When you are unable to work but have disability insurance, typically you’re going to a file a claim for disability benefits. But what happens when your claim is denied? The insurance companies don’t exist to help you — they want to meet their bottom line and keep costs down.
A lawyer can make all the difference if you are denied disability benefits in Ontario. Here are five things you should know about disability benefits ahead of contacting the experienced lawyers of Preszler Law Firm, who will fight the big insurance companies on your behalf:
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1. You’ll need to know what a disability is and what it is not.
In Canada, a disabled person can file a claim for short-term or long-term disability. You may have this coverage either through your employer, the Canadian Pension Plan, or if you purchased it privately.
You may be able to file a disability claim for back injuries, cancer, heart conditions and mental health conditions, infection, diabetes, arthritis, lupus, seizures, acquired brain injuries, and more. Essentially, any disability that can affect your ability to work may qualify you for disability benefits.
According to Employment and Social Development Canada (ESDC), pain is the most common condition related to a disability, with flexibility and mobility following. Women are more likely than men to report these conditions, along with people age 45-64 versus younger workers.
Look over your insurance policy for more information, as there may be specific requirements on what your employer classifies as a disability. A good disability benefits lawyer will be able to help you review this paperwork and see if you have a claim.
2. You’ll need medical records and experts.
These offer a diagnosis and prognosis of your disability. Experts can be brought in to discuss your condition as well as its severity.
Your insurance company is on the lookout for potentially fraudulent claims, and may do anything to try to disprove your disability. It’s therefore incredibly important that you keep all your medical records and attend all your doctors’ appointments, in addition to following doctors’ orders.
You can also keep a journal about your impairments, which is another way to record your medical condition by providing real-time updates about your symptoms and pain, as well as how your treatment plan is going. Journaling is not the same as posting about your injury on social media, however. In fact, you’ll want to be extremely careful to avoid any photos or discussions about your injury, or being tagged in any pictures at friends’ parties, etc. where you look happy and not in pain. It can be hard not to “say cheese” for photos, and we often will just work through the pain in the moment, but any of this information online can be used against you — even if you think it’s private.
Make sure not to exaggerate your conditions, or downplay them. Your insurance company most likely is watching!
3. You’ll need collateral evidence.
Collateral evidence is information about your injury or impairment that won’t be on a medical report, but what friends and family can offer about your condition in addition to a doctor’s testimony.
Remember what we said about social media? You’ll still want friends and family in your corner, even if you’re not talking about your issues with them on Facebook. It may be old fashioned, but picking up the phone to talk to them on a weekly basis about how you’re feeling is not only a good way to catch up, but it may help support your claim for disability benefits in the event of denial.
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4. You’ll need to negotiate with insurance companies.
Get a fair deal put on the table. Disability benefit paperwork can be difficult — applications can be filled out incorrectly or be incomplete. Your insurance company’s definition of disabled may be different from yours. How do you negotiate?
Evidence. To build your case, in addition to keeping those important medical records and collateral evidence from friends and family, you may need the assistance of expert evidence from medical or even vocational specialists. But your lawyer will be the one working with your insurance company and the evidence you have compiled with him or her to get you the recovery you need.
Negotiations may require more supporting documentation for your claim, for example, which a Preszler Law Firm lawyer can gather for you. This can be testimony from a medical specialist or vocational expert, or even statements from your boss, co-workers and others who can discuss the demands of your job.
5. If you are denied disability, you need someone to fight your appeal.
But even if your appeal hasn’t been denied, you want an experienced disability benefits lawyer on your side. Aside from trying to wrongly deny your claim, insurers may attempt to end your benefits early, or even provide fewer benefits than they should.
Preszler Law Firm lawyers in Ontario can help you pursue disability benefits, navigating the tricky claims process, and get you the compensation you deserve. Contact us today at 1-800-JUSTICE® for a free consultation, or fill out our online case-evaluation form.
- Preszler Law’s Guide to Long-Term Disability
- How a Lawyer Can Help with Your Short-Term Disability Claim
- Determining Eligibility for the Ontario Disability Support Program (ODSP)
- What are Interim Statutory Accident Benefits?
- 5 Non-Conventional Treatments for Chronic Pain