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What is a Disability Insurance Lawyer?

This article provides information on a variety of subjects surrounding disability lawyers and insurance claims. Specifically, it will answer:

  • How does one go about finding a lawyer?
  • What should a lawyer do for you in your case?
  • How will you be accomodated?

Lawyers, legally, should be trustworthy, honest, and disclose to you what you need to know, when you need to know it. The best lawyer for disability benefits you can possibly choose will help assist you in your disability, and initiate contact on behalf of your interests with third parties involved in your claim. Over the course of your claim, you will be talking with the firm and its consultants - perhaps regularly. It is important that you trust the lawyers' parties, as this can be an important factor in order to provide a solution that works best for all parties.

Short term or Long Term disability insurance lawyers' primary concerns are that of relevant disability, and its legal groundings. Based on your disability, a lawyer will concern his or herself with accumulating knowledge surround the disability, the ethics surrounding the professional opinions of your disability, and the capacity of care the disability lawyer is willing to give.

Find the Best Disability Insurance Lawyer

Our research has found quite a number of disability lawyers, however, many personal injury lawyer firms will claim to work with long term disability claims. Personal injury cases, specifically severe instances, will bear the classification of long term disability cases as well. However, few law firms specifically deal with long term disability insurance claims, denied insurance claims, or insurance appeals.

PW Lawyers are lawyers for disability benefits - our specialty is geared towards dealing with insurance claims, long term disability clients, and persons with disabilities. We usually do not refer our cases out to other firms for a fee like other large firms practicing in Canada. Our retainer is, as stated by the Law Society of Upper Canada, one of the "best [they've] seen". We do not charge referral fees, and our openness is guided by our care for our clients' best interests.

Disability Insurance Claim Network

Many disability insurance claimants will not know how to find a lawyer. There are many services that will help individuals find lawyers: claim networks, or law-society networks. Word-of-mouth is an approach many individuals will recommend, however, due to lack of expertise in diagnosing a case, the case at-hand may call for a different set of skills. Do your research! We offer a free consultation - as many top legal professionals should. If your disability claim lawyer does not offer a free consultation, you should look around.

Credentials, Reviews & Experiece

Beware of "over-hyped" credentials, customer reviews, and experience. While we tout our experience, a lawyer for disability benefits should be proud of his success rate. We encourage you to ask about the success rate in your consultation. The best disability lawyer will be up-front with this fact.

You should examine the knowledge-base the law firm offers online. Our efforts, while geared towards client retention, are educational as a first order of business. Here at PW Lawyers, our belief is for our disability claim clientele to be educated as best as possible. We offer live chat sessions, free consultations, and phone support for individuals looking for more information surrounding their short or long term disability claim.

What should disability insurance lawyers do for you?

Communications with the best disability lawyers should be easy, constructive, effective, and should contribute to your case. In speaking with a disability claim lawyer, you should assemble facts and be able to convey them to your lawyer in an objective way. Because your lawyer will be required to do the same to a judge, panel, or jury, the more objective information you are able to provide, the lower the chance your case will be misconstrued. Most of all, be honest.

How will you be accomodated?

In order to guarantee the best service, you should be upfront with the limitationos of your disability and forthcoming with its affect on you. The best disability lawyer will offer accomodations, insofar as your disability requires (and, in most cases, more). Your lawyer should:

  • Be aware of any medical treatments that you may need that may affect your meetings or wellbeing
  • Provide an accessible space that does not discriminate
  • Offer an alternative method of communication if you have an impairment as such

IF your lawyer does not provide the required accomodations for your wellbeing or communication with the firm, you should seek another disability insurance lawyer. We encourage you to seek alternatives. You may be able to get out of the contract (or retainer) with your lawyer on grounds that they have no provided due diligence as a representative of your short or long term disability claim. This is a confrontation you may not want to entertain. We encourage you to seek legal advice in this case.

At PW Lawyers, we're always there for you. Contact us today for more details.Long Term Disability insurance policies protect an employee from loss of income in the event that he or she is unable to work due to illness, injury, or accident for a long period of time.

What is the Waiting Period?

