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Have your your Long-Term Disability Benefits been denied for Arthritis? Do not accept your denial without speaking to our Hamilton Arthritis Disability Lawyers.
Serious arthritic pain can have a brutal and damaging impact on one’s quality of life. Over four million Canadians are affected by at least one type of arthritis in their lifetime. It is often associated with the effects of aging and with elderly populations, but the reality is that arthritis can affect anyone of any age. Arthritis can be a complex disease to manage, both for employees and for employers, as it often begins when people are in the prime of their working lives.
Arthritis, Osteoarthritis, and Other Types of Arthritis
Arthritis is often used as an umbrella term for a variety of different conditions that arise from joint pain. The two main types that we have seen debilitate workers and employees include osteoarthritis and inflammatory arthritis, such as rheumatoid arthritis.
Osteoarthritis: Sometimes recognized as degenerative joint disease, osteoarthritis is a form of arthritis that develops when the articular cartilage degenerates in a joint. The articular cartilage is a sponge-like slippery material covering the ends of bones at the point where they meet the joint, allowing the joints to slide back and forth with very little friction. For instance, the meeting point of the tibia (shin bone) and femur (thigh bone) at the knee.
It functions mainly as a shock absorber or cushion in the joint. When this “shock absorber” wears out or is worn down, Osteoarthritis or joint degeneration occurs. The articular cartilage decreases in size or volume when it wears out.
Bones lose their shock-absorbing buffers and start rubbing against each other without cartilage or with less cartilage. As the cartilage wears down, changes occur in the muscles and bones around the affected joints.
Nonetheless, the major problem with osteoarthritis is when the articular cartilage completely (or close to) degenerates, resulting in people developing pain, joint stiffness, and joint swelling when using them. Although the most common joints where people develop Osteoarthritis are the back, knees, hips, neck, and hands, it can occur in practically any joint.
Over time, the chronic pain from osteoarthritis, depending on location, can become so severe it can impact one’s ability to perform daily tasks.
With Osteoarthritis of the knee, for instance, a person may feel joint pain when walking because the cartilage cannot serve its function as a shock absorber. Osteoarthritis or wear-and-tear arthritis of the knee is commonly caused by daily “microtrauma,” injuries to meniscus cartilages or supporting ligaments, heredity, or deformity caused by fractures, either to the articular surfaces of the knee or to the femur or tibia.
Now, post-traumatic osteoarthritis is often caused by the loss of articular cartilage; hence, it is usually referred to as a “wear and tear” disease. While this isn’t entirely true because one does not need to injure a joint before developing osteoarthritis, osteoarthritis indeed develops at a more rapid rate in people who suffer acute and direct trauma to their joints and cartilage.
According to Pubmed, post-traumatic arthritis causes about 12% of all osteoarthritis cases. Those with post-traumatic osteoarthritis can experience symptoms such as swelling, synovial effusion, pain and sometimes intra-articular bleeding. In most cases, post-traumatic osteoarthritis can recover spontaneously, but the persistence of symptoms after 6 months may be considered pathological and chronic.
Post-traumatic osteoarthritis of the knee following trauma is quite common. The type of injury associated with posttraumatic osteoarthritis of the knee may be a fracture, cartilage damage, acute ligament sprain or chronic ligamentous instability. The most common clinical picture leading to a compensable knee replacement due to osteoarthritis involves trauma.
A direct injury causing either intra-articular fracture or a serious ligamentous injury resulting in chronic instability can lead to a “worn out” knee requiring replacement.
Rheumatoid arthritis: This is classified as an auto-inflammatory disease that can destroy the joints if the body’s immune system cannot function correctly. It is a type of inflammatory arthritis whereby inflammation is the major cause of joint problems. In addition to considerable stiffness and pain, inflammation can cause warmth and swelling in the joints.
Studies found that the inflammation that causes rheumatoid arthritis also leads to other problems. Rheumatoid arthritis patients usually suffer from such symptoms as fatigue, decreased appetite, depression, low-grade fever, muscle aches, pain and swelling in the joints.
Rheumatoid arthritis can span over months or years, which is why it’s also referred to as a chronic illness which can be brutally debilitating. The joints involved in rheumatoid arthritis depend on each person. For instance, some people only experience painful joints in their hands, while others may feel pain in their knees or feet.
However, a certain pattern in the joints can potentially be affected, which is one of the defining features of rheumatoid arthritis. The joints most commonly affected by rheumatoid arthritis are finger joints, wrists, elbows, shoulders, jaw, and some joints in the neck, hips, knees, ankles, and foot and toe joints.
Other types of arthritis: are generally classified as systemic conditions or musculoskeletal conditions. Systemic conditions include rheumatoid arthritis, osteoarthritis, lupus, and scleroderma. Musculoskeletal conditions may consist of fibromyalgia, reflex sympathetic dystrophy syndrome (RSDS), ankylosing spondylitis, and ehlers-danlos syndrome (EDS).
