Articles Posted in Fibromyalgia

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The personal injury lawyers here at my law firm, Goldfinger Injury Lawyers have developed a unique term for certain long term disability cases.

We call it getting “mathed out“.

What does it mean to get “mathed out“? It means that the math is working against you to defeat your claim, regardless of the merits of your disability.

Let’s explore how long term disability cases work.

These are cases which are based in contract. That contract takes the form of an insurance policy. Often we see our claimants with group policies, which contain sections for health, dental, life, and long term disability insurance. These group policies are a perk of employment (a benefit). Had the person not been gainfully employed, they would not have been covered under the policy; hence they would have no cause of action.

Some employees don’t have any benefits whatsoever, so if they don’t have their own personal long term disability insurance, they won’t have a cause of action.

On one hand the claimant needs to be thankful that they have a policy or long term disability coverage to lean on. But on the other hand, many claimants get upset that the policy seems to work in favour of the insurer and not the other way around.

The wording contained in these policies is written by large insurers. Because large insurers write the policies, you can expect that they contain a lot of favourable clauses protect their own interests and not yours. Why would you expect an insurer to draft a policy that doesn’t work in their favour? We just don’t see this sort of thing.

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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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For the 1% of personal injury cases which go to trial, the majority of those cases are tried by a Judge with a Jury.

Insurance companies automatically file Jury Notices to accompany their Statements of Defence because they know that jurors don’t like sitting through long personal injury cases. A disengaged and disgruntled juror will be less likely to side with the Plaintiff. A Judge sitting alone is trained, well versed and PAID to listen carefully to the facts. Jurors are not trained, not well versed and certainly not well paid to sit around for weeks listening to evidence. In some cases, the cost of parking, snacks and meals will outweigh the cost of the Juror’s daily stipend. Compounding the anger of a juror is the fact that many of them are employed and have to miss time from work without getting paid themselves to engage in jury duty. Nobody wins.

Jurors want to sit in on “cool trials“. What’s a “cool trial“. Think of a high profile murder case. That would be “cool” to sit in on. Or how about a violent assault, drug trafficking charge, or something involving organized crime? Anything out of a TV or movie plot would satisfy a juror’s appetite. Unfortunately, chronic pain, fibromyalgia and long term disability disputes don’t make very interesting screen plays.

Plaintiff personal injury lawyers know this. Plaintiffs themselves often do not. It’s hard for a Plaintiff to put him or herself in the position of a Judge or Jury hearing their own case. In the Plaintiff’s own mind: What else could be more important or more interesting than sitting through a 2-4 week trial to hear all about my injuries, disability and how the insurance company screwed me?

What really goes on in a juror’s mind is “who cares about this person; and; get me outta here so I can go back to my normal daily routine.Continue reading →

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Last week’s entry of the Toronto Injury Lawyer Blog entitled “How Ontario Car Accident Cases and Pain and Suffering awards work in a Nutshell received resounding positive feedback from our readers. They appreciated how complicated legal terms and concepts were broken down in easy to understand English. This is something our law firm prides itself on.

We understand that most of our clients are NOT sophisticated lawyers with years and years of technical legal training. Most of our clients are everyday people, who have not studied law.

We do our best to make things simple to understand. Why should a car accident case, or long term disability case be spoken about like it’s rocket science? The more our clients understand, the better the lawyer-client relationship.

In that vein, we continue with our “nutshell series“. This installment will focus on how Long Term Disability cases work; along with some of the most commonly asked questions about LTD cases from our clients. If you require more information about long term disability cases, please don’t hesitate to contact Goldfinger Injury Lawyers toll free at 1-877-730-1777 or at info@goldfingerlaw.com for your free and confidential consultation.

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Goldfinger Injury Lawyers has assisted countless long term disability clients with their denied LTD claims against large insurers in fibromyalgia, chronic pain and depression cases.

If you are reading this installment of the Toronto Injury Lawyer Blog Post, you likely have some questions about fibromyalgia, chronic pain, or Long Term Disability Cases in general.

If this entry does not answer the questions you may have, don’t hesitate to give us a call toll free across Ontario at 1-877-730-1777 or email Brian Goldfinger at brian@goldfingerlaw.com or our law firm at info@goldfingerlaw.com. Brian Goldfinger and our long term disability lawyers would be pleased to answer your questions, whatever they might be. All of our communication is confidential; and there is no charge; so don’t hesitate to ask away.

And with that pre-amble out of the way, it’s now on to demystifying fibromyalgia and chronic pain in the context of a long term disability claim in Ontario.

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Our law firm often gets calls from soon to be Long Term Disability claimants asking our lawyers to fill out their forms. We realize that the LTD application forms can be overwhelming, complex, with some hard to answer questions. Not all questions can be answered in a “yes/no” fashion.

