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Lots of people call my law firm for legal advice for their long term disability claims. Often for these people, it’s their first time dealing with a large insurance company over a claim of significant value which can impact the course of their financial security for the rest of their lives.

Questions like:

What should I (or shouldn’t) say to the adjuster over the phone?

How do I complete all of these forms?

Who should complete these forms?

When should I apply for long term disability benefits?

How can I apply for long term disability benefits?

What must I do once my long term disability claim gets denied?

Should I appeal the long term disability insurer’s decision; and if so; how do I go about that?

When should I retain a long term disability lawyer?

How much will retaining a long term disability lawyer cost?

How long will my case take to get settled or go to trial?

As you can see, people have a lot of questions regarding their long term disability claims. This is completely understandable. Long Term Disability claims are hard to understand right off the bat! They are contractual disputes. The terms of each contract are different. They all depend on the wording of the policy and each policy of insurance is similar; but it’s NOT the same. This is what makes things a bit confusing.

A car accident is easy to understand. In a car accident case, an at fault driver causes a car accident and is held accountable for the pain, suffering and ensuing economic losses they have created through their own negligence.

A long term disability case is based on the wording contained in the policy of long term disability insurance. These policies are long, verbose and hard to understand. There are multiple clauses, exceptions, time periods etc which makes hard even for an experienced long term disability lawyer to understand.

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If you are hurt or injured in a car accident in Ontario, you will be entitled to an array of accident benefits.

These accident benefits are paid by your own car insurer, regardless of fault. If you did not have car insurance at the time of the car accident, the order of who pays for those accident benefits is determined based on a set of priority rules as defined under the Insurance Act and the Statutory Accident Benefits Schedule (“SABS”). This is often why you see insurance companies fighting not against a Plaintiff, but against each other in an attempt to “pass the buck” so to say to determine who is responsible for paying an injured accident victim’s accident benefits. Because the truth is insurance companies would rather not pay if they don’t have to. Can you blame them?

Speaking of passing the buck, one of the benefits which an injured accident victim may be eligible for is called the income replacement benefit or IRB.

The income replacement benefit is only available to income earners. If you were not earning an income at the time of the accident, or not employed but either worked 26 off the 52 weeks for the accident, you will not be entitled to the income replacement benefit. Self employed people are considered employed and working. But, recovering the income replacement benefit for self employed plaintiff’s can be very difficult. Establishing an income in a cash business, or in a business with limited record keeping makes it hard for insurers and their accountants to verify that you were working and entitled to the income replacement benefit. If they can establish that you are entitled to the income replacement benefit, quantifying that benefit can be very tricky. The reality is that self employed people often don’t show or report the entirety of their income because they don’t want to pay as much in tax. The problem with that is that you can only recover what you report to Revenue Canada. Your income replacement benefit is based on reportable income. The income replacement benefit is NOT based on unreported income, or moneys which are kept off the books. You can’t have it both ways. Continue reading →

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Mediation can be a very nerve wracking experience; although it shouldn’t be.

But I get it.

For the majority of Plaintiffs involved in a personal injury case, it’s your first time participating in a mediation. You don’t know how a mediation works, what to do, what to wear, what to expect, or how long the mediation will take place that day.

Your personal injury lawyer should prepare you for these questions and fears, but no amount of preparation will get you ready for the real thing. You have to do it, and go through the highs and the lows to really know it.

It’s important to know at mediation, there is no Judge; no Jury; no recording devices. You cannot “win” or “lose” at mediation. The case will either settle, or it won’t settle. Sometimes, even when the case doesn’t settle, it may resolve shortly thereafter because the parties have sought additional authority, or have had some time to let the position of the other side sink in. Either way, there is no Judgement or Verdict coming out from the mediation process.

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Brian Goldfinger has been practising law long enough to have seen some very good practices from personal injury lawyers in Ontario; along with some very bad practices from personal injury lawyers in Ontario.

When bad things happen to people; they often turn to Brian Goldfinger to right the ship and turn things around.

In this instalment of the Toronto Injury Lawyer Blog, we pick Brian Goldfinger’s mind to find out some not so good stories from clients he has seen in the past in terms of what not to do when retaining a personal injury lawyer in Ontario.

