If you are involved in a disability claim, and find yourself needed legal advice or representation, it is hard to find reliable information about disability lawyers in Ottawa. You probably are wondering: What makes a lawyer a “disability lawyer”? Should I hire a disability lawyer or just represent myself? How do know if someone is a disability lawyers? Who is the best disability lawyer in Ottawa?
Like many areas of law, winning disability claims is skill intensive and you can to lose a winnable case if it isn’t handled properly. Hiring are lawyer who is a bad fit for you can result in delays, wasted money, more stress.
To avoid these problems, it is important that you educate yourself disability lawyers before you hire one. We have created this Ultimate Guide to Ottawa Disability Lawyers to educate you about disability lawyers so you can make the right choices.
To be absolutely transparent: Resolute Legal is a national disability claim law firm and I am the founder and managing lawyer at Resolute Legal. We get the majority of our income from legal fees charged to people we represent in disability claims and appeals. However, the truth of the matter is that hiring us or other disability lawyers in Ottawa may not be the best decision for you. You may be better served to represent yourself or to hire a paralegal or non-lawyer advocate. If there is one available in your area, a non-profit legal service provider might also be a better option than hiring a disability lawyer.
This Guide explains the pros and cons of hiring a disability lawyer as compared to some of your other options. It explains what’s involved with hiring a lawyer. I answer the tough questions about legal fees and other problems with hiring lawyers. I also include a partial list of disability lawyers and non-profit legal services in Ottawa. At the very end, I give you a seven-step process that you can follow to choose a lawyer who will be right for you.
Table of Contents
- What is a disability lawyer?
- Is it better to have a lawyer for a disability claim?
- How much do disability lawyers in Ottawa cost?
- How long does it take a lawyer to get you disability benefits?
- What are the problems with hiring disability lawyers in Ottawa?
- Alternatives to disability lawyers in Ottawa
- Who are the best disability lawyers in Ottawa?
- List of disability lawyers in Ottawa
- How can a disability lawyers in Ottawa help with my short- or long-term disability claim?
- How can a disability lawyers in Ottawa help with my CPP disability claim?
- How can a disability lawyers in Ottawa help with my employment claim?
- How can disability lawyers in Ottawa help with my Federal Worker’s long-term disability claim?
- Disability claim resources in Ottawa
- 7-Step process for hiring a disability lawyers in Ottawa.
What is a disability lawyer?
It’s common for lawyers to focus on one or two areas of law. A disability lawyer is a lawyer who focuses their legal work on disability-related claims involving disability benefits or compensation from insurance companies, government agencies, or employers.
There is no official certification for a lawyer to be considered a disability lawyer, so any lawyer can claim to be a Ottawa disability lawyer or represent people in disability claims and appeals. Personally, I 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 Ottawa.
Is it better to have a lawyer for a disability claim?
This is a very common question that doesn’t have an absolute yes or no answer. Whether it is better for you to work with disability lawyers in Ottawa compared to other options will depend on your individual situation.
All things being equal, I believe it’s safe to say that working with the “right” lawyer will help maximize the chance of success for your disability claim or appeal. This is based on my experience in successfully representing people who were denied disability benefits before they hired a lawyer. In fact, there are some studies from the United States that conclude hiring a lawyer can increase a person’s chances of being approved for disability benefits.
In 2017, the United States Social Security Administration found that disability claimants with lawyers were 2.9 times more likely to be approved than those without a lawyer. Also in 2017, a Martindale-Nolo study found that 60% of people with a lawyer got approved for social security disability benefits — compared to a 34% approval rate for those without a lawyer. This study found that lawyers made the biggest impact at the appeals stage as compared to the initial application.
These studies reflect my own experience as a disability lawyer helping thousands of people with disability claims and appeals in Canada. In fact, Resolute Legal’s very first CPP disability client was in a situation where she had lost at a hearing, but we were about to turn things around by improving how her case was presented to the decision-maker. You can read more about this in my article:
The Best Story Wins: The Secret to Winning Your Disability Claim
While you will gain an advantage by having the right lawyer, I strongly believe that most people should try to manage their own disability claim in the initial application and appeal stages. Contrary to what you may hear, insurance companies and government agencies do approve people for disability benefits — so you should first try applying and appealing on your own.
How much do disability lawyers in Ottawa cost?
What does it cost to hire disability lawyers in Ottawa? I have seen costs go from as low as $150 for a one-time consultation to as high as $150,000 (or more) for representation in complex disability lawsuits that recover compensation into the millions. The cost is as unique as your situation.
