- Available in All Provinces (except QC, NU, NT, YK)
Do you need to win long-term disability benefits? Are you struggling with your application or appeal? Do you have questions about working with long-term disability lawyers?
If you answered “YES”, then call us toll free at (888) 732-0470 for a free consultation or click on the button below to schedule a free consultation by phone, email or videoconference. This consultation is free, and if you hire us, there are no up-front charges, and you only pay us if we win.
- How we help you
- What to expect from the free consultation
- Types of Long-term Disability Claims
- Long-term disability claims for medical conditions
- How Our Lawyers Can Help You at all Stages of your Long-term Disability Claim
- FAQs about long-term disability lawyers
- Next Step – Download Our Free Guide on How to Hire a Long-term Disability Lawyer
How we help you
We represent clients at all stages of the long-term disability claim process, including transition from work to sick leave, the initial application for benefits, appeals of denied claims, lawsuits for benefits, and negotiation of lump-sum settlements.
For people on approved long-term disability claims, we offer a benefits protection program to help you maintain your benefits. This service gives you peace of mind and removes the stress of dealing with the insurance company on your own.
We deliver 95% of our services remotely from our offices in Toronto, Ottawa, Moncton and Halifax. With some cases, you will never have to leave your home. We travel to your city or town when necessary. Any in person meetings are held at our offices or other professional conference rooms in your area.
Sometimes your situation is complicated by overlapping disability claims. In addition to long-term disability, we represent people in claims involving short-term disability, workers’ compensation, employment disputes, and the disability tax credit.
What to expect from the free consultation
Our free consultations are done by phone, email or video conference. Whichever method you prefer. Your conversation starts with one of our disability claim consultants. They are team members experienced with all types of disability claims. They will be able to answer most of your questions. We have lawyers on our support team who can be brought in to answer more complex questions or to give legal advice.
Not ready for a consultation right now? Take a moment to download our Guide on How to Hire a Long-term Disability Lawyer. Learn the mistakes to avoid. Click on the image below.
Types of Long-term Disability Claims
We represent clients in a variety of long-term disability claims. Below I review common situations. I will explain how each long-term disability claim works and how we could help you.
Group Long-term Disability Plans for Employees
Many employees have long-term disability benefits through a workplace group benefits plan. This is the same plan that includes medical, dental and drug benefits. You file a claim for these long-term benefits through the group plan provider, which is usually an insurance company.
We can represent you in applying for long-term disability benefits through a group policy. This gives you the best chance to be approved immediately, and avoid delays in payments. If the insurance company denies your claim, we can represent you in appealing the claim representative’s decision. If appeals are unsuccessful, we represent you suing the insurance company for benefits.
Contact us for a free consultation about your group long-term disability claim.
Long-term Disability Policies for Individuals
Some people buy individual long-term disability insurance policies that are not tied to their employment. Such an individual policy only covers the person who bought it. These policies are common with self-employed professionals and business owners.
Individual long-term disability policies are more technical than group plans. Insurance companies put these claims under greater scrutiny. You are more likely to be denied. Sometimes you will have a group long-term disability plan and an individual policy. It is important to understand how the two plans will overlap. We represent you in applying for benefits, appealing a claim denial, and in brining a lawsuit for payment of benefits.
Contact us for a free consultation about your individual long-term disability claim.
Group Long-term Disability Plans for Associations
Some group long-term disability plans are run by associations or non-profit organizations. The association has a fund from which it pays benefits under the plan. This is different from typical group insurance plans where benefits are paid by an insurance company. The association fund is maintained by premium payments by members of the association and their employees.
Typically, associations will hire an insurance company to administer the plan for them. This creates confusion because many plan members think the insurance company is paying the benefits.
Association plans are more complicated than a regular group insurance plans. They often have stricter language in the policy and may exclude claims for certain illnesses. They may have strict deadlines for appeals. They may limit your right to legal representation. Some association plans take away your right to sue the plan if they deny your final appeal.
We have successfully represent clients in a variety of association group long-term disability plans. We can represent you in the initial application, internal appeals and in your hearing for a final decision. In most cases you will not be able to sue the plan in court, so your last chance to win is at the plan’s hearing or arbitration.
Following are association group long-term disability plans in Canada:
- 3S Health Disability Income Plan (SK)
- British Columbia Government Employees LTD Plan (BC)
- Healthcare Benefits Trust (HEB) LTD Plan (BC)
- HEB Manitoba Disability & Rehabilitation Plan (MB)
- Hospitals of Ontario Disability Income Program (ON)
- New Brunswick Public Service LTD Plan (NB)
- Nova Scotia Public Service LTD Plan (NS)
- Nova Scotia Association of Health Organizations LTD Plan (NS)
- Ontario Public Service (OPS) Long-term Income Protection (ON)
- OTIP Long-term Disability Plan (ON)
- SSIP Long-term Disability Plan (National)
Contact us for a free consultation about your association long-term disability claim.
