Long-term disability insurance is an income replacement for those who are unable to work due to a serious injury or long-lasting medical condition. Most long-term disability benefits replace between 60% to 70% of the income. Generally, long-term disability benefits start after other benefits, such as short-term disability or sick days, have been used up. Depending on the policy, long-term disability can last for several years or until you reach a certain age, usually 65.
The most common sources of long-term disability insurance are employer group disability plans, individually purchased policies, or government programs such as CPP disability. The specific requirements and coverage provided vary from plan to plan. Each policy will also have its own set of rules that will outline what is required to qualify for long-term disability benefits. There will likely be an assessment whether you can work in your current position. This is known as the “own occupation test.” After two years, you will likely be assessed to see if you can work in any other job that you might normally be qualified for. This is known as the “any occupation test.”
There are several steps involved in applying for long-term disability benefits. Detailed documentation and medical support are needed to make a claim. While the application process can vary depending on your insurance company, common steps include:
Many kinds of medical conditions can qualify for long-term disability benefits if they significantly limit your ability to work. Some common conditions include:
Reviewing the specific requirements to qualify for benefits is important as they may vary between insurance policies. Some policies may not provide coverage for certain conditions.
Receiving a denial for your long-term disability claim can be disheartening. Some common reasons claims are denied are:
You may still be able to receive benefits even if your claim is denied. Insurance companies will frequently deny even valid claims.
First, review the denial letter provided by your insurance company to understand the reasons for the decision. If you plan on disputing the decision, you should consider contacting a long-term disability lawyer. While the insurance company may have an internal appeal process, these are usually biased and are run by the insurance company. Speaking with a lawyer will help you understand your legal options, such as a lawsuit.
Filing a legal claim will allow you to claim not only the benefits you were owed but also interest on those benefits, compensation for the emotional distress you experienced and punitive damages. Schedule a free initial consultation with our long-term disability lawyers to gain a better understanding of your options after a denial.
Having your LTD claim be denied can be exhausting and overwhelming. A lawyer with experience in disability law can provide valuable help that reduces your burdens. Our law firm has dedicated its resources, knowledge, and skills to helping clients get fair treatment and the support they need. You are not alone, there are options available if you are denied benefits. Schedule a free case evaluation to see how our Fort Saskatchewan team can help you.
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