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    Home > Practice Areas > Long-Term Disability Claims

    After an accident, you may feel as though your life has been turned upside down. In such instances, regular consultations with your healthcare provider can provide valuable insights about your medical condition. While one always hopes for the best possible outcome, it’s not always the case. After assessing your situation, your doctor might conclude that you have a long-term disability.

    Navigating Life with a Long-Term Disability

    The aftermath of a long-term disability diagnosis can significantly impact your life. It might hinder your ability to return to a cherished job or partake in activities as effortlessly as before. Perhaps, due to constant discomfort, you find it tough to stand or sit for extended periods. What’s more, securing the compensation you need to continue living a fulfilling life without the fear of going into debt can be an uphill battle.

    Statistics Linking Disability to Employment

    In the 2017 Canadian Survey on Disability, Statistics Canada unveiled crucial data correlating the severity of disabilities with the likelihood of unemployment. The findings indicated that:

    • As the severity level rose, the chances of being employed diminished
    • Among participants aged 25 to 64, just 31% of individuals with severe disabilities were employed.

    Although this survey covers various types of disabilities and does not explicitly outline the details of long-term disabilities, it highlights a universal truth: irrespective of the type of disability, those with severe conditions can find it challenging to retain employment or continue working. The survey further revealed that disabilities related to pain, flexibility, mobility, and mental health were the most common disability types.

    At Bergeron Clifford, we frequently assist clients dealing with these types of disabilities, providing legal counsel on how to proceed with their insurance coverage claims.

    Working with Experienced Personal Injury Lawyers

    Our reputable long-term disability claim lawyers can help you file your claim or appeal in a way that maximizes its chance of success. At Bergeron Clifford, our team of legal professionals cares about your story and aims to advocate for your rights and fair compensation to live with dignity.

    What are the Causes of a Long-Term Disability?

    A long-term disability refers to a medical condition that impedes your ability to carry out your regular job responsibilities for at least two years. If you find yourself unable to return to work in any capacity, you may qualify for long-term disability benefits beyond that initial period. Some causes of long-term disabilities include the following:

    What is Long-Term Disability Coverage?

    This type of coverage is designed to replace a significant part of your current income if you’re hurt and unable to work. When you’re first injured, you might qualify for short-term disability coverage until it becomes clear you won’t be able to resume your job for an extended period, if ever. Long-term disability coverage typically provides 60% to 85% of your pre-injury income until you recover. If your health concerns are permanent, you may receive this income for the rest of your life.

    Long-Term vs. Short-Term Disability Insurance

    A key difference between long-term and short-term disability insurance is the coverage length. Short-term typically covers up to six months from the initial incident and injury, although specifics can vary between insurance plans. In some cases, if you don’t have coverage, you may be eligible for Employment Insurance (EI).

    Long-term disability insurance varies across providers, and generally, the road to receiving these benefits can take more time and be more difficult to claim. Despite your injury being permanent, the income you receive is not guaranteed.

    Other Disability Benefits Options

    In addition to insurance companies, our team of seasoned lawyers can help you navigate the complexities that come with applying for other disability benefits. Options like Canada Pension Plan disability benefits can help aid in your recovery and allow you to continue pursuing the care and support you need while we work on your insurance denial case.

    What Evidence is Needed to Win a Claim?

    Insurance companies typically require a range of documentation to validate your need for long-term disability benefits and income replacement:

    • Extensive medical records
    • Specific tests and diagnostic results
    • Notes from your doctor

    To prove that you are entitled to long-term disability, you must demonstrate that you are unable to perform the same job duties you assumed before your accident or illness. Insurance companies often set stringent conditions to fulfill this criterion, making it more challenging for you to secure the benefits you rightfully deserve.

    Potential Limitations for Disability Claim Eligibility

    Your application for long-term disability income may be outright denied, or the insurance company may initially provide benefits only to discontinue them after a short duration. They might claim that sufficient time has passed and by their standards, you can return to work despite your injuries preventing you from doing the same job you did before.


    What Happens After an Insurance Denial?

    If an insurance company has denied you the benefits you’re entitled to, you don’t need to give in or give up. You have the right to appeal an insurance denial and should do so after consulting with our experienced lawyers. With our legal team advocating for you, we can increase your odds of favourable negotiations with the insurance company or winning an appeal.

    Long-Term Disability Appeals

    We can also help you provide the necessary documents that your insurance requires to confirm your disability and inability to return to work. If the reason you cannot return to your job is because of an accident, you might also have grounds to initiate legal action against the party responsible, which we can certainly help you with.

    How Bergeron Clifford Can Help

    A retrospective cohort study linked the duration of long and short-term disability claims to prolonged recovery concerns for individuals, meaning that it is of the utmost importance to ensure those who need these benefits receive them in a timely manner. At Bergeron Clifford, we specialize exclusively in personal injury cases, bringing the requisite knowledge and expertise required to ensure the best outcome for your personal injury claim.

    If your insurance claim has been denied, the help of our long-term disability claim lawyers can make all the difference. Contact us to schedule a free consultation, learn more about our process, and discover how our legal professionals can support you on your journey after an accident.

    Frequently Asked Questions

    Long-term disability insurance is a type of coverage that provides financial benefits to individuals who are unable to work due to a disabling injury or illness for an extended period of time. It typically replaces a portion of your income throughout the duration of your disability.

    Eligibility for long-term disability benefits can vary based on your insurance policy. Common requirements include being employed and actively working at the time the disability occurred, satisfying a specified waiting period, and providing medical proof of your disability. Our team can help determine your eligibility by examining the specifics of your policy.

    If your long-term disability claim is denied, you have the right to appeal the decision. It is crucial to understand the specific reasons for the denial and gather additional evidence to support your claim. Our team of lawyers will ensure you understand the appeal process and guide you in charting a path forward for your claim.

    The duration of the claims process can vary considerably, depending on factors like the complexity of your case, the responsiveness of the insurance company, and the need for further medical evidence. It often takes several months to a year or more to reach a resolution.

    Many long-term disability policies include provisions that allow for some level of work while receiving benefits. However, the specific details and limitations can vary. We recommend reviewing your policy and consulting your legal team to fully understand the constraints and reporting requirements should you choose to continue working during the processing of your claim.

    Our team of personal injury lawyers works on a contingency fee basis, which means we only get paid if we successfully obtain fair compensation for you. Our fee is then a percentage of the recovered benefits or settlement. For more details about how this payment process works, we encourage you to reach out to us.

    Going through the claims process can be challenging, particularly when your focus should be on recovery and personal health. Working with a seasoned long-term disability legal team, like the professionals at Bergeron Clifford, ensures comprehensive support for your claim. We can help assemble pertinent medical records, including diagnoses, treatments, and test results, alongside documentation of your employment history, job description, and any exchanges with the insurance company, ensuring your paperwork is in order. If any further documentation is required, we will guide you through what is needed and ensure it can be attained.

    Contact Bergeron | Clifford LLP

    Contact us at 866-384-5886 or fill out our online form if you have had a concussion or other head injury in Eastern Ontario. We can meet you at our office locations in Kingston, Ottawa, Whitby, Carleton Place, Perth or other local offices, or wherever is most convenient for you.

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    Recovering from, or adapting to, a serious injury can take time. However, given enough time and proper care, many injured people are able to return to a life very much like the one they knew before suffering the injury.

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