Orangeville Disability Lawyers

Many insurers treat long term disability benefits as a wager. Insurance companies know that many individuals suffer from a long term disability but do not file a claim – and that many of those that do file a claim will give up if their claim is denied.

But if your claim has been denied, you shouldn’t give up.

Kotak Law has provided assistance to countless Orangeville clients suffering from disabilities and from insurance companies that refuse to pay benefits. We help you take charge of your claim, and win the long term disability benefits that you deserve.

Orangeville Disability Cases in the News


Young adults in Orangeville are at far greater risk of becoming disabled due to injury or illness, than they are of passing away before reaching the age of 65. If someone suffers an illness or injury that extends beyond ‘the temporary’, long-term disability coverage provides the important function of allowing a person to focus on their recovery, rather than having to worry about making ends meet and how to pay for needed rehabilitation treatments.

If you have long-term disability coverage and are suffering from an illness or injury that will prevent you from returning to work, you will not be paid LTD payments until the waiting period specified in your group or individual insurance plan has expired. In many cases, the waiting period is 120 days after the onset of the disabling condition, but it can vary between plans.

Deadlines for filing an LTD Claim
As soon as you become aware that your illness or injury will prevent you from doing your job and you want to claim LTD benefits, notify your LTD provider of your disability. Your LTD insurance contract specifies a deadline for notifying your insurer of your disability (30 days, for some plans) and also, for submitting a completed application including medical evidence of your disability. Some insurance providers for LTD coverage require claimants to submit their completed application for LTD benefits within a specified time before the ‘waiting period’ has expired which is, in some cases, three months before the date they are eligible to receive benefits (or, 3 months before the 120-day deadline). It’s a good idea to check your policy details and/or contact your LTD insurance provider to find out about the specific legal timelines for claiming LTD benefits. If you miss the contractual dates, you risk having your LTD claim denied.

Long-term disability insurance providers must assess, within the first two years, if a claimant is disabled with respect to their own occupation, and must be able to assess within a further two years, whether the claimant is totally unable to engage in any occupation for which they are reasonably qualified. One reason why waiting too long to claim long-term disability benefits can result in a denial of benefits, is that the insurer may be at a strong disadvantage (or ‘prejudiced’) when too much time has past, as it is increasingly difficult for the insurer to conduct assessments for the relevant period.

This is what occurred in a 2016 case, Ortiz v. Great-West Life Insurance, where a man was injured in a slip and fall accident and stopped working as a result of his injuries, but did not submit a Notice of Claim for LTD benefits until more than three years later. In this case, the plaintiff also named the wrong group insurer in his claim, which meant that the actual insurer-at-risk at the time of his accident, Manulife, did not receive notice of his claim until about five years from his date of injury. The judge dismissed the plaintiff’s motion to add Manulife to his claim after Great-West Life denied him LTD benefits on a number of grounds; but the key reasons were that both the notice period and limitation period to sue Manulife had passed and the plaintiff failed to practice reasonable and due diligence to discover the correct insurer.
In another recent case, Dube v. RBC Life Insurance Company (2015), the court came to a different decision – in this case, the appeal court upheld a motion judge’s decision that a man’s late claim for LTD benefits may proceed, despite the fact that both notice and proof of his claim were given well past the dates specified in the LTD plan. Under his policy with RBC, the plaintiff was required to give notice of his claim within 30 days of becoming disabled (or, the date of his accident) and submit proof of his claim within 1 year and 90 days; but the plaintiff did not give notice and proof until 22 months and 37 months, respectively, after he was injured in a car accident. RBC then denied his claim for being too late.

In Dube, the judges considered three criteria in their decision that the claimant’s late claim for LTD benefits will be allowed. The first criterion was whether the claimant’s conduct was ‘not unreasonable’, and on this issue, it was noted that the claimant’s employer had initially told him (incorrectly) that he did not have LTD benefit coverage and this created uncertainty and confusion. Also, the employer took one year to provide the claimant with an LTD application after he gave notice of his claim, and the claimant complied with numerous requests to submit medical information. In consideration of both these facts, the judge found that the plaintiff’s conduct was reasonable. The second criterion for accepting the late claim was whether the insurer would suffer prejudice due to the breach, and on this question, the judge decided that RBC would suffer only minimal or no prejudice. The third criterion considered “the disparity between the value of the property forfeited and the damage caused by the breach”, and the judge found that there was a significant disparity for the claimant because the claimant was 43 years old at the time of the accident and could conceivably receive long-term disability benefits until the age of 65.

