If you have had your long-term disability insurance revoked, then you may have the right to reclaim it and a long-term disability lawyer can help. If you have been unexpectedly out of work due to a sudden injury or illness, long-term disability insurance benefits can be a lifeline, but the benefits can be revoked for several reasons. It is important to know your rights if you have had your LTD benefits revoked in Canada.

What is LTD Insurance? 

LTD insurance works by providing an income source that takes the place of your wages. When sudden illnesses or disabilities like injuries strike, LTD insurance offers a buffer for the financial losses of a job you are no longer capable of working. 

If you cannot work on a temporary basis or are permanently disabled from sickness or injury, LTD insurance is meant to cover you. Generally, disability insurance replaces 60% to 85% of your regular wages. It is important to know that “permanent” applies to the disability, not the nature of the disability insurance. There is no guarantee of getting lifelong LTD insurance. 

A lot of employers offer disability insurance to employees, but it is also obtained privately through life or health insurance.

LTD insurance can provide coverage for all who are eligible, including those who do not work for an employer. Self-employed workers can apply for long-term disability insurance to support business expenses if they are unable to work.

There are a number of reasons why someone would be on LTD insurance including injuries, sickness or other debilitating conditions.

In some cases, individuals can be legitimately ill and unable to work, but insurance companies will still refuse to pay benefits.

How Does Private Disability Insurance Work? 

In Canada, LTD insurance comes from two main sources, the Canada Pension Plan (CPP) or private LTD insurers. Candian employees are covered by CPP if they need it, but LTD insurance is not a government-funded plan. LTD insurance is obtained through an employer or purchased individually. Many employers also provide private disability insurance, which is commonly paid for in employees’ benefits packages, or self-employed workers can purchase private disability insurance. Workers are allowed to get benefits from both CPP and private disability insurance. 

What are the Rules of Private LTD Insurance Canada?

Commonly, private LTD insurance in Canada provides more limited care, but they are cheaper for employers or individuals. For private LTD insurance, individuals do not need to provide proof of medical evidence when applying. Under an employer who purchases a plan, all employees are protected regardless of medical histories. However, employer-provided LTD insurance includes a pre-existing condition clause. If an employee has a pre-existing condition, they are not eligible to receive benefits if diagnosed with a condition-related disability within the first year of coverage.

LTD benefits commonly have 90-day waiting periods, and after the time is up, the individual is allowed to apply if you are still unable to go back to work. Waiting periods can vary from 60 to 180 days. It is advised to apply for LTD insurance before the end of the waiting period to give doctors and insurance agencies ample time to process medical records or additional assessments. 

LTD benefits can be taxable. Depending on the policy, the LTD benefits are either from pre-taxed or post-taxed premiums. If your policy came from an employer, then it is likely pre-taxed and you will have to pay tax on the income. If you bought the private LTD insurance on your own, and you do not claim them as business deductions, then you do not have to claim the income. You have already purchased the insurance with post-taxed income, meaning you will not pay tax on top of it.

Claimants of LTD benefits in Canada are entitled to payments for two years when they are deemed to be totally disabled and unable to work. After two years the definition changes and it is more restrictive. After the two year period, you must be more than totally disabled from doing your job, but also any job that you are suited for. To continue receiving LTD, you must be found to be incapable of performing at any job that fits your experience or education.

Why Were Your Benefits Revoked? 

LTD benefits can be denied or revoked for a number of reasons. If your LTD insurance was revoked, it could be due to surveillance from the insurance company. Insurance companies can observe you on social media or otherwise and if you are doing activities that clash with your disability claim, the insurer can deny benefits. 

If your claim lacks medical evidence or is missing medical records, benefits can be revoked. All pertinent information and records should be provided when applying for a claim. A long-term disability lawyer can help you with this process. 

Many LTD policies require you to keep up with a regular treatment plan. If you have not been following a recommended treatment plan, you can lose your benefits. Seeing doctors, attending rehab, therapy, and other treatments might be required. 

After two years of receiving LTD benefits, they can be taken away due to the change in definition. You may lose benefits if you are now cleared to go back to your job or find another suitable job.

Can You File an Appeal? 

Filing an appeal if you have been denied benefits is a good idea. Filing an appeal means having the insurance company review your claim to reconsider. You can also provide them with new medical evidence to support your claim. Insurance companies are obligated by law to honour authentic claims of disability. Contacting a long-term disability lawyer may be a good idea before filing an appeal. A Long-term disability lawyer can help strengthen your case by recommending additional evidence and helping you through the process. 

Where Can You Get Help?

If you have had your LTD benefits revoked you can contact a long-term disability lawyer for assistance. A long-term disability lawyer can file a lawsuit against the disability insurance company to restore your long-term disability insurance payments. 

Collecting important medical documentation for your long-term disability lawyer to look over will be crucial to the claim. A long-term disability lawyer will send a notice to the insurer on your behalf and will create a strategy to represent your claim.