When you’ve been injured badly enough to classify your injuries as permanent or total disability, life starts to look a little uncertain.
Few people find the process of claiming permanent disability to be easy or smooth. It is quite common for insurance providers to deny claims. Some do it routinely, just to see who they can wriggle out of paying. In some cases, they start paying benefits only to cut them off, abruptly and without warning, even while you’re still undergoing treatment for the condition that caused you to file for them in the first place.
Waiting periods. Occupational quibbles. Arguments over pre-existing conditions. Time limits. Nothing about the disability process is easy.
Fortunately, the team at Merchant Law is here to help.
What happens if my long-term disability claim is denied? How can Merchant Law help?
If your claim is denied you’ll need to appeal the decision. If the appeal is denied you’ll then need to file a lawsuit. At that point, your lawyer will be working to negotiate a fair settlement. Very few long-term disability claims cases go to court. Most settle during a mediation or Alternative Dispute Resolution (ADR) process.
We start by examining your claim to determine the grounds that have been used to deny it. We then begin working up a case that shows the disability insurance company is in the wrong. We’ll speak to the insurance claims adjudicator on your behalf.
It is vital that you call us as soon as you know your claim has been denied. These steps are all time-sensitive.
It can also take 18 to 24 months to resolve your case. During that time, we’ll be gathering evidence, speaking to medical experts, and working hard to make your case as strong as possible.
How do I know if I’m “totally disabled?”
To get long-term disability (LTR) benefits, you must have any illness or injury that keeps you from performing work for at least 17 weeks. This means you cannot pursue your “own occupation,” the job you were working at the time the disability occurred.
During that initial 17 week period most people are covered by their employer’s short-term disability policy. Far fewer short-term disability claims get denied.
After a 24-month period, most insurance policies will only allow you to continue collecting benefits if you can show that you cannot work in any occupation through a combination of bodily ability, education, training, and experience. They want you to show you can’t get any gainful employment, even employment at a much lower wage. You are not expected to try to go back to college or trade school to learn a new profession, though if you can in some cases you’d be better off as LTD only pays 70% to 80% of your former wages every week.
Proving you can’t work anywhere or do any kind of work is a much harder claim to prove. We turn to evidence like medical records, doctor’s orders, X-rays, MRIs, CT scans, psychological evaluations, and prescriptions to help you prove the disability is real. Occupational experts can serve as expert witnesses to prove why the disability keeps you from working any job at all.
We can also use testimony from family members and friends to demonstrate how your life has changed. We ask you to document your day-to-day life as well. This can help provide the insurance company with a clear picture of what you can and can’t do.
The insurance company wants to paint you as a malingerer. Someone who isn’t really disabled, who just wants to live without working on their money. They will try to paint you as a liar who could work if you really wanted to.
Our disability team helps to refute these claims and get you the compensation you deserve.
Other Avenues for The Disabled
Our team can also help you apply for other benefits, such as AISH. If a negligent party caused your injury then we can help you by pressing a personal injury claim which can also put money you need to live on back in your pocket. If you were injured at work and were denied workers compensation benefits, we can help you with those claims as well.
Here at Merchant Law, we believe you when you say that work has become impossible for you. We will fight hard to make sure you can continue to live in comfort and in dignity.
Is it legal for the insurance company to hire someone surveill you?
Yes. Furthermore, you should expect surveillance any time you sue an insurance provider. They are constantly on-guard against fraud, and they would be overjoyed to uncover evidence that you are not as disabled as you say you are.
Even innocent, seemingly unavoidable activities like dragging your garbage to the curb or picking up a package can be used against you, if those activities violate doctor’s orders. You may well need to hire someone to handle those responsibilities for you, or get a friend or family member to take care of them, until the disability claim is complete.
Don’t give these insurance companies any more ammunition than you have to.
Why trust Merchant Law with your long-term disability claim?
We’ve gone up against every one of Alberta’s insurance companies. We know the tricks they play, and we know what it takes to win. We’ve advocated for clients with every disabling condition you can think of, from chronic conditions like chronic pain and fatigue to acute conditions like severe back and neck injuries. We’ve helped cancer patients and patients with major psychological conditions as well.
Most of our disability lawyers have over 20 years of experience with personal injury and disability claims. We’re known for being some of Alberta’s toughest negotiators and savviest litigators. We’re also responsive and caring.
Set up a no-obligation case review today. We can make the process of making a long-term disability claim go much faster and smoother.