Many individuals in Sarnia count on long-term disability benefits if they suffer from a serious injury or illness that prevents them from working. If you’ve paid into a long-term disability policy, either through your work or through a private insurer, you may decide to file a claim for benefits after receiving a serious medical diagnosis.
If an insurance company denies your claim for long-term disability benefits, but you believe you should qualify to receive them, a Sarnia long-term disability claims lawyer may be able to help you file an appeal.
Our long-term disability claims lawyers can meet with you in Sarnia for a free initial consultation. Call (416) 364-2000
Understanding Long-Term Disability Eligibility
The eligibility requirements for long-term disability benefits vary between insurance companies. However, generally speaking, in order to receive long-term disability benefits, a claimant must have a health condition that is:
- Severe to the degree that they cannot work or perform routine tasks
- Expected to affect the claimant for at least one year
Claimants suffering from both physical and mental health conditions may be eligible to apply for long-term disability benefits. That said, not all severe conditions are covered by every insurance policy. That’s why it’s advisable to review your policy’s guidelines and requirements for medical conditions covered by your plan before filing an application for benefits. If you require clarification about your plan, a Sarnia long-term disability claims lawyer may be able to help explain its conditions.
Sarnia Long-Term Disability Claims Lawyer Near Me (416) 364-2000
Filing Long-Term Disability Benefits Applications
In order to claim long-term disability benefits, you may be required to complete an application through your insurance company. Generally, in order for applications to be considered, a claimant must have experienced symptoms of their disability for several months. In order to substantiate your claim that you have a long-lasting health condition, you may need to provide evidence, including:
- The results of different medical tests
- Recommendations or letters from healthcare professionals
- Proof that you are receiving on-going medical treatment
Your insurance company may request that you visit a different medical professional to assess the severity of your condition. They may also require you to seek treatments for your condition in order to improve your health.
Sometimes, insurance companies deny claims for long-term disability benefits. This can happen when claimants fail to provide the supporting documents required. If your injury or illness prohibits you from compiling necessary evidence, a Sarnia long-term disability claims lawyer may be able to help you collect and file the appropriate documents to complete your application.
Understanding Long-Term Disability Benefits
Long-term disability coverage is designed to replace a portion of an individual’s income if they are unable to work. Some insurance companies offer the following types of coverage:
- Own-occupation coverage: provided when individuals cannot perform the tasks required to complete the duties of their current occupation
- Any-occupation coverage: provided when individuals cannot perform the tasks required to work in any job
Both of these forms of insurance coverage may provide a percentage of an individual’s wage while they are unable to work. The exact wage percentage an individual may receive varies between insurance policies. Most policies cover between 60-70% of a recipient’s regular income.
You may also be required to apply for coverage from the Canada Pension Plan (CPP). The CPP may be able to cover part of your benefits, which may reduce the amount you receive from your insurance company.
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File an Appeal if Your Long-Term Disability Claim Is Denied
Insurance companies may deny long-term disability benefits claims for a number of reasons, including:
- The claimant’s injuries or illnesses are not severe enough to qualify for benefits
- The claimant’s medical condition was misrepresented in their application
- The claimant’s disability is excluded from their coverage plan
- The claimant was not covered under the policy for long enough to draw disability payments
In these cases, a Sarnia long-term disability claims lawyer may be able to appeal the insurance company’s initial ruling. There may be a limit on the length of time claimants have to appeal their denied claims. The assistance of a long-term disability claims lawyer serving Sarnia may help you file an internal appeal within the mandated period of time.
Speak to Preszler Injury Lawyers Today
If you live or worked in Sarnia and your claim for long-term disability benefits has been denied, Preszler Injury Lawyers may be able to provide you with useful assistance and advice. To discuss your claim, call us today at (888) 541-7603.