The cost to hire a disability lawyer depends on three main drivers of legal costs: the scope of work you need done, the experience of the lawyer, and the financial risk assumed by the lawyer.
The scope of work to be done
The scope of work refers to the type, amount, and difficulty of work you want the lawyer to do. Do you want one consultation to explore your options? Do you need a lawyer to help with paperwork for a few days? Or do you need full legal representation for several months?
Depending on what you need done, the legal costs can fall into these ranges:
- $50 to $500 for one-time consultations
- $5,000 to $7,500 for internal appeals
- $5,000 to $15,000 for disability appeal hearings
- $15,000 to $100,000 (or more) for complex disability lawsuits done on a no-win, no-fee basis
The lawyer’s experience & skill
Some lawyers are more expensive than other lawyers. You will generally pay more for lawyers who have a higher level of experience or who have a high demand for their services. Lawyers with less experience or less demand for their services will typically charge less.
It’s important to understand that lawyers are not all the same. If you are going to pay more for a lawyer or law firm, make sure you do your homework to ensure the lawyer or firm has the experience and reputation necessary to justify the higher-than-normal rates.
The lawyer’s financial risk
Generally speaking, you will pay more for legal services if your lawyer takes on the risk of not being paid for the work done. For example, if your lawyer only gets paid if they win disability benefits or a financial settlement, then you can expect the costs to be higher to account for the risk. This type of pricing is seen in no-win, no fee agreements.
On the other hand, if your lawyer gets paid regardless of the outcome of the case, you can expect the legal fees to be less than they would be in a no-win, no-fee situation.
To learn more about the costs of hiring a lawyer, see my article:
How Much Does a Disability Lawyer Cost in Canada?
How long does it take a lawyer to get you disability benefits?
I find there are a lot of misconceptions about what it means to hire a lawyer for a disability claim. At one end, there are people who believe that having a lawyer to write a threatening letter to the insurance company will result in the approval of a denied claim. On the other end, there are people who fear that hiring a lawyer means the case will take years to reach a decision.
After having helped thousands of people with disability claims, I strongly believe that hiring the “right” lawyer can result in faster approval of your disability claim or appeal. I say the “right” lawyer because not all lawyers are the same — some will be faster than others simply because they have more experience and/or better office systems and operations management.
Experienced disability lawyers in Ottawa get faster results because they are better at understanding the full context of the disability claim denial. When they understand the context, it becomes easy to identify what needs to be done to get approval of benefits or a financial settlement. When they don’t understand or appreciate the context, they are more likely to take actions that are less effective at securing approval of benefits.
I can only speak to my own experience, but we regularly help people get approved in a matter of weeks or months — not years. Again, the speed at which a lawyer can help you win approval of benefits will depend on the context of your situation.
To learn more about how context affects disability claims, check out my article:
4 Reasons to Avoid Disability Claim Internal Appeals
What are the problems with hiring disability lawyers in Ottawa?
Having helped thousands of people with disability claims and appeals, I am confident that hiring a lawyer is not the right choice for everyone. At Resolute Legal we believe that, with the right resources, education, and support, the vast majority of people can competently handle their own disability claims and appeals up to a certain point.
If you are considering hiring a lawyer for your disability claim or appeal, it’s important to understand the most common problems with hiring lawyers. This will help you confirm that hiring a lawyer is the right choice and how to make it a positive experience
Based on my experience, there are five common problems with hiring a lawyer for a disability claim or appeal:
- Hiring a lawyer may be an unnecessary expense
- You may get overcharged by the lawyer
- You may have a bad fit with the lawyer
- Lawyers can take longer to do the appeal than if you do it yourself
- You will lose some control over the appeal
To read in-depth about these problems and how you can avoid them, check out my article:
Problems with Hiring a Lawyer for Your Disability Appeal
Alternatives to Ottawa disability lawyers
While this guide is focused on disability lawyers, it’s important to understand that there are other options available to you. There are three categories of service providers for disability claims and appeals:
Even though Resolute Legal fits into the first category, my goal is to educate you about all your options — so that means teaching you about all categories of service providers.
Lawyers in Canada have to go through three years of law school followed by a one-year apprenticeship. They receive a general legal education that includes training in legal advocacy and writing. Lawyers are heavily regulated and must follow the rules of professional conduct and ethics. A lawyer can represent a person in any type of disability claim or appeal. Lawyers are required to have malpractice insurance to protect clients against financial losses caused by the lawyer’s negligence. There can be a wide range in the level of competence between various lawyers; they gain experience by representing people in disability claims and appeals.
