If the recovery process resulting from a serious injury or illness prevents you from returning to work, you may be facing a number of financial challenges. If you buy into a group insurance policy through your employer or pay premiums to a private insurance provider, you may decide to submit a claim applying for long-term disability benefits.
The process of preparing an application for disability benefits can be complicated and time-consuming. Missing a single, important detail may unintentionally disqualify your claim. That means that, even if you believe you are entitled to collect benefits, your insurance provider may deny your request.
If you live or work in Waterloo, a long-term disability claims lawyer serving the region may be able to help you thoroughly complete an application, or if necessary, appeal your insurance company’s denial of your claim.
Eligibility for Long-Term Disability Benefits
Waterloo residents who become seriously ill or sustain severe injuries and cannot return to work as a result may qualify for long-term disability benefits through their employer’s group insurance policy or an individual plan.
Although eligibility requirements for long-term disability benefits varybetween insurance policies, most insurance providers may require claimants to meet the following criteria:
- The claimant’s policy must be current and in good standing.
- The claimant must have received a diagnosis for a serious medical condition from a medical professional
- The claimant’s medical condition prevents them from performing the duties of their current job for a minimum of 12 months.
If you are unsure if you are eligible to collect long-term disability benefits, a lawyer serving the Waterloo region may be able to provide assistance by:
- Reviewing and explaining the details of your policy’s eligibility requirements
- Organizing relevant diagnostic and medical records, per the Canadian Medical Protective Association (CMPA).
- Working with medical and vocational experts to support your claim
- And possibly more
Even if you believe you meet the eligibility requirements to begin collecting long-term disability benefits, your insurance provider may still deny your claim. In these cases, a Waterloo long-term disability claims lawyer may be able to file an appeal on your behalf.
Why Some Long-Term Disability Claims Are Denied
An insurance company may deny a claim for long-term disability benefits for a number of reasons, including:
- Incomplete applications
- Unclear or inaccurate medical documentation
- Claims submitted past mandated filing deadlines
Long-term disability benefits are designed for individuals who, due to a chronic physical or mental disability, are no longer capable of generating income at their current workplace. Occasionally, insurance companies may assert that, even if claimants are unable to perform the duties of their current job, they may be capable of earning a living through other types of work. According to these policy terms, insurance providers may deny claims for compensation.
In situations where long-term disability claims are unfairly denied, a Waterloo lawyer may work with vocational experts to counter the insurance company’s assertions or provide medical evidence to further support their client’s claim.
Long-Term Disability Benefits Expectations for Non-Salaried Employees
The Financial Consumer Agency of Canada reports that, on average, most long-term disability insurance policies provide compensation for 60-70% of a claimant’s regular income.
Salaried employees with consistent rates of pay may have an easier time recovering the correct amount of benefits owed to them than freelancers, contract workers, or employees working at hourly rates, whose monthly income may be less consistent.
In these cases, insurance companies may base these workers’ long-term disability benefits payments on their lowest rate of pay. A Waterloo long-term disability claims lawyer may be able to provide the insurer with documentation from various pay periods so that their client’s compensation rate will be based on an amount more closely aligned to their average income.
Contact Preszler Injury Lawyer Today
If an injury or illness has affected your ability to return to work, the frustration and anxiety of filing a long-term disability claim can be overwhelming. If you require assistance with this process, call Preszler Injury Lawyers today at 1-800-JUSTICE to review the details of your case.