How do you know you are eligible for LTD benefits?
In order to be eligible for LTD benefits within the first two years of becoming ill or injured, you must be able to show that your condition renders you unable to perform the duties of your current job. If your disability continues beyond two years, you are eligible for LTD benefits if you can show evidence that you are unable to perform any type of work for which you are reasonably qualified, given your education, training or experience.

LTD benefits application
When you complete an application for LTD, you will be required to submit detailed medical evidence, including your attending physicians’ statements that support your claim for disability benefits. Your insurer will require your physician(s) to complete a questionnaire which commonly includes information about your medical history, symptoms, a diagnosis, ongoing treatments, hospitalization, medical tests, functional abilities and a prognosis for recovery.

A representative or case manager for your LTD insurance provider will assess the completed application and medical evidence to determine whether your level of function meets the demands of your current job, to decide whether you meet the required definition of disability. Be aware that the insurer will also require a report from your work supervisor outlining the required duties of your current job.

A wide variety of conditions may prevent someone from performing their job or from performing any gainful employment, and symptoms may be physical, psychological or/or mental. Your long-term disability application will require evidence that you are receiving ongoing care and treatment that is deemed appropriate for your given disability. After your application is approved, you are also generally required to inform your LTD provider if there are any changes in your medical condition.

How long can I receive LTD benefits?

If you suffer from a prolonged injury or illness, and have provided medical evidence to support your claim, you are generally eligible to receive LTD payments until age 65, or the retirement date that was specified in an employer-provided plan.

If your claim is not approved until past the date on which you were eligible to receive LTD payments, your insurer should provide you with past-due payments from the date your eligibility for LTD began.

Denied LTD claim
If your claim for LTD benefits is denied, you should be given a specific reason. Insurers often have an internal appeal process; however, it is difficult to alter the insurer’s original position using the internal appeal process. Also, if the internal appeal process drags out a claimant may miss the deadline for filing a civil action. Therefore, we recommend retaining a lawyer immediately after your claim is denied so the court action against the LTD insurer can be commenced quickly.

Under any circumstances where your claim for owed long-term disability benefits was denied or your benefits were terminated, you are advised to seek the assistance of a skilled LTD claims lawyer at Kotak Personal Injury Law.

Disclaimer: This article is intended to supply general information to the public. We make every effort to ensure the accuracy of this information. However, as laws change quickly, the reader should always ensure the accuracy and applicability of such information with respect to their particular case. The information contained in this article cannot replace a thorough and complete review of the reader’s situation by competent legal counsel who has had an opportunity to review all of the facts.

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  • Everyone I dealt with at Kotak Law was friendly and professional. They were efficient and settled my case in a reasonable amount of time. My Lawyer Rajiv was the best, he kept me well informed and during the settlement mediation kept me calm and intructed me well. We reached the best settlement possible. Thank you Rajiv!!

    Rebecca Copland Avatar Rebecca Copland
    September 9, 2023

    I am grateful for the exceptional services provided by Kotak Law and his incredible team. From the moment I reached out to them, I knew I was in capable hands. Throughout my legal journey, Rajiv displayed an unmatched level of professionalism, dedication, and expertise. He not only fought tirelessly for my case but also took the time to ensure I understood every step of the process. His support and strategic approach were truly impressive. I must also give a special mention to Nainesh, whose support was invaluable. They always addressed my queries and concerns, offering reassurance during what could have been an overwhelming time. The entire team's commitment to my well-being and their compassionate approach made a world of difference. They kept me informed, provided regular updates, and worked diligently to secure a favorable outcome. Thanks to Kotak Law and his team. If you're seeking legal representation that goes above and beyond, look no further. I wholeheartedly recommend Kotak Law Firm for their exceptional services. Thank you again for your outstanding work!