Paralegals receive one or two years of general legal education. Ontario is the only province in Canada where paralegals are regulated and licensed as legal professionals. This means that paralegals in Ontario must prove they meet minimum requirements for education and legal knowledge. They must also abide by the rules of professional conduct and ethics, similar to those that lawyers follow.
Paralegals in Ontario can represent disability claimants before tribunals — including the Social Security Tribunal (CPP disability); Social Benefits Tribunal (ODSP and Ontario Works); the Workers’ Compensation Appeal Tribunal (WSIB or workers compensation claims); and the Ontario Labour Relations Board (for employment disputes). Like lawyers, licensed paralegals are required to have malpractice insurance to protect clients from financial losses caused by the paralegal’s negligence.
Licensed paralegals can provide a very high level of competence and professionalism in representing people in disability claims and appeals. As with lawyers, paralegals gain experience by working on disability claims; there may be a wide range of competence between paralegals based on their individual level of experience or access to a colleague with a high level of experience. Outside of Ontario, non-licensed paralegals fall under the category of disability advocates.
Advocates differ from licensed paralegals and lawyers in that they are unlicensed. This means that, unlike lawyers and paralegals, advocates aren’t held to standards for education or competence. They are not required to follow rules of ethics or professional conduct. Advocates are also not required to have malpractice insurance, so there may be no financial compensation for clients who suffer financial losses due to the advocate’s negligence.
Advocates provide a variety of disability claim and appeal services including filling out disability claim forms and helping people with internal or reconsideration appeals. Some tribunals, like the Social Security Tribunal for CPP disability appeals, allow advocates to represent a person at a tribunal hearing.
Advocates play an important role in helping people with disability claims and appeals. Even though they are unregulated, there are many competent advocates who provide services that are high quality, professional, and ethical.
Who are the best disability lawyers in Ottawa?
This is the question most people want answered, but unfortunately it’s not so easy to choose one person or firm. Being the “best” is subjective, so there isn’t one right answer or consensus for who is Ottawa’s best disability lawyer.
It’s important to understand that lawyers in Ottawa must follow rules of professional conduct and ethics. These rules also place restrictions on how lawyers can present themselves in marketing and advertising.
Lawyers are prohibited from doing any marketing that makes a false or misleading statement. A lawyer must market their services in a way that is demonstrably true, accurate, and verifiable. Additionally, lawyers are prohibited from using any advertising that suggests they have “qualitative superiority” to other lawyers. In other words, lawyers cannot outright claim to be the best lawyer or say that they are better than other lawyers.
One way some lawyers have sought to get around these restrictions is with lawyer awards. These awards are a roundabout way for the lawyer to “prove” that they are the best lawyer. Some lawyer awards are legitimate; however, many of are dubious at best — and in some cases they’re nothing more than a paid endorsement.
The Ontario Law Society has (rightly) cracked down on these lawyer awards because of how misleading they are to the public. Even awards from seemingly reputable sources can be manipulated by lawyers and law firms. The firm may not be the best in its category — just the best at getting out the vote to win the award.
We address how to compare lawyers below in our seven step guide to hiring a lawyer, but you should be very wary of making decisions based on lawyer awards or any marketing that suggests the lawyer is the best.
List of disability lawyers in Ottawa
During consultations with people who are considering hiring a lawyer, I am often asked “Who are your competitors in Ottawa?” I have no problem answering this question. In fact, you are in luck because I believe Ottawa has the highest density of disability lawyers in the country! So you have lots of choices.
When I give people a list of competitors to consider, I focus on law firms that I know who have at least one lawyer who dedicates 50% or more* of their practice to disability claims from insurance companies, government agencies, and employers.
Here is a partial list of law firms** (in no particular order) that have at least one lawyer whose practice is focused primarily on disability claims and appeals:
- Raven Law
- McNally Gervan Lawyers
- Auger Hollingsworth
- Yegendorf & Associates
Also, most disability lawyers in Ontario work province-wide, so you don’t necessarily have to look only for lawyers based in Ottawa. Here are some disability lawyers that work province-wide:
- Howie, Sacks & Henry
- Waxman and Associates
- Rastin & Associates
- Yazdani Law Office
- Share Lawyers
- Samfiru Tumarkin
- Preszler Law Firm
- MK Disability Lawyers
* Please note that 50% is just the figure I have chosen for the purposes of this guide. A lawyer or law firm can do less than this and still be competent to handle a disability claim or appeal.
** This list is to the best of my knowledge. If you know of a lawyer or law firm that should be added to this list, please contact my office. We will add them once we verify that they meet the “75% disability claims” criteria.
