Edmonton Long-Term Disability Lawyers

A serious injury, illness, or mental health condition can make it impossible to keep working, even when your monthly bills continue. For residents of Edmonton, long-term disability insurance may provide important income replacement when a medical condition prevents you from performing your job.

Our Edmonton long-term disability lawyers help people whose disability benefits have been denied, delayed, or terminated by an insurance company. We can review your policy, explain the “own occupation” and “any occupation” tests, and help you understand whether your insurer’s decision may be challenged.

To speak with our Edmonton long-term disability lawyers, contact Preszler Injury Lawyers for a free initial consultation or call 1-888-494-7191. We can deal with the insurance company while you focus on your health.

What is Long-Term Disability Insurance in Edmonton?

A sudden accident or a slowly progressing illness can disrupt your entire life including your ability to work. According to the Canadian Life and Health Insurance Association, 1 in 3 people will be disabled for 90 days or more at least once before retirement. A disability can stop your income, but not your bills.

Long-term disability insurance is a type of income replacement benefit that provides income if you are not able to work because of injury or illness. Most LTD plans cover between 60% to 70% of your income if your injury or illness prevents you from working.

Long-term disability insurance is commonly available through an employer’s group disability insurance policy. Sometimes the employer pays the premiums, sometimes the employee contributes, and in some cases individuals purchase private coverage through a broker.

How to Apply for Long-Term Disability Benefits in Edmonton

A long-term disability policy can be purchased through an individual insurance plan or through your employer’s group insurance provider. In many cases, disability coverage starts with short term disability benefits which may later transition into long-term benefits.

Short term disability benefits generally provide coverage while you’re off work for 3 to 6 months. It’s important to note that every disability policy will vary from provider to provider so we recommend you review your policy or contact a member of our legal team for help.

Every disability policy comes with a policy booklet which outlines the terms and conditions of the agreement. Most policies also outline the steps to follow if you need to apply for disability benefits. The most common steps are to obtain a claim form, have a medical certificate completed by your physician, and complete and submit the application to the insurance company.

At Preszler Injury Lawyers, we understand Insurance policies can be difficult to understand. If you are having difficulty navigating your claim, you can schedule a free initial consultation with our Edmonton LTD lawyers.

Medical Conditions That May Qualify for LTD Benefits

Some policies contain exclusions or limits for certain conditions, so it is important to review the wording of your policy. In many cases, the specific diagnosis is less important than the impairment it causes and whether that impairment prevents you from working.

Some conditions that may qualify claimants for LTD benefits include, but are not limited to:

• Fibromyalgia
• Multiple sclerosis
• Arthritis
• Post-traumatic stress disorder (PTSD)
• Herniated discs and back pain
• Heart disease
• Neurological disorders
• Panic attacks
• Migraines
• Crohn’s disease
• Psychological disorders
• Paralysis
• Lyme disease
• Lupus
• Cancer
• Depression, anxiety, and bipolar mood disorder

Symptoms that are difficult to measure with a single test can still be disabling. Chronic pain, fatigue, depression, anxiety, and other mental health conditions may seriously interfere with concentration, stamina, mobility, attendance, and performance at work. Although these may be harder to prove, our long-term disability lawyers in Edmonton can help you collect evidence to demonstrate the extent of your disability.

The Role Your Doctor Plays In Your LTD Claim

Your doctor will play a key role in your application. Without strong medical support, your claim may be rejected. When you make a claim, your insurance company will likely ask for medical evidence showing that your condition prevents you from working.

Work closely with your healthcare providers so their notes and forms explain your diagnosis, symptoms, treatment, restrictions, limitations, prognosis, and how your condition affects the usual duties of your occupation. It is also important to follow reasonable treatment recommendations, because insurers often argue that claimants have not taken steps to mitigate their loss.

How is Eligibility Determined for Long-Term Disability Claims?

In order to receive long-term disability benefits you must meet the “disability test” in your policy. The test for eligibility usually changes depending on how long it has been since your disability started. For the first two years of your disability, most policies offer coverage if you cannot work in your “own occupation”. After two years this test can become more difficult by requiring you to prove that you cannot do “any occupation” to which you are reasonably suited to do by training, education, or experience.

Every disability policy can vary so it is very important to read the policy carefully. If you have questions about your eligibility, or if the insurance company has denied your disability benefits, we recommend you contact our Edmonton disability lawyers today for help.

Why LTD Benefits Are Denied or Terminated

Insurance companies often deny disability claims, and this can be for a number of different reasons. The denial can come at any stage of your claim, including right at the outset. Here are some of the most common reasons that claims are denied:

• Your insurer believes you are not “totally disabled”
• You are considered to have a pre-existing condition that is not covered under the policy
• You have not followed medical recommendations
• You are not receiving appropriate medical care
• A change in your health and function
• You refuse to return to work when the insurance company wants you to
• You applied for long-term disability benefits too late
• And more

By law, insurers are generally expected to handle claims fairly and in good faith. If an insurer denies a valid claim without proper justification, a disability lawyer may be able to help dispute the decision and pursue benefits that should have been paid.

What Happens if Your LTD Benefits are Terminated Before or at the Two-Year Mark?

While you receive long-term disability benefits, insurers work in the background, continually assessing your progress, function, and review updated medical records. When your insurance company first assesses eligibility, it will usually look for proof that you are unable to perform the important duties of your current job. This is often described as the “own occupation” test. After approximately two years, many policies change to an “any occupation” test, which may require proof that you cannot work in another job reasonably suited to your education, training, or experience.

Under most policies, the two-year mark is an important stage in the life of a long-term disability claim. At this stage, the “own occupation” test can end and the new “any occupation” test comes into effect, making the eligibility for disability benefits more difficult. In some cases, the insurance companies will suggest you can do another job and deny your benefits. In some cases, this might include a job you have never done and one that you don’t think you are healthy enough to do.

If you are facing this situation, our personal injury lawyers in Edmonton can help you understand the denial and formally dispute the insurer’s decision. Our lawyers can make a claim against the insurance company for the disability coverage you are entitled to as well as punitive and aggravated damages..

Contact our Edmonton Long-Term Disability Lawyers for Your Free, No-Obligation Consultation

Navigating a long-term disability claim can be difficult and confusing. No two claims are the same and both your obligations and that of the insurance company vary from policy to policy. Insurance companies do not always apply the confusing and technical terms fairly. This can result in an unreasonable denial of disability benefits.

No one should have to face a serious injury or illness while watching their bills pile up – especially when you paid for a safety net. Our legal team can help you recover previously denied benefits, money you have lost because of the denial such as interest on loans, aggravated damages for the worsening of your condition in the face of a denial, and in some instances even pursue punitive damages to punish the insurance company for handling your case in an unfair way.

To learn more about how our Edmonton disability lawyers can help you and your family, schedule a free initial consultation with Preszler Injury Lawyers today. Our phone lines are open 24/7 at 1-888-494-7191.

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FIGHTING FOR LTD BENEFITS IN EDMONTON?