Non-occupational long-term disability (LTD) typically comes with chronic pain, emotional anguish, and hefty health expenses. These are bad enough. However, the worst thing about it is it keeps you from going back to work to cover those expenses. It’s a catch-22.
Up to 12% of Canadians lose days of work every year due to disability
The impact of disability on workers and organizations is significant. A person with a disability loses at least 40% of their earnings while away from work. Employers pay up to five times an employee’s annual salary to train their replacement.
57% of long-term disability benefits applications get denied
Private insurance companies do not publish denial rates for long-term disability claims. However, some data is available for Canada Pension Plan (CPP) disability applications. Service Canada reports a 43% acceptance rate in 2015 (latest data available). Denied applicants can appeal the decision, but about two-thirds (66%) give up after the first denial letter.
Denial rates of private insurance companies are likely to be higher. Moreover, the claims and appeals process will probably be much more challenging.
However, you shouldn’t give up. Diamond & Diamond can help you fight for your rights and get the benefits you deserve.
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What Is Considered a Non-Occupational Long-Term Disability?
There is no such thing as a standard for what constitutes a non-occupational long-term disability. In most cases, you must prove you are totally disabled. However, private insurance companies typically make the threshold quite challenging to reach.
Generally, LTD is any injury or condition of a psychological or physical nature that prevents you from working. An occupational disability is work-related.
Non-occupational long-term disability refers to injuries or medical conditions unrelated to your job, making you ineligible for workers’ compensation. An example would be sustaining spine injuries in a car accident while on vacation.
Other common disabilities claims involve:
- Circulatory issues
- Mental Disorders
- Musculoskeletal conditions
- Nervous System disorders
Most people have a long-term disability plan as part of the group life insurance paid by employers in Ontario. It is also possible for you to pay the premiums for long-term disability insurance on your own. In either case, the policy must be in force before the onset of your disability to claim benefit payments.
Qualifying for payments typically requires meeting your policy’s description of what constitutes “total disability.” In most cases, total disability means you cannot carry out essential duties of your occupation because of your injury, illness, or condition. However, some policies might use the phrase “any occupation,” meaning work other than what you did before the onset of your disability.
In other words, the fine print in your policy might make it hard for you to claim LTD benefits. However, an experienced LTD attorney can get through the legalese and ensure you get the most out of your policy.
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What Are Long-Term Disability Benefits?
If you qualify for long-term disability coverage, you can claim disability income replacement. The benefit is usually paid monthly, typically 60% to 85% of your regular wage.
However, most LTD insurance policies stipulate you can only receive LTD benefits after a waiting period. The waiting period may be up to six months, during which you may have eligibility for short-term disability benefits.
After the waiting period, you can apply for LTD benefits, provided you meet the requirements. You might be eligible to receive benefits until you turn 65. However, some insurance companies may limit the time frame to two years. To continue receiving benefits, you must prove that you are totally disabled and cannot do any type of work.
The problem is most insurance companies will not make it easy to file or process disability claims. Some may deny your claim because of a pre-existing condition or other exclusions. Others may try to reduce the benefit amount for whatever reason.
It is in the best interest of insurance companies to deny or reduce your LTD benefits. They routinely make it hard for you to succeed in your claim. Our job is to ensure they keep their end of the deal.
You can try to file a claim on your own and hope for the best. However, the better way is to fight fire with fire and get professional help.
Contact Our Toronto Long-Term Disability Lawyers at Diamond & Diamond
Non-occupational long-term disability can be emotionally, physically, and financially devastating. If you have a long-term disability insurance policy, you should be able to claim benefits without trouble.
Unfortunately, that is not the case. Insurance companies make it difficult to file claims and receive benefits. We can help you overcome obstacles and jump hurdles when filing for LTD benefits.
Diamond & Diamond Law has years of experience dealing with insurance companies in various scenarios. Our lawyers have successfully handled many personal injury lawsuits and long-term disability cases. We help our clients prevail over challenges ad get the compensation they deserve.
We aim for a quick resolution of your case. Contact us at 1-800-567-HURT or fill up an online form to schedule your free consultation.
Do you suffer from injuries or illnesses outside of work that prevent you from working? You may be entitled to Non-Occupational Long Term Disability benefits. Contact our experienced long-term disability lawyers at Diamond & Diamond.
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