Chronic pain is a persistent and often debilitating condition that affects millions of people, making even the simplest tasks feel insurmountable. Defined as pain that lasts for three months or more, chronic pain can result from injuries, illnesses, or conditions such as fibromyalgia, arthritis, or neuropathy. Unlike acute pain, which typically resolves with treatment, chronic pain may not have an identifiable cause and can linger despite medical interventions.
The impact of chronic pain extends far beyond the physical. It can disrupt your ability to work, maintain relationships, and enjoy life. Fatigue, depression, anxiety, and sleep disturbances often accompany chronic pain, creating a cycle that is difficult to break. For many individuals, continuing to fulfill job responsibilities becomes impossible, leading them to explore options such as filing for long-term disability benefits.
Filing a Long-Term Disability Claim in Canada for Chronic Pain
Chronic pain is recognized as a legitimate disability under Canadian law, which means those who suffer from it may qualify for long-term disability (LTD) benefits. However, the process of filing an LTD claim can seem complex and overwhelming, especially when dealing with the daily challenges of pain. Below, we outline the steps you need to take to start your claim.
- Understand Your Policy
Start by reviewing the terms of your LTD insurance policy or employee benefits plan. Policies typically outline the definition of disability, the types of conditions covered, and the waiting period for benefits to begin. Some plans may require applicants to prove they cannot perform their own occupation, while others may require proof that they are unable to perform any occupation.
- Gather Medical Evidence
Strong medical evidence is crucial for successfully filing a chronic pain LTD claim. Chronic pain can be subjective, so your insurer will rely heavily on documentation from healthcare professionals to evaluate your claim. This includes detailed records from your physician, specialist reports, diagnostic test results, and any applicable treatment history. A supportive doctor who can clearly communicate your limitations is invaluable.
- Complete the Application Thoroughly
Insurers require multiple forms, including one completed by you, another by your doctor, and sometimes additional forms from your employer. It’s essential to ensure these forms are filled out accurately and completely. Even minor mistakes or inconsistencies can delay the approval process.
- Demonstrate How Pain Impacts Your Ability to Work
Your claim should clearly outline how chronic pain hinders your ability to perform job-related tasks or makes working altogether unmanageable. Providing examples of specific challenges or accommodations that didn’t help can strengthen your case.
- Submit on Time
Insurance companies often impose strict deadlines for submitting LTD applications. Missing these deadlines can result in an automatic denial. Stay organized and keep track of all required timelines.
Why Do Chronic Pain Disability Claims Get Denied?
Despite chronic pain being a legitimate disability, many legitimate claims are denied. Insurers may question the severity of your pain, given its subjective nature. Common reasons for denial include:
- Lack of Medical Evidence: Since chronic pain doesn’t always show up on diagnostic imaging or lab tests, insurers may claim insufficient proof of disability.
- Subjective Symptoms: Pain is subjective, which can lead insurers to argue that it is exaggerated or fabricated.
- Non-Compliance With Treatment: If you fail to follow prescribed treatments or attend medical appointments, insurers may use this as a reason to deny your claim.
- Insurer Bias: Without objective markers, some insurers are reluctant to approve claims based solely on patient testimony and medical assessments.
If your claim is denied, don’t lose hope. Denials are not the end of the road; instead, they are an opportunity to appeal the decision and present more comprehensive evidence.
How Kotak Law Can Help You
Navigating the long-term disability claims process can feel overwhelming, especially when dealing with chronic pain. That’s where Kotak Law steps in. Our experienced disability lawyers specialize in helping individuals secure the compensation they deserve. Here’s how we can assist:
- Step-by-step Guidance: From reviewing your policy to submitting your claim, we ensure that every step of the process is handled with care and precision.
- Building Strong Cases: We work with medical professionals, vocational experts, and other specialists to compile the evidence needed to support your claim.
- Fighting Denials: If your claim is denied, we will commence an action against the insurance company and force them to the negotiating table.
- Protecting Your Rights: Our firm fights to protect your rights and achieve the best possible result.
At Kotak Law, we understand how life-changing chronic pain can be, and we’re dedicated to making sure you get the benefits you’re entitled to. You don’t have to face the claims process alone; we stand by you every step of the way.
If you or a loved one is living with chronic pain and struggling to secure LTD benefits, contact Kotak Law today.
