Long-Term Disability Claims in Toronto and How to Get Help π
If you’ve been injured and are unable to work because of your injuries, you may be eligible for long-term disability (LTD) benefits. These benefits, whether available through your employer or purchased privately, are intended to function as an income replacement if you are unable to do your job due to illness or injury. Although each plan is different, most long-term disability plans will replace 60% to 70% of your normal income. However, these benefits do not usually begin immediately following your accident, and they are not always easy to get. Most long-term disability policies only begin paying benefits after short-term disability benefits expire, typically after a 90-day or 120-day period. If, after this initial period, it becomes obvious that you will not be able to perform the important duties of the job you had prior to the accident, you may then receive LTD benefits. Most long-term disability policies in Canada will cover a percentage of your salary for a 24-month period of time. These benefits are designed to allow you to look for other work, and/or to train for a job other than the one you had previously. Following the 24-month period, there is usually a “change of disability” clause that comes into play. At this time, if it becomes obvious that your injuries have affected your ability to obtain any job, you may be entitled to receive LTD benefits until age 65.
When Can I Claim for Long-Term Disability?
Obtaining this “total disability” long-term coverage can be difficult. During the period following an injury, you may be understandably worried about finances, and wondering how long it will take to settle your claim. Any time you have an accident injury claim, you will want to work with a personal injury lawyer, who will be able to guide and advise you. Since medical professionals are often reluctant to make a prognosis until initial healing has occurred, your personal injury lawyer will need some time to gather all of the medical documentation necessary to prove your case; it can take 12 to 18 months for a clear picture to emerge of how your injuries may impact your future ability to work or to perform daily duties. Once all of the relevant medical evidence has been obtained, mediation or arbitration regarding a settlement can begin. Mediation takes place outside of court, and involves negotiations between your lawyer and the insurance company, with a neutral third party with expertise in the area of disability benefits present. It’s the most cost-effective and efficient way to resolve the dispute. Arbitration is a type of formal mediation that also involves a third-party mediator, but in some instances, the opinion of this third party is legally binding. If your case goes to court, it normally takes three to four years before it is heard, and COVID-19-related delays may mean even longer wait times.
Be sure to find a personal injury lawyer to fight for you. Only lawyers who have experience in this field know what’s required to file a claim and to navigate the system successfully. In Ontario, the initial consultation with a personal injury lawyer is usually free of charge, and, in addition, these lawyers work on a contingency basis, which means that they don’t get paid until you receive a settlement. With a skilled personal injury lawyer on your side, it’s far more likely that you will receive a favourable outcome.
When Your Claim Is Denied
There are a variety of injuries that may qualify you to receive LTD benefits, including spinal injuries, brain injuries, psychological issues arising from the accident trauma (such as post-traumatic stress disorder,) or a combination of injuries. Some visible or “objective” injuries offer obvious evidence, but issues such as chronic pain or psychiatric conditions like PTSD are more difficult to prove. Because of the value of LTD claims, they are often a target for fraudsters, so insurance companies will deny claims that fail to meet a high standard. In fact, it’s estimated that more than 60% of long-term disability claims are initially denied. A claim can also be delayed or denied if the company suspects the injury is being misrepresented, if the injury fails to meet the policy definition, if the paperwork is improperly completed, if the medical records are lacking, if deadlines have been missed, or if the claimant has failed to comply with treatment recommendations. Even after your claim is greenlighted, it can be terminated by the insurer, forcing you to again provide medical evidence of your inability to work.
A good personal injury lawyer will know what type of medical records are necessary to back up your claims, and can help you to provide the evidence you need.
Contact a personal injury lawyer with any kind of accident injury related issues, and learn more about getting the compensation you deserve.