By Matt Lalande in Uncategorized on December 24, 2024
Recent reports indicate a rise in long-term disability claims in Canada, with mental health-related disabilities becoming increasingly prevalent. In 2022, 39% of individuals reporting a disability cited mental health-related issues, marking a six percentage point increase from 2017.
From our perspective, insurance companies have increasingly resorted to wrongfully denying long-term disability benefits claims, often after initially approving and paying out short-term disability benefits or providing coverage for two years. These denials are typically justified by the insurers through assertions that the claimant’s condition has improved, that the claimant has failed to adhere to a prescribed treatment plan, or that the definition of disability has undergone a change. This alarming practice has left countless disabled individuals without the financial support they desperately need and deserve.
It is essential to recognize that a denial of long-term disability benefits does not necessarily represent the end of the road. The reasons for denial may vary, ranging from insufficient medical evidence to support your claim, a change in the definition of disability within your policy, damaging surveillance footage, the failure to adhere to a prescribed treatment plan or simply that the adjuster has made the decision to push you back to work based on an internal review or a review of your file by an internal medical consultant.
However, rather than engaging in speculation, the most prudent course of action is to seek the professional guidance of a qualified long-term disability lawyer. It is simply impossible to navigate the disability insurance system alone after a denial of benefits.
Facing a denial of your long-term disability benefits can be overwhelming, but you’re not alone. Understanding your rights and the steps to challenge this decision is crucial. This guide, authored by experienced disability lawyer Matt Lalande, provides actionable advice to help you navigate the appeals process effectively.
Facing a denial of long-term disability benefits is not just frustrating—it’s an overwhelming experience for the claimant, intensifying stress levels and placing significant strain on their mental and physical health. The financial uncertainty often affects the entire family, creating tension and anxiety as they try to make ends meet. While struggling to manage their health and recovery, claimants are forced to navigate a complex appeals process, often feeling powerless against the resources of large insurance companies. This compounded stress can leave individuals feeling isolated and unsure of where to turn for help.
The probability of an insurance company reversing their decision after a denial is virtually zero – and once they deny your claim, it’s you against them. The only thing they will offer you is their appeals process, which, in our opinion, is inherently biased. The same insurer that denied your claim is the now…adjudicator for your appeal.
The reality is that facing a denial and dealing with your insurance company is not a task to take on alone. Without a strong advocate, claimants are often at the mercy of insurance companies that will deny claims and turn off communication. A disability lawyer can level the playing field, cutting through the complexity of policies and the legal system to ensure your case is presented with precision, protecting your rights and fighting for the benefits you deserve.
Finding a qualified and experienced long-term disability lawyer in your area is crucial when seeking to appeal a denied claim or navigate the complexities of the legal system. And remember, if you live in a rural area and are not within the parameters of a disability specialist, don’t give up! Although it is a bit more challenging to find a disability specialist, you can hire remotely and conduct your case meetings with your lawyer via video-conferencing platforms.
Here are several ways to locate a reputable disability lawyer:
Friends and family: Reach out to friends and family members who may have experience working with disability lawyers in Canada or know someone who has. Personal recommendations from trusted sources can provide valuable insights into a lawyer’s professionalism, communication skills, and success rate.
Lawyers you know: If you have previously worked with a lawyer for other legal matters, such as a real estate transaction or a family law issue, consider asking them for a referral to a disability lawyer. Many lawyers have professional networks and can recommend colleagues who may be able to recommend someone who specializes in disability law.
Media advertising: Pay attention to advertisements in local newspapers, magazines, television, or radio. Some disability law firms may advertise their services through these channels, providing information about their expertise and how to contact them for a consultation.
Local bar associations: Contact your local bar association, such as the Hamilton Law Association, and inquire about their lawyer referral services. These organizations often maintain lists of lawyers practicing in various areas of law, including disability law, and can connect you with qualified professionals in your area.
Internet and Google reviews: Conduct an online search for disability lawyers in your area using search engines like Google. Many law firms have websites that provide information about their services, experience, and client testimonials. Additionally, you should read Google reviews and ratings from previous clients to gauge their satisfaction with the lawyer’s services and outcomes.
Remember – when selecting a long-term disability lawyer, it is essential to choose someone with extensive experience handling cases similar to yours, a track record of success, and a commitment to providing personalized attention and guidance throughout the legal process. Consider scheduling initial consultations with potential lawyers to discuss your case, assess their expertise, and determine if they fit your needs. Many disability lawyers in Hamilton offer free initial consultations, allowing you to gather information and make an informed decision without financial obligation.