A waiting period is the qualifying period the insurance company takes to clarify your policy. This period can range from four months to 52 weeks. However, in some claims, an employee can qualify for early intervention.

An early intervention is when the insurance company gets involved in your claim within a few days of incurring your injury.

What are time limits?

Time limits are the amount of time you have to file your claim. Each and every policy is different. If you occur any delays in your policy, it can change the outcome of your benefits.

What records should I provide?

Your insurance company will request from you a series of documentations for your application. As each insurance company is different, most request the following:

  • A physician statement
  • Employee's statement
  • Medical information and employer's statement

More documents may be required by your insurance company.

What types of disability are covered?

Each coverage varies from policy to policy. Usually, policies cover any type of injury or illness that prevents you from being able to work.

Some policies exclude certain illness and work-related injuries. To find out if your injury or illness is covered, contact us.

What reasons could terminate my Long Term Disability Claim?

There are many reasons you claim may be rejected or terminated.

Below is a list of most common and possible reasons:

  • You are the age of 65 or attain the age of 65
  • You are in prison
  • You are retired or retire during the duration of the claim
  • Required documentation was not submitted
  • You recover fully
  • Refuse to participate in treatment program
  • Fails to report for a medical examination
  • Start a new job
  • Refuse to continue application process
  • Death (in some cases your estate can receive a lump sum of your benefits)

My insurance company changed the definition of my disability and now I am no longer eligible to receive my benefits! What does this mean?

Since Long Term Disability is not standardized, your contract can be subjected to change. Usually, policies require that the insurance company pay for your benefits for two years, as long as you are unable to work your previous job. After the two year mark, your insurance company can stop your benefits unless you provide evidence that you are unable to work any job due to your disability.

My insurance company terminated my claim but I am not recovered to go back to work! What do I do?

Document and keep all records of your insurance company telling you about your termination. In many cases, policies require an objective tracking of evidence throughout your claim.

Objective evidence is physical evidence that supports your injury. Such evidence includes doctor visit documentation, test and imaging results, consultation documentation etc..

It is important that if your claim has been terminated and you are not ready to go back to work; you need to keep a paper trail and you will need to seek legal advice.

Does my age matter?

Yes.

The benefit period ends at the age of 65. With some insurance companies, if you are totally disabled at 65, your benefit can extend for 24 months before the age of 75.

You could be eligible for the Canada Pension Plan (CPP) disability benefit. The CPP disability benefit is available to those that have made a contribution to their CPP and who are not able to work regularly due to their disability.

I am part of a union, are the claims different for me?

Yes. Being a unionized worker means you have other factors to consider, compared to a group or individual insurance policy.

If you have a “self-insure” benefits package, you have entered into the Administrative Service Only (ASO) Agreement with the insurance company. This allows the insurance company to act as the administrator of your plan. The insurance company will process and cover all the significant steps in your claim.

When a claim is denied or terminated under “self-insure”, you are eligible under the Collective Bargaining Agreements (CBA) to dispute your termination or denial. This dispute will go through a hearing with the union.

Legal representation is required in these hearings.

My payable income has reduced significantly! Why?

Other sources of income during your claim can reduce the amount of payable income of your benefit. This may be due to direct and indirect offsets.

Below is a list of direct and indirect offsets:

Direct Offsets

  • Any income received by the government (Ex. Social Services Ontario Works)
  • Benefits programs including Canada Pension Plan (CPP), employee disability benefits, Worker’s Compensation
  • Benefits paid under an auto insurance plan

Indirect Offsets

  • Retirement benefits linked to any employment
  • Canada Pension Plan (CPP) disability pension benefits payable to you by your dependants
  • Benefits payable from any association or other group benefit program
  • Income from any job or business for profit

Filing for your Long Term Disability claim can be a rigorous and strenuous process. At PW Lawyers, we are able to help you through this process so you receive the care you deserve.

If you have any questions, do not hesitate to call us for a free consultation at (905) 940-5554.


Paul Wilkins

Principal Partner

Paul is a member of the Ontario Trial Lawyer’s Association and the Advocates Society. Frequently involved in pursuing his clients’ claims, his areas of focus include statutory accident benefits, short term and long term disability benefits, disability claims and Canada Pension Plan disability benefits.

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