We are often asked who are our competitors. Following is a partial list of lawyers who offer to represent people in disability claims and appeals in Ottawa (in no particular order): Raven Law, Howie Sacks & Henry law firm, Share Lawyers, Waxman & Associates, McNally Gervan Lawyers, Auger Hollingsworth, Yegendorf & Associates and Resolute Legal.
This is not necessarily complete list, but is a good starting point.
How can Ottawa disability lawyers help with my short- or long-term disability claim?
If the insurance company has denied your short or long-term disability insurance claim, it is important to understand your rights and obligations. Depending on your situation, there could be many obligations and deadlines that apply to you. It is important that you take action to secure your employment rights while appealing the denial of disability insurance benefits.
A disability law firm can help you in the following ways:
- Give you a free consultation 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 and 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 need 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.
How can disability lawyers in Ottawa help with my CPP disability claim?
If Service Canada has denied your application for CPP disability benefits, it is critical that you not miss the 90-day deadline to appeal. Your appeal strategy will be different depending on whether you are doing a Reconsideration Appeal (with Service Canada) or a Tribunal Appeal (to the Social Security Tribunal).
You must take special care when appealing your case to the Social Security Tribunal. There are technical requirements you must meet. There are tight deadlines for requesting the appeal and getting in documents before the hearing. Your tribunal hearing is essentially your “last kick at the can” so you have to get it right. Consult a disability law firm early on in the process. If you wait until your hearing is fast approaching, or worse yet after you have lost your hearing, it may be too late for the law firm to help you.
A disability law firm can help you in the following ways:
- get a complete copy of your CPP disability claim file from Service Canada
- identify the best strategy and action plan for your situation
- identify the gaps in evidence that need to be filled
- obtain medical records, reports and other documents needed to win your appeal
- prepare a persuasive written arguments (appeal letters and briefs) for why your claim should be approved
- prepare you to testify at the Social Security Tribunal Hearing
- attend your Social Security Tribunal Hearing to present the evidence and make oral arguments
How can a disability in Ottawa lawyer help with my employment claim?
Many people with disability claims have other related legal issues involving their employer. Common disability-related claims against employers can include: wrongful denial of short- or long-term disability benefits; wrongful termination of employment; harassment; or violation of human rights.
Such claims against the employer have to be coordinated with any disability-related appeals or lawsuits you have against an insurance company or government agency. A disability lawyer can help you identify all of your disability-related claims and coordinate them to maximize your chances of success and recovery of compensation.
Where possible, it’s ideal to have the same lawyer or law firm handle all of your disability-related claims; you want to avoid a situation where you have to hire multiple lawyers or law firms that may not be able to coordinate effectively.
A disability lawyer can help you in the following ways:
- Explain your employment rights and obligations
- Confirm if you are entitled to severance pay or compensation from your employer
- Confirm if you have a potential claim against the employer for harassment or violation of human rights
- Represent you in a claim or lawsuit against the employer for compensation for severance pay, disability benefits, or harassment
- Represent you in a human rights complaint against your employer
- Negotiate financial settlements between you and the employer
How can disability lawyers in Ottawa help with my Federal Worker’s long-term disability claim?
Federal government workers are covered for long-term disability benefits through the insurance companies Sunlife and Industrial Alliance. Sunlife covers federal unionized workers and Industrial Alliance covers non-unionized workers. Both of these disability benefits plans are common in Ottawa given the high numbers of federal government workers.
Sunlife – LTD Plan for unionized federal workers
Because of the high number of federal government workers, the Federal Government Public Service long-term disability plans is one of the most common disability benefits programs in Ottawa. This plan covers most unionized workers employed by the Federal Government or its agencies and corporations. Members of PSAC are covered under this long-term disability plan.
The Federal Government disability benefits plan is administered by Sun Life. This is referred to as group policy 12500-G. This is a very good disability benefits plan that includes a disability payment of 70% of pre-disability income after a 13-week waiting period. However, the plan is complicated because there are many unusual mandatory offsets and conditions that are not seen with most other disability benefits plans in Canada.
The federal government has strict policies requiring mandatory retirement for unionzed employees on a prolonged sick leave. This is often referred to as medical retirement under the Public Service Superannuation Act (PSSA). You must carefully coordinate the mandatory retirement requirements to make sure you maximize your total disability income available form all sources. Failing to coordinate these benefits properly can result in unexpected tax bills in the tens of thousands of dollars.
If Sun Life denies your long-term disability claim, then you have the right to appeal. The appeal process involves two appeals directly with Sunlife and and final appeal to the Disability Insurance Plan Board of Management (National Joint Council).
