Long-Term Disability Lawyer
If you are unable to work indefinitely due to an illness or injury, you are likely entitled to long-term disability (“LTD”) benefits under your insurance policy.
If your claim is denied, cut off, or in the process of being investigated by the insurer, contact Levitt Sheikh to receive a better understanding of your rights and options, such as appealing an insurer’s decision or commencing litigation.
Representing Your Interests
Insurance companies are in the business of collecting more money from premiums than they pay out to their insured under their policies. To advance this goal, they have become skilled at using various tactics to deny their insured their disability claims and force their insured to walk away from money that they are rightfully owed.
Let our disability lawyers advise and represent you to rectify the situation. If you or anyone close to you finds themselves in a situation where their LTD benefit claim is denied, cut off or in the process of being investigated, do not hesitate to take action by booking a consultation with one of our experienced long-term disability lawyers at Levitt Sheikh. We will provide you a better understanding of your rights and options and will represent you in a potential lawsuit against your insurance company.
We look forward to providing a consultation where we can learn more about your situation. The fastest way to get started is to set up a consultation today.
Applying for Long-Term Disability Benefits
If you have STD benefit coverage under your insurance policy, LTD benefits typically start when your STD benefits end. The period of STD benefits coverage depends on your individual policy; however, they typically cover you from 15 weeks to 6 months. You should start the LTD application process near the end of the short-term disability period to avoid an interruption to your income between benefit periods.
The application to apply for LTD benefits requires three documents: the employee’s statement, the employer’s statement, and a physician’s statement. It is best to ask your employer’s Human Resources department for the application forms or go to your insurer’s website and download the forms yourself.
Note that obtaining medical evidence to substantiate your insurance claim is critical. Most insurance providers will not approve your claim without medical evidence which shows that you are disabled and unable to work.
After you have applied, your insurance company will notify you in writing if you have been approved for LTD benefits.
Receiving Long-Term Disability Benefits - What to Expect
You may be wondering what type of benefits you can expect to receive under your LTD coverage plan, whether LTD benefits are considered taxable income, how long LTD benefits last for, and whether you can leave Canada while receiving LTD benefits.
LTD benefits are income-replacement benefits. They will normally cover 60%-70% of your wages or base salary; however, every plan is different.
Whether the benefits are considered taxable income will usually depend on who pays your premiums. Generally, if you pay the premiums to the insurer, then the payments you receive are not taxable. If the employer pays the premiums, the payments are taxable.
The LTD benefits will continue to cover you for the period of illness or injury until a certain age or upon the occurrence of an event specified in your policy. Generally, LTD benefits last until the insured turns 65 years old.
You are legally permitted to leave the country while on LTD. However, many insurance companies might perceive a vacation as a sign that you are not as disabled as you claim to be. If you do choose to leave the country, whether for a vacation or other reason, you should limit your activities to those that are consistent with your reported disability.
How do I Know if I Have Long-Term Disability Insurance Coverage?
You may verify with your employer whether a disability insurance policy offered by the employer at no cost or at a discounted group rate is available. Otherwise, if your employer doesn’t offer disability insurance, or if you are self-employed, you can also consider looking into an individual disability insurance policy.
What Qualifies as a Long-Term Disability?
What qualifies as a long-term disability can vary depending on the language in your insurance policy.
As a general rule, any illness or injury that affects an employee’s ability to carry out the main functions of his or her job past the short-term benefits (”STD”) coverage period entitles that employee to receive LTD benefits.
When an employee first applies for long-term disability benefits, the assessment of “total disability” to qualify for the benefits is based on whether the employee can perform the essential elements of his or her “own occupation”.
At the two-year mark of receiving the benefits, however, there is a change in the assessment of “total disability”. The insurer will typically assess whether the insured can perform the essential elements of “any occupation”.
Inability to perform the essential elements of “any occupation” means an employee is unable, due to their disability, to do any job for which they are reasonably suited given their education, training, and experience. Most of the time if they cannot do their own job, they cannot do any job.
What If My Claim is Denied?
If your claim is denied, you can appeal the decision with your insurance company. However, appeals can drag on and you could be left without any income as insurance companies delay the process.
Furthermore, when you appeal, you do so through the insurance company’s own internal processes making it unlikely that your denial will be reversed. It is best to commence a legal claim against the insurance company. Contact one of our lawyers today if you have been denied benefits.
Because every insurance policy is unique, and since the law in this area is always context dependent, you will benefit from counsel with a deep level of experience in long-term disability law to advise you. Our lawyers at Levitt Sheikh ensure you are aware of your rights and options and are ready advocate on your behalf to help you receive the benefits you deserve.