Long-term disability claims for medical conditions
You may wonder what medical conditions qualify for long-term disability? Or if your medical condition affects how you should handle your long-term disability claim?
The short answer is that any medical condition can potentially qualify for long-term disability. The focus is on how much disability the medical condition causes. And if the disability is temporary or permanent.
The type medical condition does affect how you should approach a long-term disability claim. For example, if you have an “invisible” illness, like chronic pain or chronic fatigue, then you must use certain strategies to prove your disability. Because others won’t be able to see your disability or measure it with a medical test.
Following are articles where we discuss how to win long-term disability for specific medical conditions:
- Long-term Disability for Back Pain
- Long-term Disability for Bipolar Mood Disorder
- Long-term Disability for Carpal Tunnel Syndrome
- Long-term Disability for Chronic Fatigue Syndrome
- Long-term Disability for Chronic Pain
- Long-term Disability for Chronic Regional Pain Syndrome (CRPS)
- Long-term Disability for Crohn’s Disease
- Long-term Disability for Depression
- Long-term Disability for Fibromyalgia
- Long-term Disability for Heart Disease
- Long-term Disability for Migraine and Headaches
- Long-term Disability for Irritable Bowl Syndrome (IBS)
- Long-term Disability for Knee Disorders
- Long-term Disability for Lupus
- Long-term Disability for Lyme Disease
- Long-term Disability for Multiple Sclerosis (MS)
- Long-term Disability for Neck and Cervical Disorders
- Long-term Disability for Psoriatic Arthritis
- Long-term Disability for Vestibular Disorders
- Long-term Disability for Visual Disorders
How Our Lawyers Can Help You at all Stages of your Long-term Disability Claim
Starting a Disability Leave
The decision to start a disability leave will be one of the most difficult decisions of your career. You have worked hard and don’t want to throw away all you have accomplished. You don’t want to lose your job or medical benefits. And you face an uncertain financial future if there are delays or problems with your applications for disability benefits.
We help you by removing the uncertainty. We work with you to create a plan for transitioning from work to going on sick leave. At this stage, we do a full review of your situation to identify any weaknesses in your case from the insurance company’s point of view. We then help you fix these weaknesses so you can present a strong case for disability benefits when you go on sick leave.
We help you avoid common mistakes by having your disability well documented before you stop work. We help you identify the right time to stop work. We gather medical records to support your claim. We coordinate with your doctors to get the right medical reports. We arrange other medical testing that is needed to give your claim the highest chance of approval.
If you are at this stage, reach out to us to schedule a free consultation.
Also, take a moment to download a copy of our Sick Leave Guide: How to Avoid the 4 Most Common Mistakes.
Waiting Period for Long-term Disability & Short-term Disability
All long-term disability plans have a waiting period. It is also sometimes called an elimination period. This is the length of time you must must be continuously disabled in order to be eligible for long-term disability benefits. The most common time is 17 weeks, but it can be as long as one year.
During the waiting period, you may for short-term disability benefits under a group disability plan. If you don’t have group benefits, you may also qualify for short-term disability from the Employment Insurance (EI) Sickness Program. If you want more information, check out our article that explains the difference between short- and long-term disability benefits.
Our long-term disability Lawyers can represent you in applying for short-term disability. We fill out the forms and submit them on your behalf. We gather any medical records needed to support your claim. We also coordinate medical reports from your doctors to give you the best chance of success.
We can also represent you in appeals if the insurance company denies your claim. If you are at this stage, contact us to schedule a free consultation. Our strategy at this stage is to reduce your stress, help you avoid common mistakes, and to get your claim approved as fast as possible.
Applying for Long-term Disability Benefits
As you near the end of the waiting period, you can apply for long-term disability benefits. How this works depends on your situation.
If the same insurance company handles both the short- and long-term disability claims, then it can be an easy transition. Because they already have your information from the short-term disability claim. In this scenario, you only fill out a single benefits transition form.
However, in most cases, there will be different organziations handling your short-term disability and long-term disability. You will have to submit a full application for the long-term disability. They won’t have the information form your short-term disability claim.
