Long-Term Disability Lawyers

Long-term disability is a worthwhile investment for people who work labor-intensive jobs and are worried about suffering a potentially serious or life-threatening injury. It’s an excellent safety net in the event that you need to take off an extended period of time from work. On top of losing your income, the mounting medical and treatment bills can be extremely overwhelming for any individual or family to endure.

Despite having coverage, however, sometimes insurance companies refuse to honor your policy once you become disabled. It’s times like these that the help of long-term disability lawyers is needed. The experienced long-term disability lawyers at Mirian Law Firm are prepared to take on your case.

What Does Long-Term Disability Mean?

In legal terms, “long-term disability” typically refers to a condition or situation where an individual is unable to work or engage in gainful employment due to a physical or mental impairment, illness, or injury.

This condition is expected to last for an extended or indefinite period. Long-term disability can have legal implications, particularly in the context of disability insurance, workers’ compensation, and social security programs.

Common Types of Long-Term Disability Claims in Ontario

Long-term disability claims can be filed for a number of reasons, including illnesses and personal injuries. Individual cases can vary in terms of complexity due to the financial, emotional, and physical intricacies that are involved.

Types of long-term cases include:

When it comes to conditions like depression or anxiety, long-term disability can be difficult to prove without a shadow of a doubt, but we’ll fight on your behalf to ensure that your voice is always heard. Often, it’s the unseen conditions that can hit you and your family the hardest.

What Is a Long-term Disability Insurance Denial?

Long-term disability insurance denial refers to the outcome of an insurance company’s decision not to approve a claim for long-term disability benefits made by an insured individual.

When an individual experiences a disabling condition that prevents them from working and makes a claim under their long-term disability insurance policy, the insurance provider reviews the claim to determine if the policy’s terms and conditions are met. If the insurance company determines that the claim does not satisfy the requirements or if there is insufficient evidence to support the claim, they may issue a denial.

Reasons that Long-Term Disability Claims Can Be Denied

Long-term disability claims can be denied for various reasons. Here are some common factors that may lead to the denial of a long-term disability claim:

Lack of Medical Evidence: Inadequate or insufficient medical evidence to support the claim is a common reason for denial. Insurance companies often require comprehensive medical documentation demonstrating the severity and persistence of the disabling condition.

Pre-Existing Conditions: Some policies exclude coverage for pre-existing conditions, meaning that if the disabling condition existed before the policy’s effective date, the claim may be denied.

Failure to Meet the Policy’s Definition of Disability: The policy’s definition of disability can vary. If the claimant’s condition does not meet the policy’s specific criteria for disability, the claim may be denied.

Insufficient Waiting Period: Many long-term disability policies have waiting periods before benefits become payable. If the claimant has not satisfied this waiting period, their claim might be denied.

Occupational Disputes: Some policies define disability based on the claimant’s ability to perform their occupation, while others consider the ability to perform any occupation. Disputes over the interpretation of these definitions can lead to denials.

Inaccurate Information: Providing inaccurate or incomplete information during the claims process can be grounds for denial. It’s essential to be honest and thorough when submitting a claim.

Non-Compliance with Treatment Plans: If the claimant is not following the prescribed medical treatment plan or is not cooperating with healthcare providers, the insurance company may deny the claim.

Failure to Submit Claim on Time: Long-term disability policies have specific deadlines for submitting claims. Missing the deadline can result in denial.

Policy Exclusions: Policies often have exclusions for certain conditions or circumstances. If the disabling condition falls under one of these exclusions, the claim may be denied.

Disagreement with Medical Assessments: If the insurance company’s medical experts disagree with the claimant’s healthcare providers regarding the severity and impact of the disabling condition, this can lead to a denial.

Claimant’s Ability to Work: If the insurance company believes the claimant can perform some form of work or an alternative occupation, they may deny the claim.

Dispute Resolution Failure: If the claimant’s appeal or dispute resolution attempts fail, the claim may remain denied.

Unsubstantiated Claims: Claims that lack objective medical evidence or rely solely on subjective complaints may be viewed with skepticism and subsequently denied.

As unfair as it is, your insurance company may retain the right to go ahead with disability insurance claim denial against you for whatever reason they see fit. But that doesn’t mean you can’t successfully file an appeal or bring a lawsuit and still receive the settlement that you deserve.

Unfortunately, it may prolong the payment process. At this point, you and your family are probably already tired from dealing with the emotional and physical trauma of a drawn-out illness or injury.

Insurance companies write up policies that are difficult for the average person to comprehend. They often use arbitrary runaround language and buzzwords to get you to agree to their terms and conditions. Naturally, this can get even more confusing when the time comes to file a long-term disability claim and the claim is denied.

How Can a Disability Lawyer Help You Claim Your Insurance Benefits?

Disability lawyers are legal professionals with expertise in disability insurance law and regulations. They specialize in assisting individuals who are seeking disability insurance benefits. Here’s how a disability lawyer can help you with your claim:

  • Policy Review and Assessment
  • Claim Preparation
  • Appeals and Disputes
  • Litigation Support
  • Negotiation with Insurers
  • Maximizing Compensation

What To Do If Your Disability Benefits Are Denied?

If you ever find yourself in this position, then the first thing you need to do after receiving sufficient medical treatment is to contact Mirian Law Firm. Our lawyers are experienced in handling long term disability denials.  And the best part is that you don’t have to pay anything unless we recover money for you. Whether you need a disability lawyer to come to Mississauga, Brampton, Toronto, or anywhere else in Ontario, we can help. Call us today to schedule your free case assessment!