McLeish Orlando's Disability Lawyers

At McLeish Orlando, our lawyers know how to take on insurance companies in disability claims. While we are able and willing to negotiate with insurers when appropriate, our litigation team is ready to pursue full compensation in court.

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Long term disability (LTD) insurance is a form of income replacement. It protects your income if you have the misfortune of becoming too injured or ill to work. People can purchase disability insurance themselves or their employers may provide it as a benefit.

When our injury lawyers take your disability claim to court, we are fighting to hold your insurance company liable for its lack of good faith when it denied your claim or did not pay you in full. We make sure the insurance company doesn’t shirk their responsibilities to you.

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Long-term Disability Insurance

Long term disability insurance is a form of income replacement that an individual either purchases on their own or is provided by their employer.  It is a lifeline for people who are no longer able to work as a result of injury or illness. Every long term disability insurer has an obligation to treat each claimant with the utmost good faith.  Policyholders assume that the insurance company will accept and pay valid claims for disability insurance benefits. Unfortunately, that is often not the case. A significant number of meritorious disability claims are denied outright, or payments are terminated before a person is capable of returning to work.

What are the Leading Causes for LTD?

More than 6 million Canadians aged 15 and over – accounting for 22% of the Canadian population – identify as having a disability, according to a survey conducted by Employment and Social Development Canada. In Canada, the most common types of disabilities among adults are pain, mobility, and agility-related, with the 10 most common types of disabilities related to the following conditions:

  • Pain
  • Flexibility
  • Mobility
  • Mental/psychological
  • Dexterity
  • Hearing
  • Seeing
  • Learning
  • Memory
  • Developmental

What Conditions Qualify for Long-term Disability?

Long term disability insurance covers a broad range of medical conditions, ranging from physical injuries to mental health illnesses. It is important to understand how the insurance policy defines a “disability” because the particular definition impacts which conditions may qualify. However, disability generally includes many different types of conditions, such as the following:

  • Brain injuries
  • Orthopaedic injuries
  • Multiple Sclerosis
  • Cancer
  • Fibromyalgia
  • Chronic Fatigue Syndrome
  • Mood disorders
  • Cardiovascular disease
  • Arthritis
  • Anxiety or Depression

The Difference Between STD and LTD

An employer’s group insurance may provide for a short term or long term disability policy. Short term disability insurance provides benefits for a short period of time, typically up to six months, while the employee is sick or injured. Short term disability applies where the employee is temporarily disabled and cannot work or make an income during the recovery period.

By contrast, employees that are unable to return to work at the end of the short term disability period may then qualify for long term disability insurance coverage. Long term disability insurance provides financial assistance where an employee is unable to work due to being sick or injured, which further prevents them from completing the duties of their employment.

Each long term disability policy contains a test for entitlement that needs to be met in order to receive benefits.  While each test for entitlement is unique to the specific policy, there is typically an “own occupation” test at the outset of disability.  This means that a person will meet the test for long term disability benefits if they are unable to perform the essential tasks of their own occupation.  Many policies contain a change in definition of disability to an “any occupation” test, typically after a person has received 2 years of long term disability payments.  The any occupation test typically requires a person to show that they are unable to engage in any occupation that they are reasonably suited to by virtue of their education, training and experience in order to receive disability benefits.  There are numerous factors that are considered in determining the reasonableness of an alternative occupation including the level of responsibility and compensation associated with the alternative occupation in comparison to the previous position held by the person.

Common Issues with Long-Term Disability Claims

The process to apply for Long Term Disability can be daunting – especially if your application has been denied. An insurance company may deny your long term disability claim for a variety of reasons:

  • Insufficient medical documentation to prove disability
  • Exclusion for pre-existing conditions that are not covered by your insurance policy
  • Changes in medical or functional status rendering you no longer disabled
  • Change in test for entitlement from “Own Occupation” to “Any Occupation”
  • Insurance companies deny long term disability claims often – best practices dictate that you should get legal advice from an experienced lawyer if your LTD claim has been denied.

Working with Long-term Disability Lawyers in Toronto

McLeish Orlando’s disability lawyers have a long history of holding insurance companies accountable when they deny legitimate claims or unjustly terminate benefits before the policy holder is capable of returning to work. We force disability insurers to live up to their obligations and honor the terms of their policies. We have represented physicians, teachers, lawyers, business executives and many others who either have an any occupation policy or who have purchased a lifetime “own occupation” option for their disability test for entitlement.  Our lawyers have forced long term disability insurers across the Province to:

  • Pay all arrears of payments with interest and reinstate terminated payments; or
  • Pay a negotiated, lump sum cash-out of all past and future payments

If your long term disability claim has been denied, contact McLeish Orlando’s disability lawyers for a free consultation.  Help is a phone call away.

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