Long-Term Disability

We understand that the process of applying for disability benefits and having your application denied at the outset or at any point in your claim is a frustrating and stressful experience when you need income replacement as a result of being unable to work.

As an insured person, or “claimant”, there are things you should know or do that can help make your case run smoothly.

GET TO KNOW YOUR POLICY AND TAKE NOTES

You will want to and are entitled to have a copy of your policy, so you can become familiar with the policy and its wording.

You should look for information that answers these questions:

• What is the procedure for filing a claim?
• What documents do you have to provide?
• How much time do you have to file a claim?
• How much time do you have to appeal a denial?

It is important to make notes from every call and keep an ongoing record of all the conversations and contact you have with your insurance company. This will help you to remember a timeline of events for your claim.

​As well, take notes of all your doctors, specialists, medications, treatments, and symptoms as you will be asked to provide this information when you apply for disability benefits (on the Employee Statement), and by the insurance claims adjuster.

Short-term and long-term disability benefits cover claims related to both physical and mental illnesses. It is important to consult a long-term disability lawyer when benefits are denied or if your claim is not being handled properly by the insurance company.

It is important, to be honest with your doctors about all your symptoms, pains, and difficulties you are having and to report any changes in your status. This will help to determine your limitations and restrictions. ​When your doctors/specialists can identify your limitations and restrictions, they can provide medical evidence to support them and your claim.

KEEP GOOD RECORDS AND REQUEST FOR MORE INFORMATION

Keep records of everything related to your disability case. You will want to keep a copy of your application package. Important documentation also includes all correspondence received from your insurer, all correspondence sent to your insurance company (including e-mail exchanges), and all copies of medical records relating to your case.

At Benjamin Law, it is crucial that provide us with the necessary documentation relevant to your claim including a copy of your policy, correspondence from the insurance company, and a list of your doctors, treatment centres and medications. It is also helpful if you have business cards from your doctors, hospital admission sheets, prescription receipts, and copies of your application for disability benefits.

If you are still on a claim or have not yet commenced a lawsuit and have not hired a lawyer, be aware that every conversation you have with your claims manager/claims adjuster is documented by him/her. You want to be honest in your conversations with your claims adjuster and give them the necessary information to adjudicate your claim but know that he/she is a representative of the insurance company and is not calling you to become your friend.

When processing your claim, the insurance company may ask you to submit further medical information to substantiate your claim and explain how your symptoms prevent you from working. Your physicians can help you by providing this information if you give them the authorization to do so. Your insurance company needs to be able to review the relevant medical information, so they can understand why you are unable to work.