Filling out LTD application forms is not something which our lawyers do. But, we can help give you a few tips on how to get your Long Term Disability claim a fighting chance of getting approved. Without further ado, here are Goldfinger Injury Lawyers’s tips on how to get your LTD claim approved at first instance:

1. If you want a benefit, you first need to apply for it! This seems like such a simple premise, but you would be amazed at how many people don’t understand it. Your Long Terms Disability benefits won’t just land magically in your lap without you first applying! Do you really think that an LTD insurer wants to pay you money without you not even yet applying for said benefit? LTD insurers don’t exist to give away money for nothing… There are mounds and mounds of forms which need to be submitted. And just because those forms have been submitted, doesn’t mean they will be looked at in a timely manner. Get those application forms submitted, and don’t sit around on it. There are  provisions in every LTD policy our lawyers have seen with respect to the timing of the application in relation to the last day you may have worked. Waiting around on getting that application in will jeopardize that timing and may give the insurer a reason to deny your LTD claim for failure to abide by the limitation periods as set for in the LTD policy.

2.  Make sure that your family doctor or specialist is on board with the LTD application. You will need a doctor or specialist to complete a medical certificate in support of your LTD application. If your family doctor or specialist doesn’t believe that your disabled, chances are the medical certificate which s/he completes will also NOT support your LTD application. That unfavourable medical certificate will give the LTD insurer a reason to deny your claim. If you have a more supportive doctor of your disability, consult that doctor for his/her assistance in completing the medical certificate.

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One of your benefits through work may be a form of Long Term Disability Insurance. LTD Insurance can also be purchased outside of work privately, through a policy which follows you from job to job. Having an LTD policy is always a good thing. You can also have more than one.

Long Term Disability insurance is provided by a large insurance company or bank like Manulife, Great West Life, Sun Life, Industrial Alliance, SSQ, Desjardins, Standard Life, RBC, Co-Operators etc. These are some of the most common insurance companies we see which provide LTD insurance across Ontario. If you’re reading this installment of the Toronto Injury Lawyer Blog, chances are that you may have LTD coverage with one of these companies.

The purpose of this coverage is to ensure that you get paid in the event of serious illness, or disability which prevents you from working for an extended period of time.

An insurer will pay an monthly LTD benefit. The quantum of that LTD benefit depends on the wording of your policy along with your pre-disability income. We commonly see LTD polices which will pay out a range of between 60-80% of the claimant’s monthly pre-disability income. Continue reading →

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If you have applied for Long Term Disability Benefits with a private LTD insurer such as SunLife, Manulife, Great West Life, Industrial Alliance, SSQ, Co-Operators, Empire Life, RBC Insurance, La Capitale Insurance, BMO Insurance; and had your claim denied, then this is the article you need to read.

It’s important to know that in order to recover a Long Term Disability Benefit from one of these insurers, you first need to APPLY for it. Just sitting around and waiting for a cheque to roll in is a pipe dream. Insurers won’t pay a benefit, unless you’ve taken the time to complete the paper work (properly), and then submit it.

If don’t apply for the LTD benefit, I can assure you that you won’t get approved.

If you wait too long to apply for the LTD benefit, I can assure you that your claim will get denied for delay. Many LTD policies contain clauses that the LTD benefit must be applied for within a certain  period of time. Failure to make a timely application is grounds for an LTD insurer to deny your claim. If you take the time to read the fine print of your Long Term Disability Policy, you will see plenty of clauses which are drafted in favour of the large, deep pocketed insurer, instead of in the favour of the individual policy holder (a person like you and me).

None of this seems fair; but it isn’t intended to be fair. Keep in mind; an insurance policy is a product designed by an insurer to make money. If these policies weren’t profitable, I can assure you that insurers would not put them out there for the public to buy. Continue reading →

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Many of our clients suffer from fibromyalgia, depression and chronic pain. These injuries arise and present themselves in a wide variety of ways. Each case is fact specific. We never know how these injuries will present themselves or manifest.

Our lawyers see fibromyaligia, depression and chronic pain in the context of car accidents, long term disability (LTD) claims, motorcycle accidents, slip and fall cases and assault claims.

Even though the starting of these points of these claims may be different, the end result is similar. An inability to work, function, or engage in your normal routine of daily living.

The struggle of having to explain to family, friends and loved ones the nature of your injury and how it impacts you life, when the injury is invisible is taxing. It would almost be easier if you had a broken leg. That way, everyone would see what’s wrong with you. Having to describe the pain and depression is difficult and hard for others to understand or sympathize with.

Insurers know this. That’s why in chronic pain, depression and fibromyalgia cases we see lawyers for insurance companies file Jury Notices right away. They know that they can play upon the subjective nature of chronic pain, fibromyalgia and depression in order to defeat your claim. Their goal is to have the jury disbelieve your version of the events along with your pain, such that your case will get dismissed.

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