In general, as long as you continue to meet your insurance provider’s eligibility requirements, you may be able to continue receiving long-term disability benefits until your policy expires. Most long-term disability policies only continue until recipients reach age 65. However, some policies have more stringent rules for continued eligibility after a recipient has been collecting benefits for an extended period of time.
If your insurance provider unfairly decides you are no longer eligible to receive long-term disability benefits you may be able to appeal the company’s decision.
Understanding Why You May Not Stay on Long-Term Disability Benefits
Several factors may determine how long an eligible benefits recipient can remain on long-term disability and why their payments may come to an end.
Some long-term disability benefits policies may only provide coverage for a specific length of time, often for two, three, five, or ten years. After this predetermined period of time, recipients who have exhausted their available benefits may be required to seek out alternative forms of income to help them maintain financial security.
Many long-term disability insurance providers either stop paying benefits or reduce their payment amount when the recipient reaches age 65. At this age, the recipient may be able to begin collecting payments from their pension.
Eligibility Requirements Can Shift Over Time
While you’re receiving long-term disability payments, your insurance company may want to receive regular updates on your medical condition to ensure you still meet their qualifications for benefits. If these updates on your condition lead them to believe your condition has improved, allowing you to return to the workforce, you may no longer qualify for long-term disability benefits.
Additionally, eligibility requirements for long-term disability benefits may change over time. In order to initially qualify for long-term disability benefits, policyholders may have to prove that their medical conditions will not allow them to perform the duties of their current occupation.
However, after receiving long-term disability payments for a lengthy period of time, benefits recipients may need to prove that their illness or injury prevents them from performing the duties of any job. For example, if your previous job required physical activities you are no longer able to perform because of injuries you sustained, your insurance provider may determine that you are able to perform other jobs that don’t require this level of physical activity.
In these cases, your insurance provider may decide to stop issuing your benefits payments.
Other Options for Compensation
If you exhaust your long-term disability benefits but are still unable to return to work, you may be eligible to apply for Canada Pension Plan (CPP) disability benefits.
In certain cases, policyholders meet their insurance company’s qualifications for long-term disability benefits, but their claims are still denied or their benefits payments are unfairly ceased. This may occur for a number of reasons, including:
- Missing or insufficient medical information
- Supporting documents submitted in the claim are inaccurate
- The insurance provider believes the claimant is capable of returning to work
If your claim for long-term disability benefits has been denied or your payments have been unfairly cut off by your insurance company, a long-term disability claims lawyer may be able to help you challenge their decision. A lawyer may be able to assist you by filing an internal appeal with the insurance company, or by pursuing an external appeal or lawsuit in court on your behalf.
Under the Limitations Act of 2002, S.O. 2002, Chapter 24, individuals filing a lawsuit against their insurance company only have two years from the date of receiving their notice of a denied claim to do so. If this deadline passes, these unfairly denied claimants may be unable to take action.
Discuss Your Benefits Claim with Preszler Injury Lawyers’ Team
If your insurance provider has denied your claim for long-term disability benefits, or your benefits payments have been stopped before you’re able to return to work, Preszler Injury Lawyers may be able to review your policy and help you navigate the appeals process or litigate your claim, if you qualify. Call Preszler Injury Lawyers today at (416) 364-2000 for a free, initial consultation.