A long-term disability application package includes three forms:
- Notice of Claim Form (You fill out)
- Employer’s Report Form (Employer fills out)
- Attending Physician’s Report (Your doctor fills out)
If you are a self-employed professional or have an individual insurance policy you must be extra careful with your application. Mistakes with the application can cause big problems going forward. And make it difficult to have your legitimate claim approved.
To learn more about the application process, see our article on How to Apply for Long-term Disability in 7 Steps.
We represent people in applying for long-term disability benefits. We fill out the forms and collect the medical evidence needed to support your claim. We work with your doctors to get the best possible medical reports. We refer you for other medical testing if needed to support your claim. We prepare you for your interview with the insurance company. We prepare you for any early independent medical examinations they schedule for you.
We proactively review your situation to identify red flags or issues from the insurance company’s perspective. We then help you fix these problems before they become an issue with the insurance company. This gives you the best chance of having your long-term disability claim approved. The earlier we can help with your claim, the less likely you are to experience preventable delays in getting benefits approved.
Our strategy is designed to reduce your stress, help you avoid common mistakes, ensure you have a strong evidence to support your claim, protect you from the insurance company’s tricks, and to maximize your chances of claim approval.
If you are at this stage, please contact us for a free consultation.
Change of Definition of Disability
If the insurance company approves your long-term claim, there is a strong chance that they will stop your payments after two years. This happens because most group long-term disability insurance policies have a change of defintion of disability that happens after two years.
For the first two years, most group long-term disability plans will pay as long as you prove you can’t do your “own” job or occupation. However, after two years the criteria changes. They only have to pay if your can prove you can’t do “any” job.
If you are on an approved long-term claim, you should expect a lot of activity in the 12 months leading up to the change of definition. They will arrange for you to undergo medical assessments and have you fill out forms. They are consulting with their own medical experts to see if they can prove you should be able to work in “any” occupation. They will do lengthy interviews with you about your current status, improvements, upcoming treatment, and plans for return-to-work.
We help you at this stage with our Benefits Protection Program. With this program, we represent you in communications with the insurance company. We help you fill out forms. We prepare you for interviews. We help you avoid making mistakes that allow the insurance company to deny your claim on legal technicalities, even if you continue to be disabled from any occupation.
The lead up to the change of definition is one of the most stressful times of any disability claim. Our goal is to reduce your stress as much as possible. If you are at this stage, please contact us for a free consultation to learn about our Benefits Protection Program.
Appealing a Denial of Long-term Disability
At some point you may have to appeal a decision from the insurance company. This may be the decision to deny your application for benefits. Or it could be a decision to stop payment of benefits. Either way, you will have to submit a formal appeal with the insurance company.
The first step is to decide if you will do the appeal by yourself. Or if you should have a lawyer represent you. We have discussed when it is appropriate to hire a lawyer in our article on Long-term Disability Internal Appeals.
If you are thinking about representing yourself, check out our article on the 7 Steps to follow when appealing a long-term disability denial.
However, you should reach out to us for a free consultation, even if you are thinking of representing yourself. We can review your situation to identify any major issues you may not have considered.
We have great success in representing clients in appeals of long-term disability. For 95% of situations, there are no up-front costs and you only pay us if we are successful. With us by your side, you give yourself the best chance to get benefits approved more quickly.
Lawsuits for Long-term Disability Benefits
When all internal appeals fail, the last resort is to bring a lawsuit against the insurance company or disability benefits provider. We refer to the lawsuit as doing a legal appeal.
We find there are many misconceptions about what it means to file a lawsuit. Many people assume it means they are in for years of fighting. And that they have to wait for a judge to make a decision. This is only half true.
When we file a lawsuit the insurance company assigns new people to review and manage your claim. They appoint a lawyer to review it as well. These new people often bring a fresh perspective and can immediately approve your claim. We also negotiate lump-sum settlements. Also referred to as out-of-court settlements.
Lump-sum settlement are not right for everyone, but in some cases they are the best option. With a settlement, the insurance company pays you a one time payment, rather than approve the claim and pay monthly benefits each month.
We represent clients in lawsuits for long-term disability benefits. Our goal is to reach the best outcome for you. Often this means we use the lawsuit to pressure the insurance company to approve your claim. However, we can also negotiate a lump sum settlement if that makes sense for you.
Less than 1% of long-term disability lawsuits actually end up in court. I don’t have the exact statistic, but that is my best guess. Most cases will resolve before trial with an approval of the claim, a lump-sum settlement, or in a minority of cases, the person drops the lawsuit.
FAQs about long-term disability lawyers
Next Step – Download Our Free Guide on How to Hire a Long-term Disability Lawyer
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