability?
Long-term disability benefits are designed to support individuals who cannot work due to a medically recognized condition. While eligibility criteria vary by policy, here are some common conditions that may qualify for LTD coverage:
- Physical Disabilities : Conditions like chronic pain, spinal injuries, arthritis, heart disease, or cancer often prevent individuals from performing work-related tasks.
- Mental Health Disorders : Mental health challenges, including depression, anxiety, PTSD, and bipolar disorder, are increasingly recognized as legitimate causes of disability.
- Neurological Disorders : Conditions such as multiple sclerosis (MS), Parkinson’s disease, and traumatic brain injuries can severely impact your ability to work.
- Autoimmune Disorders : Diseases like lupus, fibromyalgia, or Crohn’s disease often lead to debilitating symptoms that qualify for disability benefits.
Your eligibility for LTD benefits ultimately depends on your policy’s specific definitions and whether you meet the criteria for being “disabled” under its terms.
Why Are Long-Term Disability Claims Denied?
Unfortunately, many valid claims are denied for reasons that may seem unreasonable or unfair. Common reasons include:
- Insufficient Medical Evidence : If your medical documentation doesn’t sufficiently convey the severity of your condition, your insurer may reject your claim.
- Policy Exclusions : Certain conditions may be explicitly excluded from coverage in your insurance policy.
- Non-Compliance with Treatment : Failing to follow prescribed treatments, such as attending therapy or taking medications, can result in a denial.
- Lack of Objective Proof : Insurance companies often look for “objective” evidence of disability, such as imaging results or lab tests. This can be a challenge for those with conditions like chronic pain or mental health disorders.
- Pre-Existing Conditions : Benefits are typically unavailable if your disability is linked to a pre-existing condition that was present before obtaining coverage.
Facing a denial can be disheartening, but it doesn’t have to be the end of the road.
How Kotak Law Can Help with Denied Disability Claims
At Kotak Law, we know how devastating a denied claim can be—but we also know how to fight back. Our team of experienced disability lawyers in Toronto will review your case and advocate for your rights.
Here’s how we can help:
- Comprehensive File Review : We’ll analyze your claim file and identify any gaps in documentation or errors made by the insurer.
- Legal Representation : Our experienced lawyers will communicate and negotiate directly with the insurance company on your behalf.
- Court Representation : If a settlement isn’t possible, we’ll take your case to court to ensure your rights are fully protected.
You don’t have to face a denied disability claim alone. Kotak Law is dedicated to helping clients in Toronto get the benefits they deserve.
Get the Support You Need
If your insurance company has denied your LTD claim or if you need advice with the application process, contact Kotak Law for trusted guidance. We are committed to helping you secure the financial protection you’re entitled to so you can focus on your health and recovery.
Connect with us today for a free consultation and discover how we can support you through this difficult time.
For professional, compassionate legal help with your disability claim, turn to Kotak Law, your trusted Disability Lawyer in Toronto.
