If you’ve been injured in an accident or have been diagnosed with a serious illness and cannot work as a result, your financial security is likely to be a major concern. When medical conditions prevent insured workers from performing the duties of their jobs, they may be eligible to recover long-term disability benefits.
Long-term disability benefits provide eligible policyholders with a percentage of their regular earnings while they’re unable to return to work. In Canada, long-term disability plans usually replace between 60-70% of a recipient’s normal income. Generally speaking, in order to qualify, policyholders must have received a medical diagnosis for a condition that prevents them from doing their jobs. They must also have exhausted all other compensatory options available to them, such as paid sick leave, vacation time, and short-term disability benefits.
Some examples of medical conditions that may qualify an individual for long-term disability benefits include:
- Heart disease
- Back problems
- Chronic pain or complex regional pain syndrome (CRPS)
- Lupus or Lyme disease
- Psoriatic arthritis or fibromyalgia
- Bipolar mood disorder
- Post-traumatic stress disorder (PTSD)
- And possibly more
Eligibility requirements for long-term disability benefits vary between insurance policies. As a result, many people’s claims for long-term disability benefits are denied by their insurance providers. In fact, insurers may deny an applicant’s benefits claim for a number of reasons, even if their medical condition legitimately impedes their ability to work.
If your claim for benefits was unfairly denied, with the assistance of a long-term disability lawyer, you may be able to fight the insurance company’s decision by filing a lawsuit against them.
Of course, at a time when you’re unable to earn a pay cheque and may be incurring expensive costs for medical care, the notion of hiring a lawyer to appeal or fight your claim’s denial can be a legitimate financial worry. To alleviate the stress of not being able to afford legal representation, Preszler Injury Lawyers operate on a contingency fee basis.
What Are Contingency Fees?
Preszler Injury Lawyers’ contingency fee structure means that clients only pay for legal services in the event that there is successful resolution of their case. The fee charged is based on a percentage of the damages that are recovered on your behalf. Contingency fees can help eliminate the fear of additional out-of-pocket expenses you’re required to pay while you’re unable to work.
Our clients’ peace of mind is our top priority, and we’re honoured to provide our services to those who need it most. We aim to accommodate injured and ill people during difficult periods of their lives. For that reason, your initial consultation with a member of our team is entirely free of charge. And thanks to our contingency fee structure, if we work on your case, you won’t pay us unless you win.
Some Benefits of Contingency Fees
When legal fees are provided on a contingency basis, people with unfairly denied long-term disability benefits claims can pursue litigation without worrying about upfront, out-of-pocket payments for their legal advocacy.
For those struggling to support their families or simply make ends meet after a disabling medical diagnosis, contingency fees make it possible to pursue a claim against your insurer with the valuable assistance of a seasoned lawyer. During a difficult time when health and recovery should be top of mind, contingency fees allow seriously injured or ill individuals to focus on their medical needs, while their lawyer pursues justice on their behalf.
Understanding the Process of Appealing/Litigating a Denied Claim
If your long-term disability payments were unfairly denied, a disability benefits lawyer may be able to help you appeal or litigate the insurance company’s decision.
Based on the reason provided for a claim’s denial, a lawyer may advise you to file an internal appeal directly through your insurance provider. Many claims for benefits are denied because of missing or insufficient supporting documentation. If this is the case, a lawyer may be able to help you compile and submit crucial medical evidence, including assessments from healthcare providers and other experts, in the hopes of overturning an unfair determination.
However, the internal appeals process can take a long time and generally results in nothing. If you’re unable to earn your regular wages and your claim for benefits has been denied, you may not be able to wait for a reassessment. Plus, even after submitting additional supporting documents substantiating your claim, an insurance company may still decide to deny your benefits.
All this being the case, a disability benefits lawyer may advise you to file a lawsuit against your insurance company. If so, your eligibility to collect long-term disability benefits would be determined by a judge, and not the insurance company.
After reviewing your case, your lawyer would prepare a pleading, known as the statement of claim. This pleading usually outlines your case against your insurer and how much you are seeking in damages in civil court.
As the defendant of the lawsuit, the insurance company would then typically file a rebuttal, responding to the information outlined in the statement of claim. This responding pleading is called a statement of defence and it establishes the insurance company’s intention to defend and their position relating to the allegations made in the statement of claim.
At this point, your lawyer will prepare you for discovery. This stage of the process is not a trial, but it does require unfairly denied benefits claimants to submit to examination under oath. Your lawyer will most likely discuss what to expect during this stage of the process, and attend the proceedings with you. If either you or your lawyer are unable to answer a question during the discovery process, they may request to submit a response after the examination. Doing so is known as an undertaking.
In mediation, a neutral mediator enters the process to help settle the lawsuit. During mediation, the neutral third party will work with both parties’ legal representation in an attempt to find a reasonable solution. If your case is satisfactorily resolved during mediation, you will not be required to take the matter to trial.
If a long-term disability benefits lawyer is able to help resolve your claim, you may be awarded payments for:
- Previously denied benefits payments
- Future benefits
- Legal fees
- Damages for mental stress experienced
- Punitive damages
- And possibly more
What to Do Before Contacting a Lawyer
Before contacting a lawyer to review your case, making sure you’re fully prepared can best help you take advantage of your free initial consultation. It may, therefore, be beneficial to take the following the actions before seeking legal assistance:
- Obtain a copy of your insurance policy by requesting it from your company’s Human Resources department, or by reaching out to your insurance provider.
- Review your notice of denial, and identify the reasons for your claim’s rejection.
- Take note of any deadlines for appeal listed on your notice of denial. If you fail to meet your insurer’s deadlines, you may lose your chance to pursue unfairly denied financial compensation.
- Take note of the first denial date. This date is crucial as a denial triggers the commencement of the Limitation Period.
Hiring Preszler Injury Lawyers
Preszler Injury Lawyers work on a contingency-fee basis. If you do not have the financial wherewithal to hire a lawyer on an hourly rate basis, our fee structure will allow you to pursue the financial compensation you’re owed, without the stress of upfront or interim legal fees.
To discuss your case in a free, initial consultation, call Preszler Injury Lawyers at 1-800-JUSTICE today.