Articles Posted in Disability Claim

It’s an unscientific fact that insurance companies don’t like fibromyalgia claimants. It makes no difference of the context of that fibromyalgia claim. It could be for your short term disability claim, long term disability claim, slip and fall or car accident.

Don’t take it personally. It’s not YOU they don’t like. It’s your symptoms, injuries, and what they stand for.

Here’s the harsh reality about fibromyalgia. It won’t show up on an x-ray, CT scan, MRI or any other fancy objective scan. There are trigger points but those don’t show up on computer tests. Insurance companies LIKE those sort of tests. It puts your injuries in to a black and white context. If it’s there on the scan and visible to the naked eye on a computer screen, then you have it and you’re likely suffering from it. If your injury doesn’t show up on the scan, then it doesn’t exist. It’s probably a figment of your imagination, or a way for you to lie in your attempt to deceive the insurance company.

It makes it much easier for an insurance company to lump your claim in to a simple formula that an unskilled, and untrained adjuster can follow. If the claimant has an ankle fracture, then he/she is entitled to “X” amount of dollars. If the claimant has a broken femur then he/she is entitled to “Y” amount of dollars…And so forth. I hope you get the picture.

The moment that your injuries cannot be put in to a simple mathematical and easy to understand equation is the moment that the insurance company needs to think and take a better look at your claim. When the insurance company has to slow down its operations for your claim, it hampers their productivity and profits. This is NOT good for their business.

The problem is that fibromyagia cannot be put into a simple mathematical equation and cannot be looked at from a “black and white” perspective. There’s a lot of grey area when dealing with these types of claims.
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We receive many calls every week from people who have been denied their Long Term Disability Benefits, by private disability insurers such as Great West Life, SunLife, Manulife, Standard Life, Industrial Alliance, SSQ, Co-Operators, Empire Life, RBC Insurance and others.

People want to know what to do after they’ve been denied.

Denial, or termination letters are often lengthy detailed letters which include the provisions of your LTD policy, the definition of the term “disability” based on the policy, excepts from medical records or medical reports, along with the insurer’s reasoning to deny or terminate benefits.

After these long winded reasons are provided, the insurer will also then include ways that you can appeal their decision. Statements like you have 90 days from the date of this letter to appeal this decision through our Appeals/Investigation Committee are common. People call our law firm in an absolute PANIC stating that they’re under the gun and that their opportunity to appeal the claim is fast approaching.

What I tell these people is NOT TO WORRY, and NOT TO PANIC. These internal reviews or internal appeals are often a waste of time and energy. Here’s why Continue reading →

We received quite the response from a recent Toronto Injury Lawyer Blog post dealing with trends in long term disability claims. The response was so overwhelming, we thought that we would futher explore those new trends in long term disability law and policies, along with other things which you ought to know when advancing your claim.

The first thing which you should know about making a long term disability claim is that with the exception of a bad faith claim, a claim for mental distress, along with a punitive/aggravated damages; these claims are essentially claims for your BENEFITS. The amount of what those benefits are is defined by your policy of insurance. This means that if your policy sets out that your monthly disability benefit amount of 66.67% of your pre-disability net income (which amounts to lets say $2,100/month), then your monthly disability benefit is $2,100/month.
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When we think of injury or disability, the first thing which comes to mind are objective injuries. These are the sort of injuries which are obvious to the naked eye.

Often, a picture of a person in a cast, a person in a wheelchair, or using a crutch comes to mind. We think of broken bones, lost limbs, blood and gore.

What we don’t think about are the injuries we cannot see.

We don’t think about depression, anxiety, chronic pain, loss of memory, fatigue or any of a number of other countless symptoms which are subjective.

The distinction between what is a subjective injury, and what’s an objective injury is crucial to understanding many long term disability claims. Why is this distinction important?
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What’s new in the world of Long Term Disability Law in Ontario? Well, I’m glad you’ve asked.

Not to sound like an insurance salesman, but have you even given any thought to what you would do if you found yourself in the terrible position of being so sick, or so injured that you can no longer work?

Canada Pension Plan Disability Benefits only cover so much. ODSP payments are also very limited. Your EI will expire after around 8 weeks or so. Cashing in RRSPs is a tough pill to swallow.

That’s were Short Term and Long Term Disability Insurance comes in. Critical Illness Insurance may also apply.

At our law firm, we see things when the bad stuff hits the fan so to say. When things go wrong recovering STD/LTD benefits, people call us. We see lots of crazy, and not so crazy stuff. The purpose of this Toronto Injury Lawyer Blog post is to give you a better understanding of what Courts are saying with respect to handling these claims, along with the changes we are seeing on behalf of insurers in the industry. Some of the big names which provide LTD and STD insurance are Manulife, Great West Life, SunLife, Industrial Alliance, Desjardins, Canada Life, SSQ and Standard Life.
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When you open a new bank account, often the bank will try to sell you on purchasing additional insurance. Sometimes, that insurance is complementary. Be careful.The same can be offered through your workplace. People think that their job comes with benefits. But when those policies and benefits are further examined, we quickly learn that those policies and benefits don’t cover everything you thought they did. The effect is that it creates false sense of security for policy holders that they are protected, when in fact, they aren’t.

I’ve had lots of people tell me that their employer or their credit card covers them for accident insurance. Then, while on a beautiful Carribbean vacation, they get in to a catastrophic car accident. You or a loved one might have broken some bones, or got pretty badly hurt. You figure that your medical bills will be taken care of. But, upon arrival at the hosptial, it turns out that your bills are NOT covered by insurance.
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