Did the insurance company deny your long-term disability claim? Are you getting payments, but worried they may stop soon? Maybe they’re asking you to do something that doesn’t seem right. Our Halifax long-term disability lawyers can answer your questions and give you a plan.
Call our disability claim support team at 902-800-8336 to tell us what’s going on. Or you can fill out the form on this page for a Free Claim Review instead, and we’ll contact you.
Our team is sensitive to how stressful it can be to call a law firm when you don’t know what to expect.
When you call us, you’ll speak with people who are expecting your call. We want to hear your story and offer solutions. We won’t pressure you to hire us.
1969 Upper Water St., Suite 201, Halifax, NS B3J 3R7 | Tel: 902-800-8336
Common Long-term Disability Problems
We have seen it all after representing over a thousand people in long-term disability claims. So, the following is a list of the most common problems you might face.
- The insurance company denied your claim, even though your doctor supported you
- The insurance company denied the claim because there was “not enough evidence of a disabling condition”
- You’re being pressured to sign forms but you don’t want to sign them
- The insurance company is pressing you to attend medical appointments but you’re not sure about it
- You doctor isn’t supportive or didn’t provide thorough information
- Your claim was denied because it was “late” or because of a “pre-existing” condition
- The insurance company denied your claim because “your current treatment does not indicate a serious condition”
- Your claim was denied because the insurance company says you “refused” to do something they asked
- You and your doctor agree it is too soon to return to work, but the insurance company is pressuring you
- The insurance company claims your sick leave is caused by “workplace issues” — not a disability
- The insurance company agrees you can’t do your own job, but says you can do “other jobs” — even when that isn’t true
There are solutions to all of these problems.
Sometimes the answer is obvious; however, usually, we need to do a full review of your insurance claim file to see what is really going on. This is because often, the insurance company’s “official” reasons for denial are not the real reasons.
For example, most insurance companies will have behind-the-scenes doctors reviewing your file and giving opinions. When that happens, the key to success is to discover what those doctors have said and then getting medical evidence to override them. We love uncovering this type of stuff.
Resolute Legal offers a free claim evaluation. So, we get you a copy of your insurance claim file. Then, we do a full review and point out all the issues for you and suggested solutions. You can then tackle it on your own, or hire us to do it for you.
Know your rights and obligations
Both you and the insurance company have rights and obligations regarding your long-term disability claim.
Let’s start with your rights. You have a right to be treated fairly and with respect. You also have a right to a copy of a booklet that describes your long-term disability plan (but not the full policy). Finally, you have a right to have your claim decided in good faith. In other words, the decision should be based on a fair assessment of the medical evidence.
You also have some obligations. Firstly, you have an obligation to be honest and upfront with the insurance company about your situation. So, you should give any information you think they would want to know. Secondly, you have an obligation to attend ongoing medical treatment. You have to do everything in your power to get better. Thirdly, you have an obligation to prove your claim by providing medical evidence. In other words, you have to pay for medical files and reports. Finally, you (usually) have an obligation to attend medical appointments and treatment arranged by the insurance company.
Do you think the insurance company is ignoring your rights? If so, give us a call and tell us what’s going on. Then we can confirm if they are in the wrong and what steps you can take.
How to appeal a long-term disability claim denial
You always have the right to appeal any decision from the insurance company. If they deny your claim or stop your payments, then you can appeal that decision.
An appeal is a process to have the decision reviewed. It starts with having the insurance company review the decision. This is called an internal appeal. It’s “internal” because the insurance company’s own employees are the ones who do it.
To learn more, check out our article on 7 Steps to Appeal a Long-term Disability Denial.
Usually, you can have 2-3 rounds of internal appeals. You may think that internal appeals aren’t fair because the insurance company gets to decide. However, we have a lot of success in getting our clients approved in this stage. It all depends on your situation and the reasons for the denial. We recommend everyone do at least one internal appeal.
However, there are times when doing a second and third internal appeal will be a waste of time. Sometimes it can even be dangerous to your case. I discuss this further in an article called 4 Reasons to Avoid Internal Appeals.
Once you exhaust all internal appeals, there is a final stage of appeal. This depends on the type of plan you have. Generally, there are two scenarios. In most cases, your final appeal will be with the courts. We refer to this as a legal appeal because it is done through the court system. However, in a minority of cases, you will not have the option to do a legal appeal. In those cases, your final appeal will be with an external arbitrator chosen by your disability plan. We see this, for example, with people covered under the Nova Scotia Public Service LTD Plan.
What is a long-term disability lawyer?
It’s common for lawyers to focus on one or two areas of law. So, a long-term disability lawyer is a lawyer who focuses their legal work on disability-related claims. These claims might involve disability benefits or compensation from insurance companies, government agencies, or employers, for example.
There is no official certification for a lawyer to be considered a disability lawyer, so any lawyer can claim to be a Halifax long-term disability lawyer. Anyone can represent people in disability claims and appeals. However, I personally believe that the term “disability lawyer” should be reserved for lawyers who focus exclusively (or near-exclusively) on representing people in disability-related matters. Of course, this is only my opinion; it is certainly possible for any lawyer to competently handle a disability claim even if that’s not the main focus of their work.
It’s hard to verify if a lawyer’s work is focused mainly on disability-related matters, so if you’re looking for someone who mainly practices disability law, you’ll have to do a bit of your own research. I explain this further in the seven-step process to hire disability lawyers in Halifax.
