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Long Term Disability benefits flow for many disabled claimants with no issue.

The insurer may from time to time request a report from a family doctor, questionnaire, or request updated clinical notes and records. The insurer may also request that the claimant see their own “doctor” or “specialist” in order to assess their disability.

This is completely normal.

Unfortunately, when this happens, it opens the door for the insurer to interpret the medical data which they have received in such a way to justify a termination of long term disability benefits.

It can be really frustrating, depressing and hard when long term disability benefits get terminated. Like the electric company turning the power off; or like the water company shutting off the water making it difficult; if not impossible to live or to make ends meet.

If only there was a way to get those long term disability benefits reinstated. If only there was a way to get back on claim.

This instalment of the Toronto Injury Lawyer Blog will discuss a reinstatement of long term disability benefits and what factors need to be considered when a reinstatement option is offered.

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“In my view, the simplest answer to this issue is, “It’s 2020”. We no longer record evidence using quill and ink. In fact, we apparently do not even teach children to use cursive writing in all schools anymore. We now have the technological ability to communicate remotely effectively. Using it is more efficient and far less costly than personal attendance. We should not be going back.”

-The Honourable Justice F.L. Meyers

Arconti v. Smith, 2020 ONSC 2782

During the COVID pandemic, personal injury lawyers, insurance adjusters and defence lawyers have claimed to have adapted.

We claim to have embraced e-discoveries, video conferencing, virtual mediations and settlement conferences because we have to. If we don’t embrace the technology, then business doesn’t get done.

It means a Plaintiff’s case can’t be pushed forward.

It means that an insurance defence lawyer cannot bill.

It means that an insurance company cannot clear another file off their desk to set targets and make quarterly economic reports for their stakeholders.

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Many of our Long Term Disability clients want to know how long term disability cases settle. By this question, what they are really asking is how do they as the client, get paid.

Is it a lump sum payment?

Is it a monthly benefit that the client will receive for the rest of their life?

Are there additional damages for pain, suffering, punitive damages, or damages for mental distress?

Does the client have to pay any tax on the settlement amount? If so, then how much?

All of these are valid questions because there are so many ways which a long term disability settlement can be structured outside of Court.

For starters, in order to achieve any sort of award in a long term disability case, the Plaintiff needs to be disabled. This seems so simple, but for so many clients, it’s hard to understand.

Granted; each policy of insurance carries a different definition of disability. But at the end of the day, if the Plaintiff does not meet the definition of disability under the long term policy, there is a very good chance that the insurance company won’t want to pay out any award.

Under most policies, the definition of disability is loosely defined as over the first two years, the Plaintiff is so injured/sick that s/he cannot perform the regular duties of his/her “own occupation“. This first two years is commonly known as the “own occupation” or “own occ” period.

After the first two years, the definition of disability generally changes to the Plaintiff cannot perform the regular duties of “any occupation” commensurate with their education, training and experience. The availability of work is irrelevant. It doesn’t matter that there aren’t any jobs out there for you. If you can do any job for which you have the education, training and experience, then you won’t meet the test for disability. This is commonly known as the “any occupation” period.

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Our personal injury lawyers have seen in increased volume of overdose and pharmacy negligence cases over the past year.

Why is that?

Perhaps more of the population is dependent on pharmaceutical medication? With that increased volume of customers for pharmacists; there is a greater chance for human error when dispensing medication.

The purpose of this Toronto Injury Lawyer Blog is to examine and explain overdose and pharmacy negligence cases; along with what steps a person should take in the unfortunate event that they fall victim to an overdose through no fault of their own.

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It’s amazing that no matter how many times we write about it; speak about it; or broadcast our thoughts on radio, podcast, newspaper or television; that so few people know what to do after a car accident in Ontario.

This is very important, because there are tight time lines which you may be dealing with. Getting things done properly, and in a timely manner can be the difference between getting the benefits you need or being denied benefits.

Doing things the right way, and in a timely manner is particularly important during COVID given that things are moving slowly on a good day.

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Let me tell you a story.

It’s about an insurance company which deals with long term disability policies.

The size of the insurance company is irrelevant for this story, because most insurers are very similar in their approach. But in fairness, they are not all the same.

The insurance company underwrites thousands and thousands of group and individual long term disability policies.

If the insurance company pays out long term disability benefits on each and every long term disability claim that gets filed; then their profitability as a company suffers.

If the insurance company does not pay out on each and every long term disability claim that gets filed; then they become more profitable.

The more money which an insurance company pays out in benefits; the less money they get to keep and report as profit.

