By Matt Lalande in Long-Term Disability on April 19, 2019
If your long-term disability claim is approaching the 2 year mark, it is important to understand that your policy’s change of definition will soon be coming up. Many, if not all insurance policies contain a provision that at the 2 year mark, a claimant must be totally disabled from doing any job. It is at this time that the disability carrier may choose to perform an investigation to prove that you no longer need monthly benefits. Living with your disability is frustrating enough, let alone the added stress of worrying about your disability benefits being unreasonably cut off. If you are panicking about your future, know that our Hamilton long-term disability lawyers are here to help you.
Our team of expert legal professionals has assisted many claimants after they have been unreasonably cut off from their benefits after the 2 year change of definition. We have recovered millions of dollars in unpaid benefit claims for our clients. Contact us for a free, no-obligation consultation to learn more about your options and fight for the benefits you deserve.
When you apply for disability benefits, you will generally be required to prove that you are totally disabled in order to qualify for long-term disability income. In order to prove that you are totally disabled, you must initally prove that you are unable to perform the substantial duties of your occupation. This initially applies to the occupation which you performed when you became disabled. After 2 years, if you are still totally disabled, you must be able to show that you are unable to perform any duties of any occupation for which you are reasonably suited by education, training or experience. It is at this time that your insurance carrier will investigate your situation and determine whether you are still qualified as totally disabled according to these policy definition.
It is important to understand the terms of your insurance policy, as these terms may differ between policies and claimants. Most policies include “Own Occupation” and/or “Any Occupation” coverage that determines the classification of a total disability. “Own Occupation” refers to your inability to perform your own occupation, while “Any Occupation” coverage provides benefits to you when you cannot perform the duties of any occupation within your field, education, income level, or experience. Your policy may also consider any similar occupation to which your knowledge and expertise could be adapted to.
In the first 2 years, a total disability definition is satisfied if you are unable to perform the substantial duties of your “own occupation.” After 2 years, the definition of total disability changes to “any occupation” – meaning that a claimant must be unable to perform the duties of any occupation for which he or she is reasonably suited by education, training and experience. Some insurance comapanies have taken things a bit further – and include “any occupation for renumeration or profit”.
You should talk to a disability lawyer as soon as possible. Many insurance companies will hire their own private investigators and conduct their own research in order to terminate your disability coverage after 2 years. Your adjusters will ask you a variety of new occupationally related questions, and they may request updated statements from medical and vocational professionals – or conversly they may deny your benefits without a proper clinical investigation. They may also conclude you are not participating in a proper treatment plan – or worse, they may have their own doctor conclude you do not suffer a total disability.
If you have been denied or cut off disability, there are options available to you, and it is important that you consult a disability lawyer to assist you in the process.
Lalande Personal Injury Lawyers are experienced Hamilton disability lawyers that with the resources and legal expertise to help you navigate your claim. We have represented claimants in your situation who have been unfairly treated by their insurance carriers. We have represented many claimants at all stages of disability and we would be sure to ensure that you continue to receive those benefits as a paying policyholder, and we will pursue your case until you are fairly treated.
Our team of Hamilton disability lawyers will work with you to appeal your carrier’s decision to cut you off from your benefits. Our Hamilton disability law firm has represented disability claimants province-wide against every major disability insurance company. We work with specialists, top medical professionals, and vocational experts who examine all of the details of your case to build you a strong defence. Together, this provides the basis to prove that the demands and limitations of your disability prevent you from being able to work and that you are entitled to continue receiving your long-term disability benefits.
If you have been denied long term disability at the two year mark, or at the change of definition, contact our office for more information. Our Hamilton disability lawyers represent claimants at all stages of a claim for disability income benefits – and not only in Hamilton, but provincewide. Call us at 905-333-8888 or fill in a contact form and we will get back to you as soon as possible. Our consultations are free and we offer no fee or cost unless you get paid. We represent disability insurance claimants all over Ontario.