When selecting a disability lawyer in Canada, it is crucial to find a legal professional who not only possesses the necessary expertise and experience to handle your case effectively but also demonstrates a deep understanding of the unique challenges faced by individuals with disabilities.
For over 21 years, Matt Lalande has established himself as a leading authority in disability law. With a wealth of knowledge and a proven track record of success, Matt Lalande is well-equipped to provide exceptional legal representation to clients seeking to navigate the complexities of disability claims. The following are compelling reasons why choosing Matt Lalande and the team at Lalande Personal Injury Lawyers is a sound decision for those needing legal advocacy in disability-related matters:
Extensive experience: With over 21 years of experience in disability law litigation, Matt Lalande profoundly understands the complex legal landscape surrounding disability claims in Canada. He has successfully represented countless clients, helping them navigate the challenging process of appealing denied claims and securing the benefits they deserve.
Focused expertise: Unlike general practice law firms, we specialize in disability law. This focus allows us to stay up-to-date with the latest developments in the field and develop innovative strategies to advocate for our clients effectively. By concentrating on disability law, we can provide the highest level of representation and advice tailored to your specific needs.
Personalized attention: We understand that every disability claim is unique, and we treat each case with the individualized attention it deserves. Matt Lalande takes the time to listen to your story, understand your challenges, and develop a customized legal strategy that aligns with your goals. You can expect regular communication, updates on your case, and prompt responses to your questions and concerns.
Compassionate advocacy: Living with a disability can be emotionally and physically challenging. We recognize your difficulties and approach your case with empathy and understanding. Matt Lalande is your legal advocate and support system throughout the process, providing guidance and reassurance every step of the way.
Track record of success: Our reputation for success in disability law speaks for itself. Matt Lalande has a proven track record of achieving favourable outcomes for his clients through negotiations with insurance companies or litigation in court. We are committed to fighting tirelessly to protect your rights and secure the benefits you are entitled to under your disability policy.
No upfront costs: We understand the financial strain that often accompanies a disability claim. That’s why we offer our services on a contingency basis, meaning you don’t pay any legal fees unless we successfully recover benefits on your behalf. This approach ensures you can access high-quality legal representation without adding to your financial burdens.
We wrote the book on Disability Law: Matt Lalande’s involvement in writing “Disability Insurance Law in Canada” demonstrates his deep understanding of the intricacies of this area of law and his commitment to promoting a broader understanding of the legal issues faced by individuals with disabilities. By contributing to this leading book, Matt Lalande has helped to advance the field of disability law, shape its evolution in Canada from a plaintiff’s perspective, and ensure that the rights and interests of individuals with disabilities are protected. When choosing a disability lawyer, Matt Lalande’s exceptional qualifications, as evidenced by his contributions to this seminal book, make him an ideal choice for those seeking legal representation in this complex and evolving field.
By choosing Lalande Personal Injury Lawyers as your disability lawyer, you can have confidence that your case is in the hands of a skilled, experienced, and compassionate legal professional dedicated to achieving the best possible outcome for you. We are committed to providing the support, guidance, and advocacy you need to navigate the complex world of disability law and secure the benefits you deserve.
When preparing for a meeting with your Hamilton disability lawyer, it is essential to take several steps to ensure the consultation is productive and informative. Here are five quick reasons why proper preparation is crucial and how you can better prepare:
Maximize the effectiveness of your meeting: By gathering all relevant documents, such as your employment information, your CV, a summary of your medical conditions, and your disability insurance policy, you can provide your lawyer with a comprehensive understanding of your case. This allows your disability lawyer to quickly grasp the details of your situation and offer more targeted advice, making the most of your time together.
Facilitate open communication: Before the meeting, take some time to reflect on your experiences and the challenges you face due to your disability. Make a list of questions and concerns you want to address with your lawyer. This preparation helps you articulate your thoughts more clearly, enabling your lawyer to understand your needs better and provide appropriate guidance.
Bring a Summary of your medical conditions: For your first meeting with a disability lawyer, it’s essential to provide a clear and comprehensive summary of all your medical symptoms and conditions. It would be helpful to provide an overview of your medical conditions, along with any related symptoms, treatments, medications, and how these impact your daily life and ability to work. This detailed overview will help your lawyer better understand your case and build a stronger claim on your behalf.
