April 27, 2023
Long-Term Disability Claims: Common Mistakes to Avoid
Are you filing a long-term disability claim? Don’t let common missteps prevent you from getting the benefits you need and deserve. You can avoid any costly errors by learning the most common mistakes made on long-term disability claims.
In this blog, we’ll explore what mistakes to avoid when filing your claim.
What Is Long-Term Disability?
Long-term disability (LTD) is a type of insurance coverage that provides income replacement benefits to individuals who cannot work due to an illness or injury that is expected to last for an extended period.
The duration of long-term disability benefits can vary based on the specific policy and the individual’s condition. Still, they typically provide coverage for several years or until the individual reaches retirement age.
LTD benefits can be provided through an employer-sponsored group policy or purchased individually as a private policy.
In either case, the individual must meet certain criteria to qualify for benefits, including a waiting period and demonstrating that their condition meets the definition of disability as defined by the policy.
These benefits are designed to help replace a portion of the individual’s lost income while they are unable to work and can help cover essential expenses such as mortgage or rent payments, utilities, and medical bills.
However, it’s important to note that LTD benefits typically only replace a portion of the individual’s pre-disability income and may not provide enough to maintain the same standard of living as before the disability.
What Qualifies for Long-Term Disability in Canada?
In Canada, LTD benefits are typically provided through private or group insurance plans. To qualify for LTD benefits, an individual must meet the specific eligibility requirements outlined in their policy.
In general, to qualify for LTD benefits in Canada, an individual usually must have a medical condition or injury that prevents them from performing the essential duties of their own occupation for an extended period (usually 6 months or more). Most policies stipulate a more difficult test to meet once the disability has persisted for 24 months. Many policies require that the condition must be severe enough to prevent the individual from working in any other occupation for which they are reasonably qualified after 24 months has passed. It is even possible the policy requires the individual to meet this more difficult test right at the outset. This is why it is important to read and understand your policy. The disability test may differ from policy to policy.
In addition to meeting the medical eligibility requirements, an individual must also meet the policy’s eligibility criteria related to waiting periods, coverage amounts, and other terms and conditions.
It is important to note that the specific requirements and criteria for LTD benefits can vary widely depending on the policy and insurance provider. It is recommended that individuals review their policy and speak with their insurance provider for more information on their specific eligibility requirements.
What Are Common Mistakes in Long-Term Disability Claims?
Failing to Understand Your Policy
The first mistake people make is not understanding their disability insurance policy. It is important to read and understand the terms and conditions of your policy before filing a claim.
You should know what your policy covers, your benefit amount, and your elimination period. Your elimination period is the length of time you must be disabled before your benefits begin.
Waiting Too Long to File a Claim
Another common mistake is waiting too long to file a claim. The longer you wait, the harder it can be to prove that you are disabled. You should file a claim as soon as possible after becoming disabled.
If you wait too long, your insurance company may deny your claim, you may be out of time to fie your claim, and you may lose your benefits.
Failing to Provide Adequate Medical Evidence
One of the most important factors in a long-term disability claim is providing adequate medical evidence to support your claim.
You should provide all medical records, including doctor’s notes, test results, and any other relevant medical documents. Your medical evidence should clearly show that you are unable to work due to your medical condition.
Not Following Your Doctor’s Treatment Plan
Your insurance company will expect you to follow your doctor’s treatment plan. If you fail to do so, your insurance company may deny your claim. You should attend all doctor’s appointments, take all prescribed medications, and follow all recommended treatments.
Failing to Hire a Lawyer
Navigating the long-term disability claims process can be overwhelming. Hiring a personal injury lawyer who specializes in long-term disability claims can help ensure that your claim is properly filed and managed. A lawyer can also help you appeal a denied claim and negotiate with your insurance company.
The Role of a Disability Lawyer in Long-Term Disability Claims
Navigating the long-term disability claims process can be challenging, especially if your claim is denied or delayed. Read below to how a Peterborough injury lawyer can help you through the long-term disability claim process.
Helping You Understand Your Policy
The first step in filing an LTD claim is to understand your policy. A disability lawyer can help you understand the terms and conditions of your policy and explain what benefits you are entitled to receive. They can also help you gather the necessary medical evidence to support your claim.
Filing Your Claim
A disability lawyer can help you complete the LTD claim forms and submit them to the insurance company. They can also help you gather the required medical documentation and communicate with your healthcare providers to ensure that your medical records are complete and accurate.
Appealing a Denied Claim
If your long-term disability claim is denied, a disability lawyer can help you appeal the decision. They can review the reasons for the denial and determine if there is a legal basis for an appeal. They can also help you gather additional medical evidence, prepare your appeal, and negotiate with the insurance company to obtain a favourable outcome.
Negotiating With the Insurance Company
A disability lawyer can negotiate with the insurance company on your behalf. They can help you obtain a fair settlement, negotiate the terms of your policy, and ensure that your rights are protected throughout the process.
Representing You in Court
If your LTD claim is denied and you have exhausted all administrative remedies, a disability lawyer can represent you in court. They can file a lawsuit on your behalf and argue your case before a judge or jury. A disability lawyer can also help you prepare for court and provide legal representation throughout the litigation process.
Final Thoughts
Long-term disability claims can be complex and challenging to navigate. By being proactive and seeking guidance from experienced professionals, claimants can increase their chances of a successful LTD claim and ensure they receive the benefits they are entitled to.
If you’re looking for a trusted lawyer to help you through the LTD claims process, we’re here to help. Contact Michelle Linka Law today to learn more about our services. If you are a resident of areas like Oshawa, Peterborough, or Richmond Hill, call our personal injury lawyers today at 416-477-7288.
