Long Term Disability Claim (LTD)

Published on: September 4, 2014

Punitive Damages and Damages for Mental Distress in the Context of a Long Term Disability Case

Clients always want to know what sort of damages they can claim in the long term disability case. As previously discussed in the Toronto Injury Lawyer Blog, damages in a long term disabilty case can be limiting.

Unlike a car accident case, there is usually no wrong doer, or tort feasor for the allged long term disability giving rise to the claim. It’s not like a masked bad guy came in the middle of the night and whacked the Plaintiff with a baseball bat and caused them to suffer from fibromyaligia, depression, anxiety etc. Normally, the disability giving rise to the claim is an unfortunate health condition, which nobody would wish upon their worst enemy.

In these sort of instances, when there’s no “bad guy” we can poin the finger at; then there’s no claim for general damages, or pain and suffering damages as they’re commonly known.

The money from these long term disability claims comes from the value of back payments monthly LTD payments owing from the insurer, to the insured. If successful at trial, a Judge will likely re-instate monthly LTD benefits, such that the Plaintiff continues to get paid on a month to month basis.

But clients always want to know what other damages are available in these sort of cases. It’s a very good question, because monthly disability benefits are capped at the monthly disability amount, less any set off (CPP, WSIB, etc.). This can be limiting. But there is potentially more compensation available to a claimant, depending on the nature of their claim.
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Published on: May 29, 2014

How to place a dollar figure on your Long Term Disability Claim: The Mediation Process Explained

By Goldfinger Injury Lawyers

Our law firm sees some very seriously injured accident victims and disability claimants. Many of our long term disability clients who have cases against large multi national insurers such as Manulife, SunLife, Great West Life, Standard Life, Desjardins, Industrial Alliance, SSQ, Equitable Life etc; want to know how an insurer can place a dollar figure on their disability and inability to work for the rest of their lives.

For a disability claimant, the answer to this question can be very simple. If I can’t work for the rest of my life, then naturally, I should be entitled to MILLIONS of dollars worth of compensation. Afterall, my pain and suffering is immeasurable.

One of the most common misconceptions in long term disability cases is that claimants are entitled to damages to compensate them for their pain and suffering. This is NOT true. At our Law Firm, we refer to LTD cases as “four corner” cases. That means that your damages, or benefits, are limited to what the four corners of the policy provide for. If you have a bad policy, which, based on the wording of the policy will not properly compensate you in disability benefits; then your award will reflect that.

There are some situations where awards in long term disability cases can fall outside of the four corners of the policy.
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Published on: May 21, 2014

Chronic Pain: Subjective vs. Objective Disability (Long Term Disability Claims)

By Goldfinger Injury Lawyers

How does an insurer, judge or jury assess one’s pain level? If their pain is not showing up on any x-ray, scan, or test result, then how does a Court truly know that the claimant is in pain; and in fact telling the truth?

What’s stopping somebody from simply making a claim that they’re disabled, and lying to their doctor and to the Court alike?

How do we know that somebody is telling the truth about their subjective pain, fatigue or other cognitive difficulties (loss of memory, sadness, fatigue, loss of concentration etc.)?

These are all very good questions. Believe it or not, our the way that personal injury claims and long term disability claims work in Ontario make it pretty clear who’s faking, and who’s not.

First, we have to draw a distinction between an objective injury vs a subjective injury. An objective injury is one that will show up on an xray, scan or test. A factured ankle. A broken femur. A cranial facture. A hematoma on the brain. All of these are injuries which will show up on a test, which any doctor, or non-medical person can likely see. It’s pretty hard for an insurer to refute an ankle fracture injury when the x-ray clearly shows that the ankle is fractured.
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Published on: April 10, 2014

Top Questions for Critical Illness, Life, and Disability Insurance Policies We See at our Law Firm

By Goldfinger Injury Lawyers

This week’s entry comes straight from the Toronto Injury Lawyer Blog reader mailbag.

Question: Goldfinger: Love the Blog. Hate the new head shots. But seriously, my wife and I are looking at getting insurance. You know. We were curious about life, disability, critical illness etc. You see it all. What should we be looking out for when buying our insurance. Best Regards JJ + PJ
Well JJ and PJ, thanks for your question. Always nice to hear from our readers.

NOTE: Lawyers don’t sell insurance. We sue insurers after they’ve denied your claim.

For starters, buying insurance is not an easy decision. For starters, I could count of a million things more exciting than insurance to spend your hard earned dollars on. On top of that, insurance can be expensive.

Secondly, have you ever read an insurance policy? They’re long, boring, and very difficult to understand. You really need to be a lawyer to truly understand what they’re trying to say. And even then, some clauses and and definitions contained in those policies are subject to one’s interpretation. Any ambiguity contained in a policy will be interpreted in your favour: BUT: do you really want to have to retain a lawyer and fight in Court for years and years over benefits, when you could have just saved the trouble and hassle and received them now? That’s just a big pain in the you know what; not to mention all of the unnecessary stress and anxiety which might come with involved in being in litigation with a large deep pocketed insurance company. Hey: sometimes it’s necessary. That’s what we’re here for.

Here are a few tips I’ve learned from litigating life insurance, disability insurance and critical illness insurance policies throughout the years.
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Published on: March 26, 2014

Do I have to attend the “Independent” Medical Examination arranged by the Insurance Company? Steps in a car accident or Long Term Disability Case (Ontario)

By Goldfinger Injury Lawyers

You’ve been involved in a car accident, or you’re involved in a dispute against your Long Term Disability Insurer. The adjuster for the insurance company tells you over the phone, or in an incomprehensible letter that they want you to attend a medical examination with a doctor you’ve never heard of.

You don’t know who this doctor is.

You don’t know where their office is located.

You don’t know how you’ll ever get there because transportation has been difficult for you since your accident or disability.

You don’t know why you have to attend the examination.

You don’t know what the examination is for, how long it will last, what tests will be administered.

You have about a million and one other questions about the examination, and you have nobody to turn to.

Enter a Personal Injury Lawyer.
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