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Long Term Disability Denied Claim: Why Me!?!?! (Ontario)

The focus of this Toronto Injury Lawyer Blog Post will be on the denial of Long Term Disability Claims.

Of the hundreds of thousands of Long Term Disability Claims which large insurers like Manulife, Great West Life, Sun Life, Desjardins, SSQ, Industrial Alliance etc. handle, why was YOURS singled out for denial?

You’re a good person.

You’ve worked hard at your job for years without taking much time off like some other co-workers who abuse the system.

You’ve paid LTD premiums for years without complaint or missing a premium payment.

So why me? Why was my claim denied and not the other guy who abused the system?

Why are “good people” always getting the short end of the stick?

I don’t have an answer as to why specifically your Long Term Disability claim was denied in particular; but rest assured; you’re not ALONE!

While it may seem like the vast majority of people you know who applied for long term disability, let me tell you that hundreds of thousands of claims go the other way and get denied.

It’s not uncommon for long term disability claims to get denied at first instance, and approved at a later date; or simply denied altogether.

The important thing is to maintain positive and maintain a level head (as best you can). Easier said than done when bills begin to pile up and the collection calls begin to flood in. But doing something drastic in desperate times is never a good idea.

It’s important to keep these things in mind when dealing with a long term disability claim:

  • Your insurance company is NOT in the business of handing out free money to anyone who makes a claim. Do you think that an insurer profits on paying out on claims; rather than denying and keeping the money for themselves? The more money the insurer pays out on your claim, the less money that insurer gets to report in profit.
  • Your long term disability claim is very personal. It’s your life and your livelihood. You live with the pain, stress and uncertainty of where you next cheque is coming from every day. For the insurance company; it’s not personal. It’s all about money. That’s it!  No magic. Nothing devious. Just money. Insurance companies are large publicly traded corporations whose sole objective is to generate a profit for their investors. Insurance companies may make charitable donations, or may even have their own charitable branch. But, at the end of the day, they are NOT charities and their sole purpose NOT to gratuitously hand out money to needy people.Goldfinger-logo-icon-300x300
  • Your case will be a marathon; not a sprint. Unfortunately, that’s the way the majority of long term disability cases work. While you are waiting for your personal injury lawyer to secure a result in your case, it’s important that you apply for assistance in order to make ends meet. That means applying for Ontario Works, Ontario Disability Support and/or Canada Pension Plan Disability Benefits. All three of these government support agencies exist to help every day Canadians who cannot work or generate an income for whatever reason. Contrary to popular belief, applying for and receiving OW, ODSP or CPP Disability will not impact a “credit rating“. If you are able to return to work after receiving government assistance, then great. If not, then at least you have government assistance to help make ends meet.
  • Don’t sit on your claim. That’s exactly what your long term disability insurer wants you to do! The longer you wait to file a claim either inside or out of Court, the greater the chance of a limitation period expiring. These limitation periods for filing a claim in the first place vary depending on the small print wording contained in your long term disability policy. You have likely NEVER even read this wording, so beware. Once your claim has been denied, you have two years from the date of denial to sue. Failure to meet the claim or civil action limitation period will likely result in a limitation period lapsing. That means that you claim will NOT succeed in Court. You don’t want that.
  • See you doctor! Brian Goldfinger and our long term disability lawyers are amazed at the lack of medical support some of our clients receive because they give up and stop seeking out medical attention. Don’t give up. If one treatment/medication isn’t working, then don’t be afraid to ask for another If one specialist’s course of action wasn’t successful, then ask to see a different specialist in a different area of medicine. Don’t be afraid to ask your family doctor for a referral to see a specialist. Stand up for yourself and voice your concerns when you see a doctor. If you are forgetful of your pain/injury symptoms, then make a list which you can then present to your doctor when they ask what’s wrong with you. With a list, you won’t forget anything because it’s all written down! Going to see a doctor is free in Canada for all Canadians! Your health card is the card in your wallet with the highest limit (even greater than an Amex Black Card). There is no excuse for not getting the medical attention you need (aside other than perhaps not having a family doctor or having difficulty finding a doctor). But even in those examples, you can still attend at your local Hospital Emergency Room or Walk In Clinic to get the help and medical attention you need.
  • Call a personal injury lawyer. You can appeal your long term disability case until you’re blue in the face. If your insurance company denied you on Appeal #1, odds are they will deny you on Appeal #2, Appeal #3, and Appeal #4. By the time you’re done appealing, well over a year will have gone by and all you have accomplished is to legitimize the insurer’s denial of your long term disability case based on the number of denials. Don’t fall in to the appeals trap. It’s like bringing a rubber knife to a gun fight.



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