When you suffer a disabling injury or chronic illness and are unable to work, you might be eligible for long-term disability (LTD) benefits through a private or employer-sponsored insurance policy.
LTD insurers have strict guidelines regarding eligibility, the conditions they will cover, and when benefits will commence and terminate. Additionally, there are rules and regulations you and your insurer must follow throughout the claims process.
Failure to comply with the insurance company’s guidelines can result in a denial of benefits or cause unnecessary delays in the process. Neither situation is ideal for an individual who relies on their employment income.
If you receive a denial from the insurance company, a Hamilton long-term disability lawyer can help you identify your next step in getting the benefits you deserve. They can help you file an appeal with the insurer, or prepare to file a lawsuit. An experienced lawyer knows the tactics insurance companies use to reject claims or reduce their values, and they can help you cut them at the pass.
Our long-term disability lawyers can meet with you in Hamilton for a free initial consultation. Call (416) 364-2000
Building a Claim
There are two critical actions you can take now to protect your right to long-term disability benefits. They are to seek legal guidance, avoid gaps in your medical treatment, and to not miss any important deadlines.
Hamilton Long-Term Disability Lawyer Near Me (416) 364-2000
Seeking Legal Representation
Upon receipt of your claim, the insurance company will begin its investigation of your condition and ability to return to work. The adjuster handling your claim may request a statement from you about your injuries or illness.
They may ask to record the interview. While this request may seem harmless, many claimants unknowingly make damaging statements during their interviews that can later ruin their chances of receiving benefits.
The adjuster may also have an independent doctor conduct a review of your medical records. If the doctor does not agree with your treating physician’s recommendations, the adjuster may deny your request for LTD benefits.
For these reasons, it is in your best interest to discuss your case with an experienced Hamilton long-term disability lawyer. Your lawyer can explain how to handle communications, be there during the interview with the insurance adjuster, and help you avoid the common pitfalls that can damage your claim permanently.
Avoiding Gaps in Treatment
Since medical evidence is crucial to your claim, you will want to follow your treating physicians’ recommendations precisely. Therefore, you should keep all of your appointments, take your medications as prescribed, limit your activity level as instructed to by your doctors, and avoid taking illegal drugs or abusing alcohol.
Should you fail to comply with your doctors’ orders, the insurance company may argue your actions are preventing you from getting better and will deny your claim.
If you are struggling financially to keep up with your medical care, a Hamilton long-term disability attorney can help you explore other avenues of financial assistance while your LTD claim is in the works.
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Complying with all Requests
Successful LTD claims hinge on strong medical evidence and other documentation. Not only will you have to complete forms, but you will also have to ensure your employer and doctors are completing the necessary forms on your behalf and submitting them to the insurer on time.
Additionally, you will have to comply with the insurer’s requests for additional information within the allotted timeframe. Failure to comply with the insurer’s requests may result in a denial of benefits.
Ensuring all of this paperwork and other documentation reach the insurance company on time is a stressful endeavor, and a task many claimants cannot manage.
A Hamilton long-term disability lawyer can help you reduce the risk of receiving a wrongful denial. Your lawyer will ensure your application is completed accurately and submitted with all of the necessary documentation to support your claim. They can also manage all communication with the insurance adjuster and ensure all parties meet the appropriate deadlines.
Most insurers will cover between 66 and 85 percent of your employment income. The exact amount is generally calculated using an average of your income, often a period of time or based on your regular salary. Each policy is different. If you earn a large portion of your income through overtime, commissions, or bonuses, it behooves you to work with a Hamilton long-term disability attorney who understands how to arrive at an accurate estimate of your earnings.
Contacting a Lawyer
Even if your claim seems straightforward, the insurance company may disagree and deny your claim. After a denial, it is wise to review your case with a qualified Hamilton long-term disability lawyer to determine the ways to have your claim reinstated or settled.