If you are a member of PSAC, they provide free assistance to union members who need to appeal.
While it is not mentioned by Sunlife or the government’s information on the LTD plan, you also have the right to do your appeal via the court process. This allows you to hire an outside lawyer. The can seem intimidating, but the process is actually just another form of appeal.
There are deadlines to file a legal appeal. It is important that you not miss these deadlines while you are waiting on an appeal to the Board of Management (Joint Committee).
At Resolute Legal, we have represented many federal government workers in appealing denied disability claims from Sunlife. Like many disability lawyers, we handle these appeals on a no-win, no-fee basis. In Ontario, if we are successful with the appeal, Sunlife will be required to pay up to 50% of your legal fees and all expenses paid to do the appeal.
Industrial Alliance Insurance – LTD plan for non-unionized federal workers
Industrial Alliance provides long-term disability benefits to non-unionized federal government workers. This plan is also called the Public Service Management Insurance Plan.
If you are denied disability benefits, you have the option to do two appeals directly with Industrial Alliance. You then have the option to appeal to the Board of Trustee; however, this board does not have the power to overturn Industrial Alliance’s decision.
To overturn Industrial Alliance’s decision you must file an appeal in the court system. Resolute Legal has successfully represented several federal government management employees in appeals against Industrial Alliance.
Like most other disability lawyers, we can represent you on a no-win, no-fee basis with no up-front costs of any kind. If we are successful, Industrial Alliance will need to reimburse up to 50% of your legal fees and all of the expenses we pay to run your appeal.
Disability Claim Resources in Ottawa
Arch Disability Law Centre
ARCH Disability Law Centre is a legal clinic that focuses exclusively on disability rights. According to its website, ARCH is dedicated to “defending and advancing the equality rights, entitlements, fundamental freedoms and inclusion of persons with disabilities with low income in Ontario.” ARCH’s services focus on representing people in cases involving accessibility, attendant services, education, transportation, discrimination, and decision-making rights. ARCH is funded through Legal Aid Ontario and other donations.
Office of the Workers Advisor
The Office of the Worker Advisor is an independent agency that provides free legal advice and representation to people dealing with workers’ compensation claims. The OWA represents workers at the Workplace Safety and Insurance Board (WSIB), the Workplace Safety and Insurance Tribunal (WSIAT) and the Ontario Labour Relations Board (OLRB). The OWA is a non-profit agency funded by the Ontario government.
Legal Aid Ontario
Legal Aid Ontario provides subsidized or free legal services to financially eligible low-income Ontarians through 72 independent legal clinics. Legal Aid Ontario represents people who need to appeal a denial of benefits under the Ontario Disability Support Program (ODSP) or the Ontario Works Program (OWP). Some clinics may also handle legal issues involving the Canada Pension Plan or wrongful termination of employment.
Injured Workers Community Clinic
The Injured Workers Community Legal Clinic is an independent legal clinic funded by Legal Aid Ontario. It focuses on casework, public education, law reform, research and organizing support for injured workers.
Pro Bono Ontario
Pro Bono Ontario (PBO) strives to remove barriers to justice that people with disabilities may face. They have a toll-free, Ontario-wide advice line that is accessible for all people with disabilities. They also offer employment/long-term disability advice clinics and appeals assistance programs if you choose to represent yourself in your appeal.
Service Canada Offices
At Service Canada offices you apply for EI sickness benefits, CPP disability benefits and Veteran Benefits. For EI Sickness, you can apply online using the computers at the Service Canada Offices. CPP disability requires a paper application, but you get application packages from the offices below.
Service Canada (Ottawa Centre), 10 Laurier Avenue West, Ottawa
Service Canada (Ottawa West), Lincoln Fields Shopping Centre, Lincoln Fields Galleria Floor 1, 2525 Carling Avenue, Ottawa
Service Canada (Ottawa East), Beacon Hill Shopping Centre, 2339 Ogilvie Road, Ottawa
Social Security Tribunal
The national headquarters for the Social Security Tribunal is in Ottawa. This office handles all CPP Disability cases that are appealed to the Tribunal.
Physical Address: 344 Slater St, Ottawa, ON K1R 5Y7 Slater St, Ottawa, ON K1R 5Y7
Mailing Address: PO Box 9812, Station T, Ottawa, ON K1G 6S3
Phone: 1-877-227-8577 (toll-free in Canada and the USA)
Superior Court of Justice
The Superior Court of Justice is the court that handles all appeal lawsuits against insurance companies. If you need to appeal your claim by lawsuit it will be handled by this court. We file all appeal lawsuits with this court.
