If your disability claim has been denied or your benefits have been terminated, it's easy to lose hope. You are unable to work because of mental or physical suffering, but your insurance company fails to understand what you're going through. It's demoralizing, unjust, and frustrating.
You are not alone
We care deeply about fighting for your rights against the insurance company. You don't have to give up hope. With an experienced and empathetic legal team behind you, you can begin putting back the pieces of your life.
Call Dietrich Law today for a free, no-obligation consultation - let us help you get the compensation you deserve.
Many Canadians rely on long-term disability (LTD) coverage provided by their employer, another group plan or a personal policy, to pay income replacement benefits when they are unable to work due to an injury or illness. And, receiving long-term disability coverage when you can’t work can make all the difference in terms of allowing you to heal, afford needed rehabilitation costs and pay for day-to-day living expenses, rather than using up your savings and/or going into debt during an already difficult time in your life. Unfortunately, ‘the system’ doesn’t always work the way it should and sometimes, persons with a legitimate disability are denied long-term disability coverage by their insurer or their employer’s insurance company.
If your LTD application is denied or your insurer terminates your coverage before you’re well enough to go back to work, an experienced Cambridge disability lawyer at Dietrich Law is your best chance of successfully appealing a denied LTD claim. Although insurance companies offer an internal appeals process for denied claims, our considerable experience has shown that once an insurance company has decided to deny a claim, it can be very difficult to get the insurer to reverse their decision, particularly for someone who is inexperienced in the disability claims process.
One exception where a claimant has a fair chance of appealing a denied claim is in the early stages of making a claim. In particular, if your claim is denied because you failed to provide important, required information on your application, such as specific medical details or tests that show why your illness or injury prevents you from performing the essential tasks of your job, you may be successful in making an appeal if your application is changed to include all required medical details (including a diagnosis by the appropriate health professional), medical tests (such as X-rays) and/or proof of treatments you underwent in order to get well or minimize your disability. On the other hand, if your application was denied because your insurer claims you have a pre-existing condition that exempts them from providing coverage or you missed an application deadline, it is highly improbable that you can mount a successful appeal on your own.
In order to be eligible for long-term disability benefits under your LTD plan, during the first two years after becoming ill or injured, you generally need to provide evidence that you cannot perform the required tasks of your current occupation. After two years (or the period indicated in your policy), eligibility requires proof that you are unable to perform any job for which you’re reasonably suited, by way of education, training or experience.
If you initially received long-term disability benefits but your insurer unfairly terminated your benefits after two years or at another point before you are able to return to work, the chance of winning an appeal is extremely difficult and even unlikely, without the help of a skilled disability claims lawyer. Some of the most common reasons for terminating LTD coverage are: based on a re-evaluation of your health and/or rehabilitation, the insurer’s medical experts decide you are well enough to return to work; your insurer believes you have not undergone the appropriate treatments to get well; or you declined to submit to medical tests or treatment recommended by your insurer. Regardless of their reasons for the termination of your benefits, at this point, a civil lawsuit against your insurer is your best option for winning a claim for owed benefits.
If you were denied long-term disability benefits for any reason, call Dietrich Law today for strong and experienced representation against the LTD insurer. We will review the circumstances of your case, including your disability insurance contract and the insurer’s grounds for denial of your claim, and will fight to ensure that your insurance company fully complies with the terms of your policy.