Ensure a thorough understanding of your rights: During the meeting, your disability lawyer will explain your legal rights and the various options available to you. To make the most of this discussion, familiarize yourself with the basic concepts of disability law beforehand. This foundational knowledge will help you better understand the information provided by your lawyer and enable you to ask for more information.
By taking the time to prepare, you can set the foundation for a successful collaboration with your lawyer and work towards achieving a favourable outcome in your disability case.
Understanding the intricacies of your long-term disability policy is crucial when navigating the complex landscape of disability claims. It is essential to recognize that most if not all, long-term disability policies in Canada are divided into two distinct stages: the “own occupation” stage and the “any occupation” stage.
During the initial stage, which typically lasts for the first two years of disability, you must demonstrate that you are totally disabled from performing the substantial duties of your own occupation – the job you were engaged in when you first became disabled. This means that if your disability prevents you from fulfilling the essential functions of your specific role, you may be eligible for long-term disability benefits during this period.
However, it is crucial to be aware that at the two-year mark, the definition of total disability often undergoes a significant change. At this point, the criteria for eligibility shifts from being unable to perform the duties of your own occupation to being unable to perform the duties of any occupation for which you are reasonably suited, considering factors such as your education, training, and experience. This change in definition represents a more stringent test that you must meet to continue receiving long-term disability benefit payments.
In determining whether you meet the criteria for total disability under the “any occupation” stage, various factors are taken into account. These may include your age, the degree of specialization in your occupation, your level of specialized training or education, and the level of income you are accustomed to earning in your own occupation. It is important to understand that these factors can significantly impact your eligibility for continued benefits.
Additionally, if you have applied for benefits from other sources, such as the Canada Pension Plan (CPP) or the Workplace Safety and Insurance Board (WSIB), it is essential to bring any relevant documentation to discuss with your lawyer. Many long-term disability policies require claimants to apply for benefits from these other sources, as they may be deducted from the long-term disability benefit payments they receive. It is important to note that even if you choose not to apply for these additional benefits, your long-term disability carrier may still deduct the amount you would have been entitled to receive from your monthly long-term disability benefit.
By thoroughly understanding your policy and gathering all relevant documentation, you can work closely with your disability lawyer to build a strong case and ensure that you receive the benefits to which you are entitled. Remember, your lawyer is there to guide you through this challenging process with compassion and expertise, advocating for your rights every step of the way.
If you have been denied or cut off your long-term disability benefits, fill out a contact form or call our office today at 905-333-8888. Remember, it takes one phone call to begin your case. You have the full right to commence an action against your disability insurance company for wrongfully denied benefits. Protect your future and call our Hamilton Disability lawyers today.
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Insurance companies may deny long-term disability claims for various reasons, including insufficient medical evidence, failure to adhere to prescribed treatment plans, surveillance footage, or changes in the policy’s definition of disability.
If your long-term disability benefits are denied, seek professional guidance from a disability lawyer. They can help you understand your rights, gather evidence, and appeal the denial effectively.
“Own occupation” refers to being unable to perform your specific job duties, while “any occupation” requires proving you cannot work in any job for which you are reasonably suited based on education, training, or experience.
Yes, many disability lawyers in Canada offer remote services via video conferencing, allowing you to work with a lawyer even if they are not located near you.
A disability lawyer can review your case, communicate with insurers, challenge unfair practices, ensure compliance with legal deadlines, and build a strong case to secure the benefits you deserve.
I was a dental hygienist that suffers from really bad scoliosis. My insurance company ignored my doc & cut my benefits off & told me I could do “something”. Matt got me CPP Disability and and LTD settlement – I don’t know what I would have done without him.
My daughter was killed by a drunk driver and it forever changed all of our lives. It seemed that for two years time stopped. This was no an easy journey. Matt let me sit in on the discovery of the driver and boy, he never let up. In the end, our grand-daughter was taken care of and we were compensated for our loss – which we then donated to a cause we believed in.
I call Matt my knight in shining armour. After I was struck by a car while cycling and permanently crippled, he fielded all communications with my especially difficult and downright nasty insurance adjuster. Every step of my care was a battle and I did not have the strength to fight alone.
I lost my leg in a terrible motorcycle accident and Matt help me recover compensation I need because I could not work and the cost of prosthetics and rehab are out of this world. I don’t know what I would have done without him.
My brother ended up paralyzed after a car accident and Lalande did SO MUCH to help get things straight from him getting out of the hospital to all his care for life. We are so grateful for Matt & Heather. I don’t know how my family could have done this without them.