  1. Meet with your personal injury lawyer: All too often, Brian Goldfinger has been approached by prospective clients with personal injury cases who are being handled by other personal injury lawyers or paralegals. When Brian asks them who their lawyer is; the client cannot say. When asked whether or not they have met with a personal injury lawyer, spoken to one, or corresponded with one in relation to their case, often the answer is a firm “no”. When pressed further, the truth comes out that they never met a personal injury lawyer before. Instead, they met with a non lawyer who called themselves a “consultant” or a “client care specialist”, or some other fancy non-legal title. These people are not personal injury lawyers. They are people who give themselves fancy titles. These people may act as agents or servants or employees for the law firm they work for or represent whose sole job is to run around the City or Province and get clients and sign up clients. Never meeting with or speaking with your personal injury lawyer from the start is recipe for disaster. When you hire a real estate agent, do you meet with that agent or do you meet with his/her agent or secretary? When you need to get surgery, do you meet with the surgeon ahead of time to discuss the procedure, or do you meet with the surgeon’s agent? The same applies when it comes to your personal injury lawyer. Know who you’re hiring.

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My law firm handles a lot of long term disability claims.

These are cases whereby large insurance companies like Great West Life, Sun Life, Manulife, Canada Life, Industrial Alliance, Desjardins Insurance, La Capitale Insurance, RBC Insurance, Co-Operators Insurance etc. cut off, cease to pay or terminate one’s long term disability benefits.

We have represented people of all ages, from all different walks of life, with different occupations. People like doctors, lawyers, nurses, teachers, postal workers, university employees, municipal/government employees, civil servants, mechanics, general labourers, janitors, casino employees, factory workers, automotive sector employees, machinists, plumbers, tradesmen, bus drivers, truckers, brick layers, retail employees, clerical/secretarial staff, bankers, and even people with cushy desk jobs who work in giant towers in downtown Toronto. The list goes on.

Some people don’t lawyer up. They try to appeal these denials or terminations of benefits on their own. Our long term disability lawyers rarely see these appeals go anywhere. It’s like going to a gun fight with a rubber knife. All the appeal does is to serve the insurance company in establishing a patter of denials and kicking the can down the road for a few months in the hopes that a limitation period lapses to prevent a Plaintiff from bringing their claim in the requisite period of time. It’s an exercise by the insurance company to give the illusion that they are treating your claim with the upmost best intentions. But the reality is that your claim was doomed to succeed in the first place. Once the insurer looks at it in a negative light, it’s very difficult to sway the insurer in the other direction to have the claim approved without the assistance of a personal injury lawyer with experience handing long term disability claims.

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In the final instalment of a four-part series on long-term disability insurance, Toronto personal injury lawyer Brian Goldfinger discusses some of the unique issues that surface in LTD claims filed by educators and postal workers.

Toronto personal injury lawyer Brian Goldfinger refutes any perception that teachers and postal workers have cushy jobs as they are among the top clients he helps fight for in long-term disability (LTD) claims.

“Both jobs have generous vacations, but that’s a trade-off,” says Goldfinger, founder of Goldfinger Injury Lawyers. “When you sign up for it, there are significant amounts of stress and pressure, and nobody gives these workers their due respect.”

Teachers and postal workers share a number of commonalities, he tells AdvocateDaily.com. “Both are unionized and have access to a variety of benefits, but they’re in very high-stress, difficult jobs and they don’t get proper credit.

“They take some time off for stress, but it gets extended because their doctors or therapists believe their work environment is unhealthy for them,” Goldfinger says.

“It sounds strange because people often assume teachers are in a class of smiling, happy children, or that a postal worker has a dream job,” he says.

Goldfinger says that while many of these cases involve stress leave, physical issues are also common.

He points to a 2017 survey that found almost nine in 10 teachers have experienced or witnessed violence or harassment in the workplace.

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Recently the Ontario Government increased the cost of many Court filing fees. Notably, the cost of filing a Trial Record in the Ontario Superior Court doubled from $405 to $810. Like a cruel and ironic April Fool’s joke, the increased fee schedule will be implemented on April 1st,  2019. I cannot recall any form of debate or consultation that went in to increasing. If are seeking out the legislation with the increased court filing fees, you can find it by clicking the link here. 

