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.