Orangeville Long-Term Disability Lawyers

Long-term disability (LTD) benefits are designed to help seriously ill or injured insurance policyholders when they are unable to carry out the duties of their jobs because of a prolonged, disabling medical condition. Eligible claimants who have the appropriate level of insurance coverage and cannot continue performing the tasks associated with their current occupations because of a disabling medical condition may be entitled to receive between 60-70% of their regular wages through monthly payment installments.

Unfortunately, many insurance companies find reasons to deny claims for LTD benefits submitted by policyholders whose medical conditions legitimately prevent them from doing their jobs. As a matter of fact, even though insurers are not compelled to disclose exactly what percentage of LTD claims are denied each year, by examining the number of disability claims annually denied by the Canada Pension Plan (CPP), it can be determined that more than half of all LTD claims are initially denied by insurance companies.

If your claim for LTD benefits was denied even though your medical condition makes it impossible for you to perform the duties of your job, or if your LTD benefit payments have been terminated even though you are still not capable of returning to work, our Orangeville long-term disability lawyers may be able to assist you. Contact us today to discuss your situation in a free consultation.

Orangeville LTD Claims: Key Takeaways

Long-term disability benefits can provide essential financial support when an illness or injury prevents an Orangeville resident from working. Unfortunately, insurance companies sometimes deny valid claims, terminate benefits before a claimant is able to return to work, or rely on policy language that can be difficult to understand without legal guidance.

If you are struggling with an LTD claim, key facts you should understand include:

• Long-term disability benefits are generally designed to replace part of a disabled worker’s income when they cannot perform the duties of their job because of a prolonged medical condition.
• LTD benefits are often paid through workplace group insurance policies or private disability insurance policies.
• Insurance companies may deny or terminate claims for many reasons, including disputes about medical evidence, treatment compliance, surveillance, social media activity, or a change in the policy’s definition of disability.
• LTD claims are different from Orangeville personal injury claims, but the two can overlap if a car accident, slip and fall, or other traumatic event leaves someone unable to work.
• Ontario LTD disputes may be subject to strict deadlines, including limitation periods under the Limitations Act, 2002 and shorter internal appeal deadlines set out by the insurer within individual policies.
• Preszler Injury Lawyers offers free initial consultations and works on a contingency fee basis for eligible claimants.

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Since 1959, we’ve helped thousands of Canadians get the compensation they deserve with their long-term disability claims. One of Canada’s oldest personal injury law firms, personal injury law is exclusively what we do. Book a free consultation today with our top-rated personal injury lawyers.

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Why Are LTD Claims in Orangeville Denied or Terminated?

Unfortunately, many insurance companies find reasons to deny claims for LTD benefits submitted by policyholders whose medical conditions legitimately prevent them from doing their jobs.

Additionally, even people who have received LTD benefits could have their payments terminated by their insurance providers prematurely. Oftentimes, this occurs for reasons that can seem arbitrary and unfair. Insurance companies might cease making payments to qualified recipients of LTD benefits because:

• The policy’s definition of disability changed after two years of providing LTD payments, often referred to as “change of definition”
• The policy has time limitations for certain conditions
• The policyholder did not continue receiving medical treatment
• Surveillance investigations conducted by insurance companies found the policyholder engaging in questionable activities
• Videos, photos, and other social media posts shared by the policyholder are misconstrued or taken out of context by insurance companies
• And more

A denial letter does not necessarily mean the insurer is right. LTD policies can be complicated, and the facts of a claim may depend on medical records, specialist reports, treatment history, occupational demands, policy definitions, and communications between the claimant, employer, and insurance company.

If your claim for LTD benefits was denied even though your medical condition makes it impossible for you to perform the duties of your job, or if your LTD benefits payments have been terminated even though you are still not capable of returning to work, our Orangeville long-term disability lawyers may be able to assist you.

Understanding Own Occupation and Any Occupation Disability Tests

Many LTD policies use different definitions of disability at different stages of the claim. During the first stage, often referred to as the “own occupation” period, the question is usually whether the claimant is unable to perform the essential duties of their own job.

