Long-term Disability Lawyer Ottawa
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Facing a long-term disability is undoubtedly a daunting journey filled with both physical and emotional challenges. One significant obstacle may include potential financial struggles due to an inability to work. At Bergeron Clifford, our team of experienced personal injury lawyers is here to provide you with the legal support and guidance you need to navigate the complexities of long-term disability claims.
We recognize the unique nature of each long-term disability case and approach each with the utmost compassion, empathy, and dedication. We aim to alleviate the burden placed on you and your loved ones by working tirelessly to secure the benefits you are entitled to under your insurance policy.
What are Long-Term Disability Benefits?
Long-term disability benefits are a form of insurance coverage that provides financial assistance to individuals rendered unable to work due to a disabling condition or injury. This form of benefit aims to replace a portion of your lost income during the period of your disability. Whether you have a private policy or are covered under a group benefits plan, our lawyers can help you understand the specific terms and conditions of your coverage. For more information on long-term disability benefits, check out our blog on the subject written by our associate lawyer, Casey Dorey.
Types of Disability Insurance
Disability insurance is designed to protect individuals from the financial impact of illness or injury that affects their ability to work. In Ottawa and across Canada, the most common types of disability insurance include short-term disability (STD), long-term disability (LTD), mortgage disability insurance, and critical illness insurance. Each type offers distinct coverage to help manage different situations.
- Short-Term Disability Insurance (STD)
Short-term disability insurance provides temporary income replacement, typically for a period of up to six months. It helps cover essential expenses while you recover from a non-permanent injury or illness, offering financial support during this brief window when you are unable to work. This type of insurance is often provided through an employer, but individual policies are also available. - Long-Term Disability Insurance (LTD)
Long-term disability insurance extends financial protection when a disability lasts beyond the coverage of short-term policies, offering support for an extended period—often two years or longer. This coverage is crucial for individuals who face long-term or permanent disabilities that significantly impact their ability to return to work in any capacity. - Mortgage Disability Insurance
Mortgage disability insurance ensures that your mortgage payments are covered if you become disabled and are unable to work. This type of insurance focuses on one of your largest financial commitments—your home. While it doesn’t replace your general income, it alleviates the burden of keeping up with mortgage payments, allowing you to maintain stability in your housing during difficult times. - Critical Illness Insurance
Critical illness insurance provides a lump-sum payout upon diagnosis of a serious illness, such as cancer or a stroke. This insurance is designed to help you manage the additional expenses that come with a significant health crisis, from medical treatments to modifications to your living space. It’s a versatile financial resource that can be used however you need, whether to support your recovery or cover day-to-day living costs.
Each of these types of disability insurance plays a distinct role in providing peace of mind and financial stability during challenging times, allowing you to focus on recovery rather than financial stress.
Short-Term Disability Coverage: Common Issues and Eligibility
Short-term disability (STD) insurance typically covers 60% to 85% of your pre-injury income for up to six months. This policy is intended to support individuals recovering from temporary injuries or illnesses, helping them manage daily expenses during a work absence. Eligibility usually requires proof of employment, a waiting period, and medical documentation verifying the injury or illness.
Common issues include delays in filing claims, insufficient medical evidence, and time-sensitive applications. Many claimants face challenges when submitting paperwork late or providing incomplete documentation. It’s critical to ensure all medical records and forms are properly filed within the insurer’s required timeframe to avoid complications. Working with a lawyer can help streamline this process, ensuring a smoother claim experience.
Long-Term Disability Insurance: Policy Terms and Claim Strategies
Long-term disability (LTD) insurance offers extended financial protection, typically replacing 60% to 85% of your pre-injury income. LTD policies can cover you until retirement or for the duration of your disability. It’s important to familiarize yourself with the policy terms, including any renewal conditions and the duration of coverage.
To successfully file a claim, providing comprehensive medical evidence is essential. Your doctor’s notes, diagnostic tests, and detailed medical records can significantly strengthen your case. However, even with strong documentation, claimants may face insurer pushback, delays, or denials. Legal assistance can help you navigate these roadblocks, ensuring that you meet all the requirements to secure your benefits.
Compensation for Long-Term Disability Benefits
If your long-term disability claim is successful, you may be entitled to various forms of compensation. These can include ongoing monthly payments to replace a portion of your lost income, reimbursement for medical expenses, vocational rehabilitation services such as occupational therapy, kinesiologists, mental health support, speech and massage therapy, and potential compensation for pain and suffering. Our lawyers will work closely with you to understand your unique circumstances and fight for the fair compensation available under your policy.
