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Ottawa Long Term Disability Lawyers

Did you purchase a long term disability insurance policy to protect yourself in the event that you became unable to work? Have you run into an issue in getting your claim for benefits approved? If so, you may need the legal help of an experienced long term disability lawyer in Ottawa.

Your insurance policy may have been in place to protect you, but getting the insurance company to provide you with the benefits that are rightfully yours may prove to be more challenging than you thought.

Discuss your circumstances with a respected Ottawa long term disability lawyer at SG Injury Law today to find out how to access the financial support you need when you need it most. You can reach us through our online contact form.

Long Term Disability Resources

ottawa disability benefits lawyers

How Our Ottawa LTD Lawyers Can Help

Don’t give up if the insurance company says you are not entitled to long term disability benefits for any of the reasons listed above or for any other reason.

What are LTD or Long Term Disability Benefits?

Long term disability (LTD) benefits are benefits that Canadians can collect when they are diagnosed with a disability that prevents them from being able to continue earning a living for an extended period of time.

​​If you are injured or otherwise impaired and can no longer work, there are government funded plans that can help replace your loss of income. However, these public plans may be difficult to qualify for or may only be of short duration. To fill the gap, many employees in Ottawa and across Eastern Ontario have access to short term (STD) and long term disability insurance (LTD) coverage. Sometimes this insurance coverage is provided as a group benefit through employment. Other times, individuals may obtain LTD coverage privately.

Every policy is different, and you will have had the opportunity to purchase the amount you needed when you signed up for your long term disability insurance policy. In most cases, the amount of benefits that you can collect will be between 50% and 70% of your gross weekly earnings. However, there may be instances where there is a monthly maximum allowed, especially in instances of high wage earners.

Many long term disability insurance policies also have adjustment clauses that allow the benefit amount to increase annually. To find out what your specific LTD benefits should consist of, review the details of your policy with your long term disability lawyer in Ottawa.

How Do You Qualify for Ottawa Long Term Disability Benefits?

To meet the eligibility requirements of your long term disability insurance policy, you will need to find out what the specific terms are of your policy. For many policies, there are several criteria that need to be met, such as:

There may also be specific waiting times to be aware of as well, including the amount of time you need to wait after being diagnosed with a disability or the amount of time that the policy has been active before you can seek benefits.

The best way to find out whether you met the eligibility requirements of your LTD policy is to speak with your long term disability lawyer in Ottawa about the specific details of your disability and policy.

How Long Can You Collect LTD Benefits in Ottawa?

Every person’s long term disability insurance policy is different, and may therefore have varying terms that are set for how long you can continue to collect LTD benefits. The type of disability you are coping with, and it’s classification with the insurance company will play a significant role in determining how long you will be able to receive LTD benefits.

For example, if you have been diagnosed as “totally disabled”, you might qualify for long term disability benefits for up to two years before your disability is reevaluated. At that point, your circumstances may change depending on your level of impairment and your expected medical improvement.

Generally, long term disability benefits can be collected until a claimant is well enough to return to work, or until they reach the age of 65.

Long Term Disability Benefits Refusals

Often, even though insurance premiums are paid, insurance companies still deny valid claims for long term disability benefits. The insurance company might come up with a variety of reasons for denying or cutting off your benefits. As long term disability lawyers assisting clients with claims in Ottawa, some of the reasons we frequently see for a termination or denial of an LTD claim include:

1) You do not meet the qualifying time requirements to claim benefits.

LTD policies usually contain notice provisions. Many times people do not assume they will be impaired over the long run and do not immediately apply for STD or LTD benefits. If you wait too long, the insurer may argue that you are in violation of a notice provision and that they have been prejudiced by the delay.

2) Your impairment does not meet the technical definition of disability, according to the insurance company adjuster.

Although you may not be able to work due to your impairment, the insurer may argue that your impairments are subjective. They may say that an illness such as fibromyalgia or depression cannot be objectively verified and therefore does not meet the disability test.

3) The insurance company “medical partner” has reviewed the file and determined you do not meet the medical test of disability.

Many insurance companies have consultants who are on the insurance company’s payroll or are paid significant sums of money by insurers to provide opinions on claims. It is not unusual to see “experts” like this who do not even practice medicine in terms of actually treating patients; they solely earn income by providing insurers with opinions. Given this lack of independence it is not surprising when these consultants provide an opinion that you do not meet the disability test.

4) The test for impairment has changed after two years and you are no longer eligible for benefits.

Many LTD policies provide that for the first two years after becoming impaired, you are entitled to benefits if you cannot return to the job you held at the time you became disabled. However, at two years, the test changes for most policies. The new test is usually a variation of whether you are impaired from performing the essential tasks of any occupation for which you are reasonably suited based on your training, education and experience. In other words, if the insurance company comes up with some other job they say you can do, then they use this as an excuse to cut off your benefits.