Types of long-term disability claims
Our Halifax long-term disability lawyers have handled all types of claims. The following are claim types we have been involved in:
- Group Insurance Plans
- Individual Insurance Plans
- NSAHO LTD Plan (Manulife)
- Nova Scotia Public Service LTD Plan (Manulife)
- Nova Scotia Teachers LTD Plan (Manulife)
- Federal Public Service LTD Plan (SunLife or Industrial Alliance)
We have handled claims involving all of the major insurance companies in Nova Scotia, including the following companies:
- Sun Life
- Blue Cross
- Canada Life (Great-West Life)
- Desjardins Financial
- Industrial Alliance
- Empire Life
What medical conditions qualify for long-term disability?
We have experience with disability claims involving many medical conditions. Our founder and managing lawyer is a former occupational therapist. Therefore, he has placed a strong emphasis on all lawyers and staff understanding medical conditions. So we base our strategy, in part, on your medical condition.
Almost any medical condition can qualify for long-term disability. However, it does depend on the seriousness of your symptoms and impairments. Learn more about medical conditions that qualify for long-term disability benefits.
How our Halifax long-term disability lawyers can help
Our disability lawyer can help you in the following ways:
- Give you a free claim evaluation to explain your rights and options
- Show you how to enforce your employment rights so you don’t lose your job or medical benefits while appealing the disability insurance denial
- Get your claim file from the insurance company and analyze it to identify the “real” reasons your claim was denied, along with what actions are needed to win the appeal
- Identify mistakes made by the insurance company
- Identify the best strategy and action plan for your situation
- Take over communications with the insurance company so you don’t have to deal with them anymore
- Write to your doctor to obtain a medical report that addresses the key issues needed to win your appeal
- Write an appeal letter that argues why your claim should be approved
- File a lawsuit against the insurance company for wrongful denial of disability benefits, infliction of mental distress, and other financial losses
Your Employment Rights and Long-term Disability
If you’re dealing with a long-term disability claim, there is a good chance you are also having difficulties with your employer. You may be worried about losing your job or being fired while on sick leave. Or, maybe you’re scared that the insurance company will deny your claim before you’re ready to return to work.
Unless you are in a union, we can also represent you in any issues involving your employer. Once you hire a lawyer, there is a good chance your employer will back off for the duration of the appeals.
Frequently Asked Questions
This depends on the lawyer you deal with and what you need to be done. If you just need a consultation or legal opinion, the charges are usually $500 or less. Most long-term disability lawyers will represent you on a contingency fee agreement. This means there are no payments upfront, and you only pay if the lawyer is successful. The fees would be a percentage of the funds recovered. This will result in a premium fee for the lawyer because they assumed the risk of not being paid. However, contingency fees can be unreasonable in some situations. This is why we offer a Fair Fee Guarantee.
There is no “best” long term disability lawyer. In fact, lawyers are prohibited from claiming they are the best. Sometimes lawyers will imply they are the best by showing awards they have won. Be cautious with lawyer awards as some of them are no better than a paid endorsement. Many awards are more of a popularity contest, rather than who is the best lawyer. Legal regulators have been cracking down on lawyers’ use of awards in advertising because they are misleading to the public.
This will depend on your situation. Many lawyers will only want to get involved when you are ready to sue the insurance company. We prefer to get involved earlier so we can prevent the need for a lawsuit when possible. We have had good success with internal appeals in the right circumstances. Getting a lawyer involved early can help you avoid delays and will cost less than hiring lawyer when a lawsuit is the only option.
Many group long-term disability plans have two definitions of disability: “Own” Occupation and “any” occupation For the first 24 months, you will qualify for benefits if you are unable to do your “own” occupation. However, after 24 months, you will only qualify if you are unable to do “any” occupation. Keep in mind that the reference to “any” occupation does not literally mean any occupation. You should get legal advice on what any occupation means in your situation. This is something we cover in our free claim evaluations.
Hiring a disability lawyer is not the best option for everyone. Your alternatives are to represent yourself or find free representation. Depending on your situation, there may be free legal clinics that could help you. We believe in empowering you to make the right decisions. We encourage you to read our free guides and books. As part of our free case evaluation, we will tell you if we think you can handle the case on your own, or if there are other support services out there for you.
Why work with our Halifax long-term disability lawyers?
We focus exclusively on disability claims and appeals. In addition to your long-term disability claim, we can represent you in claims for short-term disability, CPP disability, the disability tax credit or employment-related problems. This means you won’t have to fend for yourself or try to find other lawyers or representatives to help with all of your issues.
You only pay us if we win. There are no up-front payments and we pay any expenses related to the case. You only pay us for legal fees and expenses if we are successful in winning your claim and getting money paid to you.
Some law firms focus on helping when you need to file a lawsuit, but we help you at all stages of your claim. This includes the initial application, internal appeals, lawsuits, and claim monitoring after you are approved. We believe in early intervention so you can avoid denials and minimize delays in payments.
Our founder, David Brannen, is a former occupational therapist and author of The Beginner’s Guide to Disability Insurance Claims in Canada. He also created The Story Alignment Method™, which is the process we have used to achieve over a 90% success rate across all disability claims. Please note we can’t guarantee a 90% success rate if you hire us. Past results don’t predict future results.
Finally, we offer a 100% Satisfaction Guarantee and Fair Fee Guarantee. Our satisfaction guarantee allows you to walk away in the first 45 days with no charges or questions asked. So, you don’t have to worry about making the wrong hiring decision. Additionally, our Fair Fee Guarantee gives you peace of mind that we will never overcharge you for the work we do on your case.
Call our disability claim support team 902-800-8336 for a free claim evaluation, or fill out the form on this page. Our claim evaluation will answer most of your questions and will show you how we would move forward with your claim. Our support team are nice people and don’t pressure you to hire us.
If you aren’t quite ready to speak with us now, then we recommend you download our 7-Step Guide to Hiring a Disability Lawyer. Simply fill out the form below to receive it in your email inbox.
Learn the mistakes to avoid when hiring a Halifax long-term disability lawyer
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