Common Reasons for Long-Term Disability Claim Denials
There are several common reasons why long-term disability claims are denied, including:
- Insufficient Medical Evidence: Without strong, detailed, and current medical documentation, claims can be rejected. Working closely with your healthcare provider is crucial.
- Missed Deadlines: Insurance companies enforce strict deadlines, and missing these can result in an automatic denial.
- Non-Compliance with Treatment: Failing to follow prescribed treatment plans can disqualify you from receiving benefits.
- Policy Exclusions and Pre-Existing Conditions: Many policies exclude certain conditions or deny coverage for pre-existing conditions, making it harder to qualify for benefits. It’s important to thoroughly review your policy.
Step-by-Step Disability Claim Process
Filing a long-term disability claim can be a complex process, but at Bergeron Clifford, we guide clients through each step to increase their chances of success.
- Initial Consultation: During this free consultation, we assess your situation, evaluate the strength of your case, and provide an overview of your options.
- Filing Your Claim: We assist in gathering all necessary documentation, including medical records and employment details, to build a strong case.
- Insurance Company Review: Insurers will review your claim and may request additional information. We handle communication with the insurer to ensure a timely review.
- Appealing a Denied Claim: If your claim is denied, we will prepare a comprehensive appeal, using expert knowledge to counter the insurer’s reasons for denial.
- Receiving Your Benefits: We finalize the process by ensuring that your benefits are paid out smoothly and that any remaining issues are addressed.
How to Appeal a Long-Term Disability Benefits Denial
Should your long-term disability claim be denied, our team advises prompt action, given that the window to appeal such decisions is usually limited. The exact period you have for an appeal varies; for example, in the case of CPP disability benefits, you have 90 days from the time you receive their reconsideration decision. This shortened period can cause additional stress as navigating the appeals process can be complex.
Opting to collaborate with seasoned legal professionals like our team can ease this process. We will steer you through each step, ensuring that all necessary documentation is prepared and submitted within the required timelines. We will work diligently to build a strong case on your behalf, advocating for your rights and maximizing your chances of a successful appeal.
How Our Lawyers Can Help
At Bergeron Clifford, our dedicated team of long-term disability benefits lawyers has a proven track record of success in handling complex disability claims and is committed to providing you with personalized legal representation. Our lawyers will:
- Evaluate your case: We will review the details of your disability claim and help you understand your rights and legal options.
- Gather evidence: We will work with you and medical professionals to gather the necessary evidence to support your claim, including medical records, expert opinions, and other relevant documentation.
- Negotiate with the insurance company: We will engage in negotiations with the insurance company on your behalf, striving to secure a fair settlement that reflects the true value of your claim.
- Litigate if necessary: If a fair resolution cannot be reached through negotiation, our skilled litigators will be prepared to take your case to court and advocate for your rights before a judge.
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Contact Us Today
If you are facing a long-term disability and need assistance in obtaining the benefits you are entitled to, we are here to help. We understand the complexities of these cases and are dedicated to advocating for your rights.
Contact Bergeron Clifford today to schedule your free consultation. During this initial meeting, we will listen to your concerns, evaluate your case, walk you through our process, and provide you with clear guidance on the best course of action. Our team is here to provide you with the personalized advice and support you need to navigate your case successfully.
Frequently Asked Questions
Long-term disability benefits can be available for a wide range of disabilities, including physical injuries, chronic illnesses, mental health conditions, and other medical conditions that significantly impede your ability to work. The specific qualifying criteria may vary depending on your insurance policy. We encourage you to contact us for tailored guidance based on your unique situation.
If your claim is denied, it is essential to take prompt action. Our team can assist you in filing an appeal within the required timeframe. We will conduct a comprehensive review of your case, determine the reasons for the denial, and construct a compelling counter-argument to challenge the decision. Our goal is to maximize your chances of success during the appeals process.
At Bergeron Clifford, our operational model is based on contingency fees. This implies that we do not impose any upfront charges, and our payment is contingent upon the successful resolution of your case. Acknowledging the potential financial strain you might be under, our primary objective is to afford you top-tier legal representation without exacerbating your financial obligations.
Both short-term and long-term disability benefits typically replace 60% to 85% of your pre-injury income, depending on the policy. This income helps maintain financial stability when you’re unable to work.
In Canada, the taxability of long-term disability benefits depends on whether the premiums were paid by you or your employer. If you paid the premiums, the benefits are not taxable. If your employer covered them, benefits may be taxed.
Eligibility often depends on medical documentation showing that you are unable to perform your job duties, as well as meeting the policy’s employment requirements. A detailed review of your insurance policy can help clarify the specifics.
Offsets, such as income from other sources (e.g., CPP Disability Benefits), can reduce the amount of long-term disability benefits you receive. Your policy will outline which income types impact your payout.