After a certain period, commonly around two years depending on the policy, the definition may change. At that stage, the insurer may consider whether the claimant is unable to perform the duties of any occupation for which they are reasonably suited by education, training, or experience.

This change in definition is one reason LTD benefits are sometimes terminated after a claimant has already been receiving monthly payments. If your insurance company has advised you that your benefits are ending because you do not meet the “any occupation” test, our Orangeville LTD lawyers may be able to review your policy, medical evidence, and denial letter.

Medical Conditions That May Qualify for LTD Benefits

Long-term disability claims may arise from many different physical, psychological, and cognitive conditions. Some disabilities are caused by a sudden traumatic accident, while others develop gradually or worsen over time.

Our lawyers may be able to assist with LTD claims involving:

• Chronic pain
• Fibromyalgia
• Depression
• Anxiety
• Post-traumatic stress disorder
• Cancer
• Heart conditions
• Neurological disorders
• Autoimmune disorders
• Back injuries
• Neck injuries
• Orthopedic injuries
• Concussions
• Traumatic brain injuries
• Spinal cord injuries
• And more

Some Orangeville residents may need LTD benefits after being injured in a car accident, a slip and fall accident, or another serious incident. In those situations, our Orangeville car accident lawyers and other members of our legal team can collaborate with our LTD lawyers to explore the possibility of a personal injury claim or an accident benefits claim alongside your claim for disability benefits.

What to Do if Your LTD Benefits Are Denied

ility benefits.

If your LTD claim has been denied, it is important to act quickly. The denial letter may include an internal appeal deadline, and Ontario law may also impose a deadline for starting a lawsuit. Under the Limitations Act, 2002, many civil claims are subject to a two-year basic limitation period from the date the claim was discovered, but the deadline in your case may depend on the policy, denial letter, and specific facts.

After receiving a denial or termination letter, consider taking the following steps:

• Save the denial letter and envelope
• Request a complete copy of your LTD policy
• Continue attending medical appointments
• Follow reasonable treatment recommendations
• Ask your doctors to document your functional restrictions
• Avoid posting about your activities on social media
• Keep copies of insurer communications
• Speak with an LTD lawyer before relying only on an internal appeal

Internal appeals can sometimes be useful, but they are not always the best approach. In some cases, an appeal may give the insurance company more time without improving the claimant’s legal position. Our Orangeville long-term disability lawyers can review your situation and help explain what options may be available.

Orangeville Long-Term Disability FAQs

Can I Apply For LTD Benefits If I Was Injured In An Orangeville Car Accident?

Yes, you may be able to apply for LTD benefits if you have coverage and your injuries prevent you from working. You may also have access to accident benefits under Ontario’s Statutory Accident Benefits Schedule and a claim against an at-fault driver. These claims can overlap, so it is important to understand how one claim may affect another.

What If My Orangeville Employer Says My Job Can Be Modified?

A modified work plan may be relevant, but it does not automatically mean you are no longer disabled under your LTD policy. The question may depend on your restrictions, the duties of the modified role, your doctor’s recommendations, your workplace demands, and the wording of your insurance policy.

Can My LTD Insurer Use Social Media Against Me?

Insurance companies may review public social media posts and try to use photos, videos, or comments to challenge a claim. A short post may not reflect the full reality of someone’s disability, but insurers may still take it out of context. Claimants should be careful about online activity while an LTD claim is ongoing.

Call Our Long-Term Disability Lawyers Serving Orangeville

Our Orangeville long-term disability lawyers provide all prospective clients with a free initial consultation. Even if you are unsure whether you might be able to pursue further action against your insurer to recover the coverage you are owed, consider taking advantage of your free initial consultation. By doing so, you will have the opportunity to review the details of your case, learn about options for legal action that might be available to you, and receive case-specific advice tailored to your unique set of circumstances.

To learn more, schedule your cost-free, no-obligation first meeting with our long-term disability lawyers serving Orangeville by calling 1-888-608-2111 today.

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LONG-TERM DISABILITY BENEFITS DENIED OR CUT-OFF IN ORANGEVILLE?