Injured workers need all the help they can get when it comes to receiving the long-term disability (LTD) benefits they deserve.
With almost three decades of legal practice behind me advocating for injured clients, I know better than most how difficult LTD insurance companies will make it for disabled employees — right from the very start of the process.
To help level the playing field, here is a list of my top six tips to maximize your chances of success when completing an application for benefits so you can start your own LTD journey on the best possible foot.
1. Make your family doctor an ally
The path to a successful LTD benefits application starts well before you fill out any forms. Medical evidence is typically key to an insurer’s determination in your case, so your family doctor must be alerted to the difficulties you are experiencing before you are forced off work, unless a specific incident causes your injuries.
Having a strong relationship with your family physician can only help your case, since few people will know more about your long-term health than your family physician. In addition, they often play a prominent role over the course of an LTD file because of their roles in a patient’s treatment, as well as in referrals to other medical specialists
2. Be punctual
Pay close attention to your LTD insurance policy’s deadlines, and ensure you file your application on time.
Insurers do not need much of an excuse to deny an injured worker benefits, and a late-filed application gives them the perfect opportunity for them to dismiss your claim at an early stage, without even getting into the merits of your case.
Although it is possible to challenge this kind of administrative denial, it will add an extra layer of unnecessary delay and expense between you and your LTD benefits. Unfortunately, you will have enough other hurdles to worry about, thanks to insurers’ unsympathetic approach toward injured workers.
Give yourself a head start by requesting a copy of the application form ahead of time, so that you can familiarize yourself with any deadlines and see what information you need to collect before submitting it.
3. Focus on functionality
A medical diagnosis alone is not enough to support an application for LTD benefits. To be successful, claimants must be able to show how their health condition affects their ability to work.
To help your treating physicians make that link, give them as much information as you can about the nature of your job, your health issues and when they arose, and even the terms of your LTD insurance, so that they can be as accurate and detailed as possible when reporting on your functional limitations.
4. Set your profiles to private
If your social media profiles are not already set to private before you apply for LTD benefits, now is the time to make the switch.
After you’ve submitted your application for benefits, there is a chance that your insurer will conduct surveillance in its investigation of your claim. If you have posted public pictures on your social media accounts, you could run into trouble if the activities in your posts look like they are not in line with the functional limitations you described in your claim.
5. Stick to the truth
Whether you are communicating with your insurer or your doctor, honesty is always the best policy. It’s not just insurance company representatives who frown on exaggerations or misstatements: a judge is also unlikely to look kindly on someone whose credibility has been shot if the matter ever makes it to court.
Withholding information is often just as damaging to an LTD claim, and injured workers should not be embarrassed to raise more minor issues with their treatment providers.
Although focusing on the medical problem causing the most concern at a particular moment is natural, remember that the prominence of different conditions can shift over time. It will help your case if there is some record of a secondary complaint in your medical notes or the LTD application itself.
6. Apply for CPP disability benefits
Applying for Canada Pension Plan disability benefits is worth the hassle for LTD claimants, regardless of whether they end up receiving them.
It commonly takes as long as six months to get an answer on CPP disability eligibility, but if you are successful, it will provide a steady stream of monthly income – potentially running until you turn 65. Even if you are denied CPP disability benefits, it can be good for your LTD claim, since insurers are generally entitled to offsets for any amount received from the CPP. If you fail to apply, then your LTD insurance company may be able to make deductions from your regular disability benefits, based on their estimate of your CPP entitlement.
If you are having trouble with the application process or your insurer has denied your claim for benefits, remember that our lawyers are only a phone call away.
KOTAK PERSONAL INJURY LAW/DISABILITY LAWYERS CAN HELP YOU
We understand that being denied short-term disability or long-term disability benefits can be devastating. Your time to fight your disability insurance company is limited. Please do not delay in calling a short- and long-term disability claim lawyer at Kotak Personal Injury Law. We have successfully sued numerous disability insurance companies, including Manulife, Sunlife, Desjardins, Cigna, Great-West Life, Equitable Life, Empire Life, London Life, Blue Cross, AIG, SSQ, RBC, Industrial Alliance, Canada Life, Fenchurch, OTIP, Teachers Life and more.
Call your trusted long-term disability lawyers at 1-888-GOKOTAK (Toll Free for all of Canada), or (416) 816-1500 (Local Number for Ontario Residents), (403) 319-0071, (587) 414-1010 (Local Numbers for Alberta Residents). Our consultation is free, and we don’t get paid until you do. We represent disabled people throughout Ontario, including Toronto, Mississauga, Brampton, Milton, Georgetown, Orangeville, Oakville, Burlington, Hamilton, St. Catharines, Niagara Falls, Stoney Creek, Kitchener/Waterloo, Cambridge, London, Windsor, Markham, Pickering, Oshawa, Peterborough, Fort Erie, Keswick, Kingston, Ottawa, Barrie, Timmins and other locations. We also serve clients throughout Alberta, including Calgary, Edmonton, Red Deer, Lethbridge, Medicine Hat, Fort McMurray, Grande Prairie, Airdrie, Spruce Grove, Lloydminster, St. Albert, Wetaskiwin, Camrose, Banff, Canmore, Jasper, Cochrane, Okotoks, High River, Sylvan Lake and others.