An insurer may say something like “Based on our Functionabilty Assessment and Labour Force review, we believe you are qualified to perform any of the following occupations: 1) parking lot attendant, 2) telemarketer or 3) retail sales person. As such, you are no longer considered disabled and your benefit is terminated.”

5) The insurance company says you have not had appropriate treatment.

Most LTD insurance policies contain a requirement that you are continually in treatment or under the ongoing care of a physician. Some policies may even say that you need to be in treatment that the insurance company considers reasonable. Therefore, if your family doctor has prescribed a particular form of therapy and your insurance company adjuster believes another form of treatment would be more reasonable, this can be used as a reason to terminate your benefits.

6) You gave false medical information or made misrepresentations when applying for benefits.

If your long term disability insurance company finds out that you have made misrepresentations regarding your medical health or any other material matter, they can use this as a reason to refuse your claim.

Your LTD lawyer in Ottawa will go over your denial letter with you in detail. In many cases, we may be able to provide the insurance company with the additional documentation, records, or other necessary information they need to approve your claim. However, if the insurance company remains rigid in their decision to deny your claim despite our appeal, we may need to bring your case to court to secure the benefits that you are entitled to.

Get Help From a Long Term Disability Lawyer in Ottawa

You should not have to fight with the insurance company to obtain the benefits that you already paid for. Show the insurance company you mean business when you retain the legal services of an Ottawa long term disability lawyer at SG Injury Law.

Our firm is proud to offer no-cost, risk-free claim reviews to people dealing with disabling conditions across Ottawa and surrounding cities. Take advantage of this opportunity when you fill out our convenient contact form or call our office at (613) 518-2416.

FAQs

What is Long Term Disability (LTD) insurance?

Long Term Disability Insurance, often referred to as LTD benefits, is a private or employer funded income replacement safety net that steps in when individuals find themselves unable to work for an extended period, typically lasting three months or more. This coverage ensures you receive a bi-weekly or monthly payout, offering financial relief when you need it most. LTD benefits can extend until you reach the age of 65, but the specifics of your policy will determine the amount and duration of these payments. Typically, long-term disability insurance covers anywhere between 60% to 85% of your salary. It’s important to distinguish this from government based programs such as EI sickness benefits, Canada Pension Plan Disability or ODSP.  LTD benefits are available from a long term disability insurer and offer benefits only to insured persons who paid premiums or had those premiums paid by their employers.

Insured persons may also have privately funded short term disability insurance, through the LTD/STD insurer or even their employer, which may offer coverage for the initial waiting period before they are eligible for LTD benefits.

Are LTD benefits taxable?

When it comes to Long Term Disability (LTD) benefits, one consideration is taxability. Whether your LTD benefits are taxable or not hinges on who is paying the monthly insurance premium.

Self-Paid Premiums: If you, as the insured party, cover all or part of the monthly insurance premium, the LTD benefits you receive are generally non-taxable. This means that you won’t be burdened with income taxes on this financial support. This can be a significant relief for those already grappling with financial challenges due to their disability.

Employer Paid Premiums: Conversely, if your employer or another policyholder pays the premium on your behalf, the LTD benefit is typically considered taxable income. In such a scenario, you’ll need to include the benefit amount in your tax return and may be subject to federal and state income taxes.

If your employer paid your LTD benefits, which were denied, and you are negotiating a settlement with the insurance company, then part of the LTD settlement is taxable.  Payments for arrears (past overdue payments) are taxable.  However, any lump sum for future benefits is not taxable.

To navigate the intricacies of LTD benefits and taxation, it is advisable to consult with a tax professional or review the specific tax regulations in your jurisdiction. This can shed light on the potential impact of taxes on your overall income and financial situation.

Are my LTD benefits subject to other deductions?

LTD insurance policies often include provisions outlining deductions or offsets from the monthly benefit. These deductions account for other collateral sources of income replacement you might receive while on disability.

Common offsets can encompass benefits from various sources, such as auto insurance legislation, Canada Pension Plan Disability benefits, Workplace Safety and Insurance benefits, and pension income. It is essential to note that LTD policies can vary, and group insurance plans usually feature more stringent offset provisions compared to individual policies. Therefore, it is imperative to thoroughly review your specific policy to comprehend potential deductions from your LTD benefits.

Are LTD Benefits Paid indefinitely?

LTD benefits aren’t a limitless resource, but they offer invaluable financial support during prolonged periods of disability. These policies typically pay out if the individual is classified as “totally disabled.” Initially, this is often defined as being unable to perform one’s own occupation for the first 24 months of disability. After this initial period, benefits will continue only if the person faces a complete inability to engage in any occupation. The “any occupation” definition can extend until age 65, as long as the individual continues to meet the criteria for Total Disability. The standard maximum duration of LTD benefits is until the age of 65. While LTD benefits may not last indefinitely, they unquestionably provide crucial assistance during challenging times.