Some long term disability claims are denied for good reason. Some long term disability claims are denied for other reasons which have little merit.

This is where a personal injury or long term disability lawyer comes in to the mix.

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As a personal injury lawyer, I don’t profess to be a medical expert. I certainly don’t have all of the answers to your medical questions, tech questions or political questions. As a personal injury lawyer, I like to stay in my lane of personal injury law and insurance related questions. When people have a problem in these spheres, they tend to reach out to me and my law firm Goldfinger Injury Lawyers.

Once upon a time; in order to get your opinion out in to the world, it needed to be broadcast in the traditional news media, or to your friends verbally.

Social media has given us all platforms to speak our own versions of the truth and spread our own beliefs to thousands in one simple click. Those beliefs may be fact, or fiction. But they are your truths (or mistruths) nonetheless. There is no fact checking or editor to vet your comments before they are broadcast in to the world. All you have to do is simply click a button and your opinions are broadcast to the world.

The global pandemic we are all dealing with in our own ways has reinforced the fact that we are all in this together. And being “together” means that we all, or the majority has to be on the same page when it comes to dealing with the pandemic.

What has been highlighted by COVID is that so few of us are on the same page. The amount of information, misinformation and outright lies circulating on the internet is rather upsetting.

But it’s not just the internet where we see this departure of shared values and beliefs. We see it everyday.

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The OCF-1 Application for Accident Benefits is the first, and arguably, the most important form for starting any accident benefit claim following a car accident.

If you don’t know what accident benefits are; you can learn all about them on the Goldfinger Injury Lawyers Website, or the Toronto Injury Lawyers Blog. Our personal injury lawyers frequently discuss accident benefits, what they are, their value and how they work to clients and prospective clients alike. There is a lot of discussion about accident benefits because they’re so important (and confusing too!).

In Ontario, we have a no fault system of insurance following a car accident. These no fault benefits are referred to as accident benefits. They are NOT damages for pain and suffering. Accident Benefits are created by, and legislated under the Insurance Act and the Statutory Accident Benefits Schedule. These accident benefits are constantly changing because the provincial government is constantly tinkering with them. This results in many amendments to the Insurance Act and to the Statutory Accident Benefits Schedule which makes things very confusing for consumers, lawyers and insurance representatives alike.

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Goldfinger Injury Lawyers is an Ontario personal injury law firm with a track record of success getting people compensation from damages sustained as a result of dog bites.

Dog bite claims can be tricky, particularly when it comes to finding insurance to compensate the accident victim.

A few tips which come up time and time again from dog bite claims:

1.Get all of the contact information you can for the dog owner, or the person who was walking/handling the dog at the time of the attack. This is very important because unlike a car accident, the police aren’t likely going to come to the scene of the dog attack and make a formal report. While it does happen in some cases, this represents the minority of claims. When a car accident happens, more often than not the police attend at the scene of the accident and get all of the pertinent information of the parties involved in the accident. The same cannot be said in dog bite claims. It’s a bit of the wild west after the dog bite takes place. Some dog owners flee the scene of the dog bite or are totally unaware that their dog just attacked somebody. They leave the scene without a care in the world. If that person gets away and you don’t have their contact information, then how will you, your lawyer or a local Animal Control Office investigate the claim? Photos certainly help. Names, phone numbers and addresses; even the license plate number of their vehicle if they drove can work better.

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The first rule in personal injury law is to make sure that you sue a Defendant with deep pockets. That means the Plaintiff and his/her personal injury lawyer need to be satisfied that the Defendant has the ability to pay out on a potential settlement or judgment. If the Defendant cannot pay, the Plaintiff will not be compensated despite winning the case.

You can’t get blood from a stone. Nor can a personal injury lawyer recover compensation from an impecunious Defendant.

This is a very important concept.

There is certainly vindication on behalf of an injured Plaintiff in securing a judgment against a Defendant who has wronged him/her. The feeling of winning, justice, or simply closure are very important feelings.

But these feelings cost money.

If the Plaintiff has deep pockets, and doesn’t mind spending thousands of dollars in legal fees without a prospect of recovery in order to secure a Judgment; then all the power to that Plaintiff.

But these wealthy Plaintiffs who are prepared to spend the type of money required to secure a judgment in a personal injury action are few and far between.

Most Plaintiffs don’t have deep pockets to pay a lawyer’s hourly rates. On top of that; most lawyers won’t take on cases on a contingency fee basis on a “winnable” case if there is no realistic prospect of recovery.

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