Physical Address: Ottawa Courthouse,161 Elgin Street, Ottawa, ON K2P 2K1
Phone: 613-239-1054 (this is the phone number for civil litigation cases)
SMALL CLAIMS COURT
The small claims court handles short- and long-term disability disputes where the total potential benefits owed will be $25,000 or less. If you have returned to work, but are till owed a few months of disability benefits, then the small claims court is often your best option.
Physical Address: Ottawa Courthouse,161 Elgin Street, Ottawa, ON K2P 2K1
Phone: 613-239-1079 (this is for small claims court only)
7-Step process for hiring a disability lawyer in Ottawa
Do you want to know whether you need legal advice or full representation? Do you want help with your long-term disability appeal but don’t know how or where to start? Do you worry about being overcharged or getting denied (again) because you hired the wrong lawyer?
If you said “yes” or even “maybe” to any of these questions, you should read this guide. You already have enough stress to deal with right now. Your lawyer should help relieve your stress — not add to it.
This guide can serve as your roadmap to finding the right legal advice for your long-term disability appeal. Through our seven-step process, we will help you:
- Determine how much legal help you need
- Find out if you have the right to hire a lawyer
- Identify all your disability-related legal claims
- Learn the rules for legal fees
- Clarify your goals and service expectations
- Create a list of suitable candidates
- Interview your candidates to choose the best fit
You can give yourself a better chance of getting the legal assistance you need if you know your rights and your options. This guide will help.
Step 1: Determine how much legal help you need
Do you need full legal representation where a lawyer handles all aspects of the appeal, or do you just need legal advice on a key issue so you can handle the appeal on your own?
It may make sense for you to hire a lawyer for legal advice if:
- You need to prepare your initial application forms for long-term disability benefits. Most people can prepare these forms on their own, but a lawyer can review your forms and give you suggestions to improve your application. You may be surprised by some of the avoidable mistakes claimants have made because no one helped them.
- You want to appeal an initial denial of your claim. A lawyer can identify the key steps or information you need to prepare your appeal. They can help you assess your situation and give you a specific plan for how to approach your appeal. You can then use this plan to represent yourself.
However, you might benefit from full representation if:
- Your medical condition prevents you from effectively handling the application or appeals process, and you don’t have someone else to help you.
- You handled your own application and first appeal and had both denied.
- You exhausted all internal appeals and need to file a lawsuit.
- The insurance company denied your initial application for coverage reasons (pre-existing condition)
Once you’ve determined your need for legal services, move on to the next step.
Step 2: Find out if you have the right to hire a lawyer
Depending on your situation, you may or may not have the right to hire a lawyer.
- I am not in a union. You have a right to hire your own lawyer and sue the insurance company or disability benefits plan administrator if they continue to wrongfully deny your appeals
- I am in a union. The collective agreement between your union and your employer may govern your disability benefits and appeals. Some agreements suspend your right to independent legal counsel and require you to use your union’s legal services. In these situations, your appeal must follow the grievance process laid out in the agreement; you don’t have the right to sue the insurance company or disability plan administrator.
However, not all collective agreements work the same way. In fact, most union members have the right to hire an outside lawyer for disability benefits appeals. It depends on the specific wording in your collective agreement and the disability plan documents.
You need to find out if the collective agreement suspends your right to independent legal advice. If you can’t get a clear answer from your documentation or your representatives, you can ask an outside lawyer for advice on how to proceed. The lawyer would need to see your group benefits plan and a copy of your collective agreement.
Once you have clarified your legal rights, move to the next step.
Step 3: Identify all your disability legal claims
Do you know all your disability-related legal claims? Yes, you may have more than one — maybe even several. Here are the most common:
- Short-term disability
- Long-term disability
- Worker’s Compensation (WSIB)
- Canada Pension Plan disability
- Disability tax credit
- Severance pay from your employer
- Creditor disability (for a loan or mortgage)
- Harassment or human rights violations
If you have multiple claims related to the same medical condition or disability, you must present a coordinated legal strategy for them all. Having one lawyer or law firm handling all claims will reduce the risk of delays, confusion, and excess costs.
Some legal counsel may only offer to represent you in your disability appeal. If they won’t handle all of your claims, they should at least give you guidance on the rest. Look for lawyers with the experience and willingness to handle all of your disability-related claims together, or find someone who has close relationships with other lawyers and could coordinate with them to represent you for the rest of your claims.
Once you have identified all of your claims, move to the next step.
