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Long-Term Disability

THE LONG TERM DISABILITY CLAIM LAWYER IN OWEN SOUND


 

If you’ve been denied long term disability benefits, we hope that you will consider retaining our firm to assist with your claim. Many people don’t make it this far. They take no for an answer from their insurer, whether it be Manulife, Cooperators, Sun Life or any other. Or they assume that nothing can be done. Or they believe they cannot afford to do legal battle. We assume the opposite and are pleased to assist with wrongful dismissal claims throughout Owen Sound, Collingwood, Port Elgin and all surrounding areas within Grey, Bruce and Simcoe counties.

 

Wondering if you have a long term disability claim?

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WHAT YOUR CLAIM IS ABOUT

Your claim is about a disability benefit that has been denied to you. It’s that simple. Your disability may be physical or psychological. Perhaps you were denied at the outset and never received a benefit at all. Perhaps after a year or so the insurer cut your benefit off. Or perhaps the two year mark is about to pass and the insurer is now telling you that you are on your own.

It is our job to ensure that these benefits are either paid out to you on a month to month basis OR to obtain a lump sum settlement instead. By suing and holding an insurer’s feet to the fire, we hope to trigger such a settlement at the earliest possible date.

 

THE TWO YEAR MARK

Many disputes arise two years following the date your disability first arose. Why is that? Because under most group policies, for the first two years the insurer has to pay disability benefits if you are unable to perform the duties of your original job. The test changes after two years. In most policies, the test after two years is whether you are able to work at any occupation which pays 60% of your previous income. If a judge finds that you are able to work at some position (sporadic part-time work does not count), the court will conclude that you are not entitled to insurance benefits.

In most cases, it does not matter that the type of job proposed by the insurance company is one you don’t like or that it is not available in your town. The only thing that matters is whether, despite your disability, you can be a reliable full time employee in another job.

 

WORKERS COMPENSATION AND CANADA PENSION PLAN DISABILITY BENEFITS

If you were injured at work, you must apply for workers compensation (if available). If workers compensation is denied and you appeal, your long term disability benefits should be paid until your appeal is dealt with.

Most group plans require you to apply for CPP disability benefits and, if you get them, such benefits are to be deducted dollar for dollar from your LTD benefits. For example, if you receive the maximum CPP benefit of, say, $1,100 per month and your LTD benefit is otherwise $2,400 per month, your LTD benefit drops to $1,300.

 

Why Bother To Apply for CPP? There are 3 Reasons:
  1. First, again, you are obliged to apply under most LTD policies and the insurer is entitled to have that amount to reduce the benefit.
  2. Second, if you qualify for CPP as “unemployable”, the LTD insurer will be hard pressed to argue that you do not meet the “unemployable” test for LTD benefits.
  3. Third, if you are on CPP disability, such will enhance the CPP pension you would receive at age 60 or 65.

 

WHAT ABOUT TAXES?

If your employer paid your entire LTD premium while you were working, the LTD benefits will be taxable. If you paid any part of the premium, the benefit will not be taxable. If we settle your claim on a lump sum basis, you will have taxes deducted from any retroactive amount (that is, on the amount going back from the date you were denied benefits). No taxes will be payable on that part of the lump sum representing future LTD benefits.

 

SHOULD I TAKE THE CASE TO TRIAL OR TRY TO SETTLE?

If the matter does proceed to trial and we are successful, the court can only order payment of money owed and a continuation of the monthly cheque. Apart from some other types of compensation (see below) that is all it can order. The court cannot order a lump sum payment. Further, following trial, the insurer may challenge you again after a period of time and argue that your condition has improved. In other words, your file will remain open. Many clients don’t want a life long relationship with their insurer.

For that reason, you ought to consider a settlement if fair compensation is offered. If the matter is settled prior to trial, it will usually result in a negotiated ‘lump sum’ payment. That is, the insurer will want to close its file for all time and will want to pay you a final amount of money. The amount will depend on the strength of the medical information and the period of time for which the insurer believes it is exposed to ongoing payments.

 

WHAT EVIDENCE IS NEEDED TO PROVE MY CLAIM?

In proving your claim, we rely on your past medical records, your family physician and medical experts arranged by our office. In addition, we rely on certain persons such as past employers, special friends and relatives who might be able to provide statements that are supportive. We also rely of course on your personal story of pain and attempted recovery; however, the more objective the evidence, the better.

 

MAY I SUE THE INSURER FOR ITS TREATMENT OF ME?

In certain cases clients tell us horror stories about how their claim was treated by their insurance company. In these cases, we will usually sue for compensation for something known as their ‘bad faith’ treatment of you. The fact that they have denied you benefits is not enough; there must be something more in the manner in which your claim was held that may expose the insurance company to a claim for bad faith compensation.

Again, we will discuss this with you on a case by case basis. Contact Tamming Law today to schedule an appointment with our long term disability lawyer in Collingwood.

 

CLOSING COMMENTS

Long term disability cases are complex and often hard fought. For almost 25 years, we have helped clients throughout Owen Sound, Collingwood and Port Elgin obtain excellent settlements or, following trial, excellent court awards. We look forward to helping you.