Denied or cut off LTD or STD benefits in Kingston? Here’s how we can help.
If your long-term disability (LTD) or short-term disability (STD) benefits have been denied or terminated, Kotak Law can help. We represent people in Kingston and across Ontario in disputes with disability insurance companies involving mental health conditions, chronic pain, injuries and serious illness.
Consultations are free, and there is no fee unless we recover money for you.
Kingston has a workforce concentrated in some particularly demanding occupations. Nurses and support staff at Kingston Health Sciences Centre and Hotel Dieu. Faculty and staff at Queen’s University. Correctional officers at Millhaven, Collins Bay and Joyceville. Military and civilian personnel connected to CFB Kingston.
Different jobs can present very different physical and psychological demands. When illness or injury prevents you from working, those actual job demands can become critical to whether your disability claim is approved or denied.
Kotak Law has spent years fighting disability insurers on behalf of clients across Ontario, including Kingston. Nainesh Kotak and Rajiv Haté are both recognized by Lexpert as leading long-term disability lawyers in Canada. Nainesh Kotak has practised law in Ontario since 1994.
Disability insurance litigation is a major focus of our practice — not an occasional file handled alongside a general practice.
Long-Term Disability Lawyers Serving Kingston
If your LTD insurer has denied your initial application, terminated benefits after paying them for a period of time, or advised that your benefits will end at the change-of-definition date, we can review your policy, the insurer’s reasons for its decision and the medical evidence supporting your claim.
Kotak Law represents Kingston residents in disputes involving mental health conditions, chronic pain, musculoskeletal injuries, serious illnesses and other medical conditions that prevent them from working.
A long-term disability claim is about more than your diagnosis. The question is how your medical condition affects your ability to perform the important duties of your occupation — and, depending on the wording and stage of your policy, whether you are capable of performing another occupation.
That distinction becomes especially important when an insurer is considering terminating LTD benefits.
What Makes Kingston Disability Claims Harder to Get Right
A significant part of Kingston’s workforce is employed in jobs that can be physically or psychologically demanding in ways that are not always apparent from a job title or generic job description.
Working a shift in a hospital or psychiatric setting, for example, may involve very different demands from those suggested by a written occupational description. The same is true for someone working inside a correctional institution, serving in the military, or performing a physically demanding trade.
A disability claim should properly address the actual material duties and demands of your occupation and explain how your medical limitations prevent you from performing them.
There is also a particularly important point in many LTD claims around the two-year mark.
Most group LTD policies begin with an “own occupation” definition of disability and later — often after 24 months — change to an “any occupation” definition.
We see disability benefits terminated at this stage even though the claimant’s medical condition has not improved. Instead, the insurer may take the position that the person is capable of performing some other occupation.
This is known as the change of definition, and it is one of the most important stages of a long-term disability claim.
Conditions We See Often in Kingston Disability Claims
- PTSD and operational stress injuries — particularly among correctional staff, military members and first responders
- Musculoskeletal injuries — including back, shoulder and joint conditions affecting healthcare workers, tradespeople and others performing physical work
- Chronic pain — where pain, fatigue, medication side effects or other limitations make sustained full-time work difficult or unsafe
- Depression and anxiety — conditions that can significantly affect concentration, memory, motivation, stamina and the ability to function consistently in the workplace
- Cardiac, neurological and autoimmune conditions — particularly conditions with symptoms that fluctuate and may not be captured adequately by a single examination or medical report
The diagnosis itself is only part of the disability analysis. What matters is how your symptoms and limitations affect your ability to function reliably in the workplace.
Why Kingston LTD and STD Claims Get Denied
Disability insurers deny claims for many different reasons. Common issues include:
- The medical evidence does not sufficiently connect your condition and limitations to the actual demands of your occupation
- A medical consultant retained by the insurer reviews your file and reaches a different conclusion from your treating doctors
- Surveillance or social media evidence is used to argue that your activities are inconsistent with the limitations you have reported
- The insurer applies the “any occupation” definition and identifies other jobs it believes you are capable of performing
- The insurer says there is insufficient “objective” medical evidence supporting your symptoms or limitations
- A pre-existing condition exclusion is relied upon to deny coverage
- The insurer says you have not received appropriate treatment or have not complied with recommended treatment
A denial letter is the insurer’s position. It is not a court ruling.
