Articles Posted in Long Term Disability Claim (LTD)

Most unionized employees have benefits through their employer. Those benefits have been negotiated by their unions as a perk of employment. They help make life inside and outside of the workplace that much better and add a layer of security and value to one’s employment.

But if you asked a unionized employee what benefits they are covered for, and for what amounts: most will tell you that they aren’t really sure; but they are sure that they are covered for some things (dental, physio, life, disability or something else).

Not every employee memorizes their benefits booklet and that’s ok. Those benefits booklets can also get confusing given that employees are assigned into different categories where insurance benefits and amounts vary depending on the level of seniority or position of the employee.

You union can play a big role, or a small role in your long term disability claim.

Understanding the interaction between the employee and his/her union in the context of a long term disability claim is important. Failure to understand the union’s role can defeat a long term disability claim before it even has the chance of getting off the ground.

Continue reading →

Lots on people who are applying for Long Term Disability insurance benefits; or who are receiving Long Term Disability benefits want to know why their insurance company is asking (or demanding) that you apply for Canada Pension Plan Disability Benefits (CPP-D).

What does one set of benefits have to do with the other? Why is my long term disability insurer so adamant that I apply?

All of these are great question and as personal injury lawyers who handle a lot of long term disability claims; we see them all of the time.

For starters, contained in the very very fine print of each and every single long term disability insurance policy that we have seen is a provision which states something to the effect that:

Continue reading →

One of the most commonly asked questions of me, Brian Goldfinger, is:

“Do I have a good case?”

It’s generally hard to say whether or not a person has a strong case or not. But there are a few indicators as to the strengths, or weaknesses or one’s case.

This edition of the Toronto Injury Lawyer Blog will focus on case strengths, and case weaknesses as they relate to Long Term Disability cases. In some respects, the same reasoning can be applied to car accident cases, slip and fall cases, dog bite cases etc. But there will be some specifics dealing with Long Term Disability cases which are unique to those sort of claims.

Continue reading →

Long Term Disability claims are not claims for pain and suffering or general damage claims.

They are claims for a defined monthly disability amount based on percentage of your pre-disability earnings and last  for a pre determined period of time. Under most policies, that period of time is the age of 65; although some policies have provisions whereby benefits last shorter, or longer. It all depends on what it says in the policy.

When you are receiving long term disability benefits, chances are you won’t be made entirely whole. That means that you won’t be earning as much on long term disability; as you would if you were working and earning an income.

Some policies provide that long term disability benefits are taxable. Some policies state that long term disability benefits are not taxable. Again, it all depends on what the long term disability policy states.

Many people want to know what is the best possible outcome in a long term disability case. This can be a difficult question to answer; given that everyone has different ideas on what the “best” outcome for their case is.

For starters, nobody from the insurance company will be going to jail for having not approved your long term disability benefits; or for cutting you off your claim. In addition, a personal injury lawyer cannot seize the home, car or bank accounts of the person(s) responsible at the insurance company for not approving your claim. These forms of relief simply don’t exist. Although I do suspect if these forms of relief did exist that insurance adjusters would be extra cautious and careful when handling your claim. Not all insurance adjusters are bad people. They do make mistakes from time to time. But that’s no excuse. They aren’t the ones who have to live day to day without being able to work and try to make ends meet.

Continue reading →

Long Term Disability cases are based in contract. Damages are awarded to the disabled plaintiff based on what is available to the disabled plaintiff under the contract.

Damages for the most part are limited to what’s covered under the four corners of the insurance policy.

Only in rare cases will a court order damages for bad faith against an insurer, or damages for mental distress. These outside of contract damages are awarded only in limited circumstances where there has been egregious conduct by the insurer. These cases are the exception, not the rule.

If you went to trial on a long term disability case, here are the things which a Judge can Order:

1. The insurance company pay the totality of your back payments (arrears), less any offsets such as WSIB, CPP Disability, ODSP or pension payments
2. The insurance company has to pay interest on the arrears at a set rate (normally it’s pretty low, it’s currently sitting at 2% for this quarter).
3. The insurance company re-instate your long term disability benefits (put you on claim). But keep in mind that you are not on claim forever. There is nothing preventing from the insurance company from terminating those benefits again down the line because they believe that you’re no longer disabled. The result is you have to go through the entire litigation process again.
4. The insurance company MAY have to pay for a portion of your lawyer’s fees (or may not)

Continue reading →

Long Term Disability Claims are NOT claims for pain and suffering.

Long Term Disability Claims are not based in negligence.

Nobody from long term disability insurer ran you over with a truck or hit you with a baseball bat resulting in your disability. You had something completely unrelated to your relationship with the long term disability insurer; before your disability arose. It could be serious medical condition; a bad slip and fall; or a stressful work environment. Nonetheless, the long term disability insurer had nothing to do with giving you the disability in the first place.

To be fair the way a long term disability insurer treats you can result in mental anguish, financial distress or harm. These sort of claims along with bad faith claims handling is a separate tort all together. These cases are the exception, but they certainly do happen.

But the foundation of a long term disability claim are the long term disability benefits themselves; which are a creatures of contract, not tort.

Standing alone from any separate tort or bad faith claim; quantifying the value of arrears and futures is a mathematical equation based in contract. It’s not an imaginary number which is made up by the Court.

Continue reading →