Injured and cannot work?
If you have disability insurance, you may be able to apply for disability benefits. Typically, one starts off with applying for short-term disability benefits (STD). When those benefits end, and you are still unable to return to work, you should consider applying for long-term disability benefits (LTD).
How does it work?
Every policy is different. It is important to consult and carefully read your coverage booklet. This should give you information on how to apply for disability benefits and further highlight the key terms and conditions of your policy.
LTD policies generally provide benefits for 2-3 years, provided that you are unable to perform duties and responsibilities in your “own occupation”. Thereafter, you may be required to show that you cannot perform any job related to your experience and education, which pays approximately 70% of what you would have earned before your disability (the “any occupation” test). However, if you are 65 years of age or older, it is likely that you are not eligible to receive LTD.
Why am I denied coverage?
Our lawyers often see denials of LTD benefits on the basis that the “any occupation” test is not met. Insurance companies rely on a number of reasons to deny coverage, such as a lack of adequate medical documentation, or selective footage of surveillance videos that show the insured engaging in physical activity. If your LTD claim has been denied, we can negotiate on your behalf, or commence a lawsuit, if necessary. Contact Pinto Shekib LLP to schedule a free consultation.
Disclaimer: the foregoing is for informational purposes only and should in no way be relied upon as legal advice. For legal advice tailored to your circumstances, please contact Pinto Shekib LLP.