Step 4: Learn the rules for legal fees
Hiring a lawyer is a large financial commitment. Many lawyers offer a “no-win, no-fee” arrangement — also known as a contingency fee agreement — but you still want to make sure the agreement is fair. There are strict rules for how lawyers can charge clients, especially when it comes to contingency fee agreements. You should know at least these two:
- Lawyers must charge a fair and reasonable fee
- You’re entitled to receive payment for legal costs if you win your claim or suit
Lawyers must charge a fair legal fee
This requirement can vary by province. Ontario, for instance, has this in their Rules of Professional Conduct:
3.6-1 A lawyer shall not charge or accept any amount for a fee or disbursement unless it is fair and reasonable and has been disclosed in a timely fashion.
Contingency fee agreements have the potential to produce fees that are neither fair nor reasonable. These agreements often set legal fees at 33.3 percent of any monies recovered. If your claim results in a very large settlement with very little work performed by the lawyer, then that 33.3 percent could produce an unfair fee.
If your arrangement has such a percentage, remember that it’s not set in stone. Your lawyer can only take that percentage if doing so results in a fair and reasonable fee under the circumstances.
So, how do we know what’s “fair and reasonable”? The Rules of Professional Conduct clarify:
In determining the appropriate percentage or other basis of the contingency fee, the lawyer and the client should consider a number of factors, including the likelihood of success, the nature and complexity of the claim, the expense and risk of pursuing it, the amount of the expected recovery and who is to receive an award of costs.
The Rules of Professional Conduct list other factors as well, including:
- The time and effort spent by the lawyer
- The difficulty of the matter and its importance to the client
- Any special skills or services that come into play
- The amount involved and value of the matter(s) at hand
- The results obtained
- The experience and ability of the lawyer
- Any special circumstances such as postponement of payment, uncertainty of payment, or urgency
- Any estimate or range of fees given by the lawyer
- The client’s prior consent to the fee
Ultimately, a lawyer can only charge a fair and reasonable fee for the service provided. If the percent formula would result in an unfair fee, then you don’t have to settle for that.
You’re entitled to payment of costs if you win
Should you file a lawsuit and have it ruled in your favour, the insurance company may have to pay a portion of your legal costs in addition to your compensation. “Legal costs” simply means a payment toward your legal fee as dictated by the court. If the ruling goes against you, the court may require you to pay some of the insurance company’s legal costs. Legal costs can be paid on settlement, or a judge can order either side to pay after a trial. This payment could reduce your legal fee by up to 50 percent.
The Rules of Professional Conduct require lawyers to pass any such payments to you — unless the court orders otherwise — or risk professional misconduct charges. This payment won’t become an issue if your case goes to court because a judge will specifically order it. On the other hand, if you reach an out-of-court settlement, you’ll have to make sure you receive the proper payment. We’ve seen lawyers reprimanded and even class-action lawsuits against law firms regarding this issue, so pay close attention!
When you settle out of court, the insurance company will typically make a lump-sum settlement, agreeing to pay X amount with no indication of what portion represents legal costs. Some lawyers may claim that such settlements don’t include legal costs to pass on to the client. We strongly disagree with this view; at the very least, it violates the spirit of the Rules of Professional Conduct.
Anyone with a calculator can figure out what portion of a lump sum should go to costs. Legal costs should cover between 25 and 50 percent of the legal fees charged — that’s it. A lawyer who can calculate your legal fee can determine what portion of a lump sum should pay legal costs.
Once you’ve learned what you need to know about your legal fees, move to the next step.
Step 5: Clarify your goals and expectations
Before you start speaking with lawyers, you need to know your goals and service expectations. Do you want monthly payments or a one-time settlement? How do you want to interact with your lawyer – online, by phone or video call, or in person? You must make your goals and service expectations clear to reduce the risk of conflict and dissatisfaction.
What do you want to achieve? Generally speaking, filing a lawsuit has four possible outcomes:
- The insurance company can voluntarily approve your claim, pay the retroactive money owed, and start making monthly payments to you.
- The insurance company can voluntarily agree to a lump-sum settlement where it pays you a one-time sum of money in exchange for your agreement to give up all rights under the long-term disability policy.
- If you go to trial and get a ruling in your favour, the judge can order the insurance company to pay all retroactive payments, a portion of your legal expenses, and the rest of your compensation.
- If you go to trial and receive a ruling against you, the judge will declare that you don’t qualify for disability benefits and will order you to pay a portion of the insurance company’s legal expenses.
- I want my claim approved to receive the back payment and monthly payments. I will continue to deal with the insurance company.
- I want to negotiate a lump-sum settlement of all past and future claims so that I no longer have to deal with the insurance company.