A denied disability claim can be challenged.
What Should You Do After an LTD or STD Denial?
The first step is to understand exactly why your insurer denied or terminated your benefits.
The denial letter should identify the insurer’s reasons. Those reasons need to be considered alongside your disability policy, your medical evidence and the actual requirements of your occupation.
You may also be given an opportunity to appeal the decision internally. An internal appeal is not always the best course of action, particularly where the insurer has already reviewed substantial medical evidence and maintained its position.
Before deciding whether to appeal or take legal action, it can be helpful to have a disability lawyer review the denial, the policy and the evidence.
How This Works If You’re in Kingston
You do not need to travel to Toronto to retain a disability lawyer.
We represent Kingston disability clients through phone and video consultations and electronic document exchange. This allows us to handle most aspects of an LTD or STD claim without requiring you to leave Kingston.
If your disability makes travel difficult, you should not have to travel several hours simply to speak with your lawyer.
Free Consultation for Kingston Disability Claims
If your LTD or STD benefits have been denied or terminated, you can speak with us about your claim.
There is no charge for the initial consultation.
No fee unless we recover money for you.
Toronto/GTA: (416) 816-1500
Toll-Free: 1-888-GOKOTAK
The Clock Is Running
In Ontario, you generally have two years from the date your claim is denied or cut off to sue your disability insurer. That deadline is real, and once it passes, a strong claim can become a dead one. If you’re already past a denial and haven’t spoken to a lawyer, don’t wait for a “better time.”
Questions Kingston Clients Ask Us
I work at one of the correctional institutions here — Millhaven, Collins Bay or Joyceville. Does that matter for my disability claim?
It can matter quite a bit.
Correctional work can involve significant physical and psychological demands that may not be apparent from a generic job description. Understanding and documenting what your job actually requires — and how your medical condition prevents you from performing those duties — can be an important part of an LTD or STD claim.
My LTD benefits stopped around the two-year mark. What happened?
You may have reached the change-of-definition date.
Many long-term disability policies initially assess whether you are unable to perform your “own occupation.” After a specified period, often 24 months, the policy changes to an “any occupation” test.
An insurer may terminate benefits at this stage even though your medical condition has not improved because it believes you are capable of performing another occupation.
These decisions can be challenged.
The insurer says my medical evidence is weak. Is that the end of my claim?
Not necessarily.
We review the medical evidence against the definition of disability in your policy and identify gaps or issues that may have contributed to the insurer’s decision.
Where additional medical information is needed, we can help ensure your treating providers understand the specific issues the insurer has raised so that the relevant medical evidence can be properly considered.
Can my insurer rely on surveillance to deny my disability claim?
Surveillance is sometimes used in LTD claims, but seeing someone perform an activity for a short period does not necessarily establish that they are capable of performing the sustained duties of a full-time occupation.
The significance of surveillance depends on what it actually shows, what limitations you reported and the medical evidence supporting your claim.
Should I appeal my LTD denial before contacting a lawyer?
Not necessarily.
Most disability insurers provide an internal appeal process, but an internal appeal is not always the best strategy. If your LTD benefits have been denied or terminated, it can be useful to speak with a disability lawyer before deciding what to do next.
Do I have to come to your office?
No.
Phone and video consultations work well for most of our Kingston clients. Documents can also be exchanged electronically, so you do not need to travel to Toronto to pursue your disability claim.
What does it cost to hire Kotak Law for a disability claim?
There is nothing to pay upfront.
We handle disability cases on a contingency basis. We are paid from the recovery we obtain for you, and only if we recover money on your behalf.
The fee arrangement will be explained to you and set out in writing before you retain us.
Kotak Personal Injury Law – Disability Lawyers Serving Kingston and Communities Across Ontario
Toll-Free: 1-888-GOKOTAK
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