Imagine that: $810 just to have your case placed on the trial list. This does not take in to consideration the cost of filing a statement of claim ($229), the cost of filing a motion record ($160) , the cost of a Jury Notice ($130), or the costs of any summonses to witness ($30 each).

So: If you want to have a civil jury trial in a personal injury case, whereby you bring 2 motions, the cost in court filing fees alone for a Plaintiff would be $1,359 plus the costs of summonses at $30 each. This does not take in to consideration the filing costs for a Defendant; nor does it take in to consideration the cost of legal fees, HST on legal fees, or disbursements (faxes, photocopies, medical records, police reports etc.)

Lesson: Litigation is expensive and access to the Courts is reserved for the wealthy.

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Long Term Disability insurance isn’t easy to understand. It’s not a common tort or a common cause of action.

It’s not an intentional act which causes harm, or a negligent act by an individual defendant which causes harm. That means it’s not easy for many people to understand.

Here’s a concept that’s easy for people to understand:

A Red Honda Civic runs a red light and t-bones a Blue Cadillac. The driver of the Red Honda Civic which ran the red light is charged and convicted for his bad driving. The passengers in the Blue Cadillac are all seriously injured in the car accident. The innocent accident victims in the Blue Cadillac sue the at fault driver of the Red Honda Civic.

In this very brief fact pattern, we have liability (the driver of the Red Honda Civic is at fault), and we also have damages and causation (the passengers of the Blue Cadillac got injured; and those injuries were a direct result of the negligence of the Red Honda Civic driver). The personal injury case against the at fault driver of the Red Honda Civic is clear and easy to understand.  This case is built in tort and based on negligence.

These concepts are relatively easy (in comparison to other causes of action) to understand.

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This deep freeze, thaw, cold, warm, snow, rain, back to snow, then to ice weather cycle we have seen across Ontario this winter hasn’t been good for anyone. We’re not sure if it’s snowing, raining, or ice is falling from the sky.

All of the fluctuations in temperature have lead to slippery walking conditions on sidewalks, parking lots, entrance ways, walk ways and other paths.

Over the past week,  personal injury lawyer Brian Goldfinger has been asked for comment by the CBC, CityTV and quoted by Canadian Underwrite Magazine for commentary from a knowledgable lawyer regarding slip and fall cases in Ontario. You can find links to these articles here:

Canadians nurse winter wounds as cities grapple with icy sidewalks

 Latest Canadian statistics on slips and falls on ice

https://www.cbc.ca/news/canada/london/sidewalk-clearing-law-london-ontario-1.5046917

Over the months of February and well in to the beginning of March 2019, our law firm has seen a spike from the usual norm with respect to winter slip and fall cases resulting in serious injury. Injuries like broken ankles, broken wrists, broken arms, broken hips; even fractured skulls. We have been seeing some pretty significant injury cases of late.

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Every car accident case in Ontario has three major components:

  1. Liability
  2. Causation
  3. Damages

Without a personal injury lawyer establishing all of these components, the personal injury case will fail. Meaning, that if  Defendant successfully refutes, or creates sufficient doubt to surpass a balance of probabilities, the Defendant will win the case. As a plaintiff personal injury lawyer, you don’t want to see that happen.

In addition to these three pillars of personal injury law, your Ontario personal injury lawyer also must overcome the following rules at trial which CANNOT be shared with the jury:

  1. The Threshold for General Damages (did the injured accident victim sustain a serious and permanent impairment of an important bodily function)
  2. The Deductible aka the secret credit. The current deductible stands at $38,818.97 for any award for general damages below $129,395.49. The effect of the secret credit is that the Defendant insurance company does NOT NEED TO PAY THE FIRST $38,818.97  of any award below $129,395.49. We here at Goldfinger Injury Lawyers refer to the deductible as the secret credit because plaintiff lawyers are NOT ALLOWED TO MENTION THE DEDUCTIBLE AT TRIAL. So if a Jury intends to award a Plaintiff $50,000 in general damages for pain and suffering, that award automatically gets reduced to just $11,181.38 which is a 76% reduction in value from what the jury originally intended to award! On what planet do we automatically strip the will of the jury by such a large proportion?!?!? One final note on the secret credit. How many jurors to you think earn $38,818.97/year after tax. The median individual income in Ontario sits just $27,600.

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