Do you have a long term disability plan that you purchased privately or that was provided through your employer? Below is some important information about Ontario long term care disability insurance.

If your insurance company refuses to pay for a long term disability claim, it may be a good idea to contact an Ontario long term disability denial lawyer to discuss your options.

What is Long Term Disability?

Long term disability refers to a situation in which a disability renders a person unable to work for an extended period of time. People purchase long term disability insurance plans to help them in case an illness, injury or other medical issues prevent them from working. These insurance plans may be purchased either privately or through an employer.

Common issues that cause long term disability include:

• Arthritis
• Back injuries
• Cancer
• Chronic pain
• Diabetes
• Fibromyalgia
• Heart disease
• Infection
• Mental health issues
• Nervous system disorders
• Stroke
• Traumatic brain injuries

If you experience any of these issues or if you are unable to work because of injuries you suffered in an accident, you should submit your disability claim as soon as possible to avoid a potential gap in income.

How Does Long Term Disability Work?

Long term disability benefits involve payments you receive while you are unable to work due to illness or disability. If your long term disability claim is approved, your insurance company will continue to monitor your medical condition and treatment.

You must follow the insurer’s rules in order to keep your benefits. Your doctor may need to send regular updates. You may also be required to see a specific doctor or enroll in a specific treatment program. The frequency of the required updates depend on a number of factors, including age and likelihood that the condition will improve.

The insurance company may continue to monitor your condition over a period of years.

What Are the Long Term Disability Benefits?

Long term disability benefits depend on the specific terms of the plan. The payment may be based on a fixed amount, such as $2,000 per month, or a percentage of your salary. Long term disability benefits may be paid over a set number of years or until the recipient reaches a certain age.

Disability plans typically distinguish between total disability and partial disability. It is important to review your plan carefully to determine how its terms apply to you. Even if you meet the criteria for receiving benefits, it is possible that your claim will be denied because your situation falls into a category that is excluded from coverage, such as a pre-existing condition.

Sometimes, long term disability payments may be offset by other income sources. This means your insurance company may reduce your payment by the amount you receive from other sources such as workers’ compensation, employment severance payments or personal injury settlements.

What is the Long Term Disability Waiting Period?

The length of the waiting period for long term disability benefits may depend on a number of factors. To qualify for the benefits, you must be continuously unable to work for several months. During this time, you may be able to qualify for short term disability benefits or employment insurance sickness benefits to prevent a gap in your income.

Under most plans, the waiting period is about 17 weeks. However, the waiting period may be as long as a full year. The waiting period is generally the same length of time you are eligible to receive short term disability or employment insurance benefits.

How to Apply for Long Term Disability

To apply for long term disability benefits, you need to make a claim with the plan administrator. Typically, the plan administrator is an insurance company. Follow the steps as directed by the plan administrator. You will likely be required to submit any medical documents that support your long term disability claim. Your employer and doctor may also be required to fill out reports that will need to be submitted with your claim.

The plan administrator will review your long term disability application and will determine if the claim is approved or denied.

If your long term disability claim is denied and you believe it should have been approved, you can dispute the long term disability denial. Typically the process involves an internal appeal and may end with a hearing by a decision maker such as a judge or arbitrator who is not affiliated with the insurance company.

Do you Need a Long Term Disability Denial Lawyer?

If your legitimate long term disability claim was denied, it is a good idea to contact a long term disability denial lawyer to discuss your options. Unfortunately, some insurance companies do not always act in good faith and you may actually harm your case by following their guidance.

For example, some insurance companies tell policyholders that they need to have a medical exam with a certain doctor or medical expert. However, these health care professionals may not actually be independent and may tell the insurer that your injury or disability is not as severe as it really is. This information may be used to deny your claim.

Insurance companies may engage in other tactics to delay your case. A long term disability denial lawyer can work with the insurance company to help ensure you get the long term disability benefits you’re entitled to receive.

Fill out the form on this page to find out if you’re eligible for a free case evaluation.