Several legal problems must be taken into account when filing long-term disability claims. These cover the interpretation of the terms and conditions of the policy, the situations in which a claim can be rightfully rejected, and the legal recourse available when claims are wrongfully dismissed.
Many people remain unaware of their legal rights while applying for benefits, filing a claim, or having a lawsuit dismissed. A long-term disability lawyer can offer prompt, legal counsel in the following situations:
1) When the claim is rejected: The initial application stage is where many claims are rejected. In other instances, the insurance provider will make a payment for a period before deciding to discontinue. Insurance companies frequently reject claims for illegitimate reasons. If your claim has been denied, you should get legal counsel as soon as possible and before filing an appeal. Find out more about appeals for long-term disability.
2) If you believe your claim will be rejected: Sometimes, it is clear when an insurance company is laying the basis for a refusal. For instance, if you learn about surveillance or other inquiries into your regular actions. Contact an LTD lawyer if you believe the insurance company is trying to make you fail.
3) Definition change is imminent: Although it may be longer or shorter, most group rules and some individual policies call for definition changes every two years. In most cases, “any occupation” is used as the test of incapacity instead of “own occupation.” Many insurance providers overlook that “any employment” does not necessarily mean any work in the strictest sense; rather, it must be an alternative occupation that considers your continued limits and limitations as well as your training, education, and experience.
4) Work-hardening initiatives: If your doctor opposes a work-hardening initiative that the insurance provider wants you to take part in, you should get legal counsel. If you choose not to participate, the claim may be denied. You must use extreme caution to prevent rejecting your claim in these situations.
5) Independent medical examinations (IMEs): The policy almost probably contains a clause allowing the insurer to send you to an IME. However, you should consult an LTD lawyer if you believe the IME is unfair or if you have any other queries.
Before attempting to return to work, consider that most persons with long-term disability claims desire to do so. After all, LTD only reimburses a portion of your wages prior to your incapacity, so there is a financial incentive to comply. However, given that you are no longer incapacitated, the insurance company can interpret your desire to attempt incorrectly. Before attempting to return to work, think about getting legal counsel with an Ottawa disability lawyer.