In Alberta, it’s not uncommon for individuals to be surprised when their insurance company informs them that their access to long-term disability (LTD) benefits is being cut off.
The reality is that many claimants don’t know what should set off alarm bells before it’s too late.
READ MORE: Cut off long-term disability in Alberta? 3 things you must do
Here are three “red flags” that your insurer could be getting ready to cut off your access to LTD benefits.
1. Your insurer asks you to participate in an independent medical examination
Contrary to popular belief, independent medical examinations (IMEs) are rarely an objective, third-party assessment.
Since IMEs are paid for by your insurance company, they get to pick which medical practitioner will evaluate your ability to work.
In our experience, insurers usually choose a doctor who will provide them with the information they need to justify cutting off an individual’s access to LTD benefits.
READ MORE: Asked to submit to an IME? Here’s what you need to know
If your insurance company asks you to participate in an IME, contact an experienced disability lawyer at Samfiru Tumarkin LLP. We can help you prepare for the assessment and explain what you need to do afterwards.
2. Your insurer recommends a work hardening program
In some cases, insurance companies pressure claimants over the phone to re-enter the workforce while they are still disabled.
If your insurer calls you and recommends a work hardening program, ask them to provide you with the details in writing.
The goal of this program is to get you back to work as soon as possible. Your insurance company’s return-to-work plan should include the proposed return date or the number of hours that they recommend you work each week.
READ MORE: Insurer forcing you back to work in Alberta? 3 things you must do
Once you receive this document from your insurer, contact our firm. We can review it and advise you of potential next steps.
Even if you don’t have your insurance company’s return-to-work plan, you should still reach out to us. We provide free consultations for issues involving LTD and can answer any questions that you have.
3. Your insurer mentions that your “change of definition” date is approaching
After being on LTD for two years, most policies require claimants to pass a new test to be considered “totally disabled.” This is known as the “change of definition” date.
To continue receiving disability benefits, you must prove that your condition prevents you from doing any work, not just your own job.
Insurance companies often use this change as an excuse to cut individuals off LTD – claiming that they no longer meet the definition of “totally disabled” under their policy.
If your insurer suddenly mentions that your change of definition date is approaching, or suggests you can do other jobs, seek legal counsel immediately.
READ MORE: Most common mistakes people make when they are denied long-term disability
A troubling case that our team recently handled involved a graphic designer in Calgary.
The worker, who was struggling with chronic migraines, received a letter from her insurance company – notifying her that her change of definition date was three months away.
Worried that her insurer was getting ready to cut off her access to LTD benefits, she called Samfiru Tumarkin LLP for a free consultation. We informed her of her rights and potential options in the event that her insurance company decided to stop her benefit payments.
As she feared, her insurer sent a denial letter on her change of definition date – explaining that she had been cut off LTD because she no longer met the definition of “totally disabled” under their policy.
Resisting the urge to appeal the decision without consulting a disability lawyer, the graphic designer brought the document to us.
After reviewing the denial letter and the reports from the worker’s treating doctor, it was clear that the insurance company didn’t do a comprehensive review of her file.
The graphic designer’s physician specifically noted in multiple reports that her condition prevented her from doing any work – even on a part-time basis.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
Following conversations with her insurer, we were able to secure an extremely favourable amount of compensation for our client.
Let us fight for you
If you believe that your insurance company is getting ready to cut off your access to disability benefits, or they already have, contact an experienced disability lawyer at Samfiru Tumarkin LLP.
Our compassionate team regularly resolves issues involving LTD, short-term disability, life insurance, critical illness and mortgage insurance claims across Canada.
READ MORE: Insurer being difficult? 3 reasons you should hire a long-term disability lawyer
We provide consultations at no cost to you and don’t get paid unless we get results.
Over the years, we have helped thousands of Canadians, including Julie Austin and Sandra Bullock, secure the compensation that they are legally entitled to.
Think you’re about to be cut off long-term disability? Received a denial letter?
Contact the firm or call 1-855-821-5900 for a free consultation with a disability lawyer. We help Canadians across all provinces (excluding Quebec). Get the advice you need and the compensation you deserve.
Sivan Tumarkin and Michael Gerhard are disability lawyers at Samfiru Tumarkin LLP, Canada’s most positively reviewed law firm specializing in employment law and long-term disability claims. The firm provides legal insight on Canada’s only Disability Law Show on TV and radio.