    Umesh Jain Avatar Umesh Jain
    August 8, 2023

    Just a quick thank you to both Sergey Loganov and Klara Kotanovic for their efforts over the past few months in taking care of my CPP Disability denial and appeal process. Not only did they win the case but the retroactive lump sum owing went back 10 months earlier than what I thought it would and I will be receiving the maximum monthly payment. Dealing with chronic pain from 3 surgeries in the early 2000s on my neck and now finding out I have numerous bulging discs and spinal stenosis in my low back which creates nerve pain and kicking leg syndrome is a lot to deal with medically and it was a load off my mind to have a very competent group of players on my team to deal with CPP. Lowering stress levels and being able to afford to go and have more Bowen therapy on my low back means the world at this point. Pills are something I try to take as little of as possible and I am an advocate of the growing and use of cannabis and products for both stress levels and helping with nerve pain. It also cuts down the cost of expensive pain meds which can become addictive such as opiods. Thank you again everyone for your efforts and calm demeanor in this battle we call life. Two thumbs up.

    Greg Boydell Avatar Greg Boydell
    July 8, 2023
  • I would sincerely like to Thank Kaity Yang for representing me as a client. Kaity was excellent from start to finish. Kaity understood my struggles and fought for my rights. I would and will highly recommend Kaity Yang and Kotak Law. I would also like to Thank Louise Lloyd for all her help and professionalism. Through out the process Louise was also a tremendous help. Thank-You both so much.

    Chris Loughlean Avatar Chris Loughlean
    April 8, 2023

    An excellent experience. We had tried to do it by ourselves, following the insurance company’s rules and they simply kept declining the claim and running out the clock, causing no end of stress. We turned to Kotak Law and Rajiv and his team listened, understood and sympathized. They worked hard, kept communication open and delivered results. They took an overwhelming situation and walked us through…thank you.

    Mike Kirtz Avatar Mike Kirtz
    February 8, 2023

    Rajiv Hate is amazing! I contacted Kotak law after my employer fired me and I was on LTD. However, I did the mistake of going thr Ministry of labor and the severance I received was so low. Not only this but my employer had hired a lawyer and they had drafted the release form- I signed off on it not only releasing my employer but also affiliates etc. My employer was dishonest and last minute made an amendment which I didn’t see and I released the LTD provider as well and the provider was not even there and not part of the discussion. It was such a bad deal to release all my rights for so little money. I didn’t realize all this until after I contacted Kotak and Rajiv looked at my documents. Instead of giving up on me Rajiv went ahead and fought for me. It was a long wait and I thought I had lost and was giving up, but Rajiv kept persevering. He was skilled at the negotiation and when I was tired, he found the right words to speak on my behalf and understood me. My case was won by Rajiv and it takes amazing talent like his to win a lost battle! Hats off to Rajiv and his assistant Stefan Jakovljevic for a job well done and being there for me.

    Bi Avatar Bi
    November 8, 2022
  • After dealing with my insurance company with no results, I hired Kotak Law to advocate for me. Mr Rajiv Hate did an excellent job of listening to the issues and presenting them on my behalf. Without him, I would not have been able to reach an agreement with the insurer. Would definitely recommend.

    Kevin O Avatar Kevin O
    November 8, 2022

    My experience with Kotak Law Lawyers was simply amazing. Nainesh Kotak represented my case with great care and attention. The level of empathy and comfort provided meant the world to me. I truly felt Mr. Kotak and supporting staff made the difference between a very stressful experience to one that went smoothly with a positive outcome.

    carol grilli Avatar carol grilli
    September 22, 2022

    After dealing with my insurance company with no results, I hired Kotak Law to advocate for me. Mr Rajiv Hate did an excellent job of listening to the issues and presenting them on my behalf. Without him, I would not have been able to reach an agreement with the insurer. Would definitely recommend.

    Kevin O Avatar Kevin O
    August 29, 2022

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