Can I Qualify for Disability Benefits if I Suffer From Arthritis?
Arthritic disease is a leading cause of pain and disability not only in Canada but worldwide. Millions are affected—men, women, elderly people, young people, and even children. It mainly affects an individual’s joints, causing pain and stiffness. In addition to the joints and bones, it can affect blood vessels, skin, kidneys, eyes, brain, and the immune system.
If left untreated, this crippling disease can worsen and disable a person and certainly render them unable to work and need disability income replacement benefits. Whether or not you qualify for long-term disability will depend on several factors.
Firstly, you must be able to satisfy your policy definition that you suffer from a total disability. Overwhelming authority tells us that the term total disability within the context of a disability policy does not signify an absolute state of helplessness but means such a disability renders a claimant unable to perform the substantial and material duties of their occupation in a usual or customary way. If your arthritis interferes with your ability to work and perform the substantial material duties of your occupation, then you will qualify for long-term disability benefits.
It’s important to note that you should participate in a treatment program and follow the advice of your medical doctors and specialists.
Also, it’s fairly common for individuals who suffer from disabling arthritis issues to suffer mental illness, such as serious depression and anxiety, that is pain-focused or pain-based.
It’s important to note that after two years on disability, most Canadian long-term disability carriers, such as Manulife, Sun Life, Great West Life, or Canada Life, hold policy definitions that change. After two years of collecting long-term disability benefits, a claimant must be unable to perform the substantial duties of any occupation for which he or she is reasonably suited by education, training and experience.
This is typically known as the “any occupation” test. It is a subjective test that our courts have generally applied without regard to whether the individual can perform any possible occupation on the planet.
Rather, the inquiry relates to whether the claimant can perform any occupation for which he or she would be reasonably suited by means of his or her training, education, and experiences. While all long-term disability policies differ in wording, they all generally require a consideration of the claimant’s work history, education, work experience, etc.
It’s important to discuss your case with a Hamilton arthritis disability lawyer as soon as you have been denied or cut off from LTD.
Why is my Insurance Carrier Denying my Disability Benefits for Arthritis?
Disability claims specialists, unfortunately, often look for reasons to deny or cut off their long-term disability benefits – even in cases where disability is evident.
Oftentimes, they will cut off benefits of their policyholders because the insurance carrier believes they have adequate medical evidence, missing medical records, your doctor is uncooperative or not providing required forms and information, there is video surveillance that reveals inconsistencies with your claim or evidence, you have missed deadlines or in most circumstances or the adjuster takes the position (without medical evidence or proof) that you do not meet the insurance policy definition of disability.
Many disability claims are denied or cut off at the two-year mark, or the definition changes from “own occupation” to “any occupation.” After this point, you must prove that you cannot work in any occupation related to or within the industry in which your previous occupation was classified.
This includes any occupation with a similar pay grade, educational background, vocational experience, or training. At this point, it’s important to contact an experienced Hamilton arthritis disability lawyer who can assist you in appealing your denial and obtaining the financial benefits you deserve. You have options – you have the right to fight, and you do not have to accept the denial.
How Can a Hamilton Arthritis Disability Lawyer Help me With my Claim?
Our disability law firm opts for a multidisciplinary approach utilizing the most reliable and professional medical, vocational, and social therapists and specialists within various industries to help prove your claim. Remember – you have the burden of proving your disability. It is our goal to help you confirm on a balance of probabilities that your injury, chronic illness, mental illness or medical condition has rendered you unable to return to work.
We will also provide you with our support throughout the duration of your claim, whether it is in a settlement or in court. Our Hamilton arthritis disability lawyers have access to valuable resources that can assist you every step of the way, from reliable support workers to positive and helpful customer service agents. Working with us means making your life easier during this already difficult time.
Contact a Hamilton Arthritis Disability Lawyer to Get Your Disability Benefits Back on Track
If you are suffering severe arthritic pain that is preventing you from working, our Hamilton disability lawyers offer free consultations at your convenience with zero obligation to retain our services after the initial meeting. If you are in too much pain to travel, we can meet over Zoom or come to you where it is most comfortable. We do not charge upfront fees as we understand hiring a lawyer can be an added fee you are reluctant to endure.
At Lalande Personal Injury Lawyers, we take pride in being trusted Hamilton personal injury lawyers since 2003. Over the years, we’ve helped our clients recover more than $45 Million in settlements and verdicts in personal injury, disability, and employment law cases. Whether you’re dealing with a life-changing injury, a denied disability claim, wrongful death, a hurt child or employment termination, we are here to provide compassionate and experienced legal representation. If you believe you have a case, call us today—we’re ready to help you secure the compensation you deserve.
Call Lalande Personal Injury Lawyers today, no matter where you are in Ontario at 905-333-8888 for your free consultation. Alternatively, you can contact us online, confidentially, by filling out a contact form.