What is long-term disability?

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Accidents happen at home, while driving or at work. Such accidents may leave a person unable to work for a long time.  In the worst cases the injured person may not be able to continue in their career or profession or in any job.  You might need to file a claim for long-term disability payments in those cases.   This article will cover a range of subjects to assist you in comprehending the long-term disability claim procedure.

What is a long-term disability? 

Employees who cannot work for a prolonged period due to an accident, illness, or injury may get cash benefits through long-term disability (LTD) insurance. This kind of insurance provides a percentage of the employee’s income during their absence from work.  Psychologist illnesses like depression can also qualify for long-term disability depending on how serious the illness is. 

    Needs for Long-Term Disability

    In general, the following factors may make you eligible for long-term disability benefits:

    • Seek help and medical advice for your illness or injury.  Your insurance company is entitled to know about your medical condition and whether you are seeking treatment. It will be difficult to start a claim if you don’t have supporting medical opinions and records.  
    • Ask lost of questions about your medical illness or injury and ask for appropriate referrals for MRIs and specialists.  Sometimes people give up when the Emergency Room doctor or their family doctor is dismissive of their symptoms. 
    • Make a long-term disability claim with your insurance company after you have seen your doctor or psychologist and they understand your injury or illness.  Your doctor will be asked to fill out an application for you and to send it to your insurance company. 

    Medical Conditions That Might Make You Disabled for a Long Time

    Many individuals mistakenly believe that long-term disability insurance only applies to those who have sustained physical injuries in accidents and cannot work due to such injuries. While this may be the case, you should know that various medical issues may qualify you for disability benefits including psychological problems.

    Medical problems that may be eligible for long-term disability coverage include some of the following:

    • Cancer
    • Multiple sclerosis (MS)
    • Chronic fatigue disorder
    • Concussions and post-concussion syndrome 
    • Crohn’s illness
    • Dystrophic disc disease
    • Fibromyalgia
    • HIV/AIDS
    • Lupus
    • Depression and Anxiety
    • Post-traumatic Stress Disorder
    • “Long Covid”
    • Bipolar illness

    The list of qualifying medical conditions is not all-inclusive and varies from person to person and policy to policy. It’s critical to comprehend how your insurance provider classifies a disability before submitting a long-term disability claim. You can find this information by reading your insurance policy in detail.  You need to ask your employer or the insurance company for a copy of the policy (not the benefit booklet).

    Rejection of Long-Term Disability Claims

    Reportedly, many insurance companies frequently deny valid long-term disability (LTD) claims. 

    However, according to industry estimates, around 60% of all long-term disability claims are rejected annually.

    An insurance adjuster or “case manager” will often send an LTD applicant a letter notifying them that their claim has been denied and encouraging them to appeal the insurance company’s decision. This type of letter is usually sent out a few months before the second anniversary of the claim.  The insurance company will typically notify the claimant that the definition of “disability” is changing soon and they will lose their benefits if they can do any sort of work or job.  This can be scary because the insurance company will request new medical information directly from your doctor and sometimes they will call the doctor on the phone without your permission or knowledge.  They are allowed to do this unless you revoke your consent for the insurance company to have complete access to your medical information.  You probably signed a consent form at the start of your claim and forgot about it.  

    LTD appeals are one-sided and challenging if you don’t have proper legal representation.  Your lawyer may recommend that you don’t participate in an appeal if your medical evidence is already strong that you are not able to work.  

    Disability Benefit programmes in Ontario: 

    • There are many programmes in Ontario that cater to long-term disabilities. Under each programme or plan, “totally disabled” or “complete disability” is defined differently. However, it typically indicates that you cannot work due to disease, injury, disability, or accident.

    • Group insurance policies, individual insurance plans, provincial government programmes (WSIB, ODSP, Ontario Works), and federal government programmes are all used to pay long-term disability payments in Ontario (CPP Disability and Disability Tax Credit).

    • When a person cannot work due to a disability, long-term disability payments are provided monthly. A disability plan must first cover you to get long-term disability benefits.

    • A fixed amount or a percentage of your earnings determines the monthly disability payment. Typically, it lasts until age 65 or for a predetermined number of years (such as two, five or ten).

    • A waiting period is required for most long-term disability policies (a period that you must wait before receiving your first payment). Frequently, you must first go through short-term disability or EI sickness benefits to receive a long-term disability award.

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      Legal assistance with Lawyers in Ottawa

      If you have a question or need assistance, our team of personal injury lawyers is here to help. We know every personal injury case is unique and we work hard to make sure our clients are fairly compensated.

      If you are unable to travel to our downtown Ottawa office, one of our lawyers or paralegals can come to meet you at your home or some other convenient location. During the free consultation, we will get to know you and to understand the nature of your injuries, as well as the impact the accident is having on you and your family. Contact us for a free consultation with a lawyer with complete knowledge about car accident claims. We know it’s personal.