Some lawyers and law firms only want that lump-sum settlement. If you choose that as your only goal as well, then you can work with these candidates. However, what if you want monthly payments? Or what if you start out wanting a lump sum and then change your mind? You need to seriously consider these possibilities, regardless of how unlikely they feel to you now.
Please think carefully about hiring anyone who tries to limit you to specific outcomes. You should keep all of your options open. Lump-sum settlements may be easy, but they’re not always in your best interests. A good lawyer will tell you when it’s a bad idea.
Lawyers and law firms get a lot of criticism for poor customer service, and some of it is true. In the past, most law firms expected clients to take time out of their busy days, fighting traffic to reach those posh downtown offices, just to sign documents or review goals.
Fortunately, times have changed. Law firms nowadays perform services somewhere on the spectrum between the traditional model and a remote model, so it’s entirely up to you how you want to interact with your lawyers. If you don’t use email or prefer face-to-face meetings, a traditional model is for you. Alternatively, you can explore an online model like what we use here at Resolute Legal. Our lawyers work online or travel when necessary; you sign documents online and take meetings by phone; you log into an online portal to get updates on your case and view documents, milestones, and messages. Many law firms fall somewhere in between the two extremes of these service models.
In any case, a simple phone call to your potential choice should tell you what you need to know and whether you should move onto your next candidate. Then ask candidates how they can accommodate you.
Once you have set your goals and service expectations, move to the next step.
Steps 6: Create a list of suitable disability lawyers
Do your research. Prepare a list of possible lawyers or law firms. Go online. Ask friends for referrals. When considering candidates, you want to focus on those who have experience with disability claims, employment laws, and human rights laws. Most disability claims involve all of those issues.
Factors to consider for your list
- “Long-term disability appeals” listed as a practice area
- Records of cases and settlements won
- Positive reviews, either online or from referrals
- Demonstrated knowledge of disability appeals – published books, popular articles, presentations in venues of good repute
- The capacity to represent you in other disability-related claims (as outlined in Step 3)
Factors to consider with some scepticism or a grain of salt
- Advertisements on television or other media. A good lawyer can advertise, but remember that liking those ads doesn’t automatically make that candidate a good fit. You don’t need a celebrity; you need someone who will focus on your specific needs.
- Awards. Some awards come from highly regarded peer groups who carefully choose the recipients. Others come from award mills who churn out titles for a price, or from friends and colleagues who know nothing about how the awardee really works. How do you know? Research can give you a few answers, but you’d be better off to avoid basing your choice on awards and accolades.
- Political connections. Many people believe that political connections equal greater influence. I can assure you that political connections have little influence on insurance companies. Insurance companies focus on maximizing profit for their shareholders — not who’s in office this term.
- Years of experience. You’ll often see “X years of experience” or “combined experience.” Those years only really matter if they involved legal issues similar to yours. Someone who has worked for 30 years may have never touched a disability claim in all that time.
If you’re considering hiring a lawyer or online law firm, check out our article Hiring a lawyer online vs. Hiring a local lawyer for more information.
Once you have narrowed down your list of candidates based on these factors, move on to the next step.
Step 7: Interview the law firms and choose the best fit
Schedule appointments with your candidates to speak with them about your appeal. You must speak with more than one and review them carefully so you can feel confident you have made the right choice. If you prefer email or online chat for communications, try those channels first to see how well it goes — this might be representative of what your experience will be if you hire them.
Questions to ask
- How long have you worked in disability claims and appeals?
- How much of your practice do you devote to disability claims and appeals?
- How many active disability cases do you have now?
- How do you charge for your services? By the hour? Flat fee? Contingency fee?
- How does your contingency-fee agreement work? What are the percentages? Do you adjust the percentage down based on the settlement and circumstances?
- Will I have complete online access to all documents related to my case? How will you communicate updates to me?
- Do you insist on including legal costs in all out-of-court settlements? Would you designate part of a lump-sum settlement as legal costs payable to me?
- Would you fight for an approval of benefits rather than a lump-sum settlement? If we start with the goal of a lump sum but I change my mind, would you switch to fighting for benefits approval?
- Does it make sense for me to hire a lawyer for full representation? Or would it make more sense for me to get legal advice and appeal on my own?
- Would you also represent me in related claims (CPP disability, disability tax credit, severance payment from employer, creditor disability, or human rights complaints)?
- If it turns out you’re not a good fit for me, what other lawyers would you recommend?
- If I decide to hire you, how will you handle my case?
If you have questions, please call our support team at 905-614-2574 or click below to download a copy of our Free Guide.