Are you unable to work because of a serious injury or illness? If so, you might be entitled to disability benefits to offset losses caused by your condition. Depending on the cause of your disability, you might be eligible to recover payments for your lost income, as well as other types of benefits. However, accessing these benefits is typically an exhausting process – especially for people who are just trying to focus on getting on the road to recovery.
If you are experiencing a severe medical condition that has limited your ability to work and earn income, Valent Legal is here to stand by your side during this difficult time and help you fight for the disability benefits you’re entitled to receive.
At Valent Legal, our experienced and compassionate Nova Scotia disability lawyers are committed to providing the qualified legal skills you need to seek results that count, while also delivering the personalized attention that you deserve.
Don’t wait to fight for your disability benefits. Contact Valent Legal today by phone or online to schedule your free consultation.
How a Disability Lawyer Can Help You
For most people, it’s confusing to even know where to begin with a disability claim, and it’s infuriating when insurance denies or terminates these benefits. However, a disability lawyer can help you with a wide variety of details related to disability insurance, so you don’t have to handle this frustrating process alone.
Disability lawyers focus on helping clients pursue the benefits they’re owed from insurance, their employer, or a government agency. People who work with lawyers in these types of matters may be more likely to receive the full disability benefits they deserve.
Some of the ways a disability lawyer can assist you includes:
- Meeting with you for free to review your case and help you understand your legal options
- Gathering supporting documents for your disability application, such as medical reports from your doctor
- Completing and filing any of the paperwork necessary to apply for disability benefits
- Speaking with insurance companies on your behalf
- Obtaining your claim file, analyzing why insurance denied your claim, identifying errors they might have made, and helping you build a solid case for appeal
- Helping you get answers on your application status and helping you get an approval more quickly
- Filing an appeal on your behalf if your application was wrongfully denied or your benefits were wrongfully terminated
- Helping you meet required deadlines and requirements for your disability application
- Fighting for the benefits you deserve through a lawsuit
Understanding Disability Insurance
Disability insurance provides benefits when someone is unable to work for a certain amount of time because of a serious medical condition.
This insurance and the corresponding benefits come through a variety of channels. For example:
Accident-related benefits. If you were injured in a car crash or another accident caused by someone else’s negligence, then their insurance company might provide you with disability compensation for your losses caused by the accident.
Work-related benefits. Wage Loss Replacement Plans (WLRPs) are a type of insurance protection that employers often provide to workers. This type of insurance provides short-term disability, long-term disability, and weekly indemnity benefits to replace employment income when an employee can’t work because of an accident or illness.
Canada Pension Plan (CPP). CPP disability pension and post-retirement disability benefits are available to people who have made sufficient contributions to CPP, and who have a prolonged and severe disability that prevents them from working regularly. The level of contributions that CPP requires to be eligible for benefits depends on the worker’s age, annual earnings, and employer.
Short-Term Disability and Long-Term Disability
Short-term (STD) and long-term (LTD) disability benefits are similar in that they both replace a person’s income if they are unable to work because of illness or injury, but there are also several differences between the two types of benefits.
Some of the medical conditions that most commonly qualify for either type of benefit include:
- Knee or back problems
- Depression or bipolar mood disorder
- Chronic pain
- Sleep disorders
- Carpel tunnel syndrome
- Cervical or neck disorders
- Psoriatic arthritis
- Crohn’s disease
- Multiple sclerosis
- Lyme disease
- Heart disease
A primary difference is that STD benefits are only meant to last a certain amount of time – typically around three to twelve months. On the other hand, LTD benefits usually last much longer, such as until the recipient reaches a certain age or for a specified number of years.
Another difference is the waiting period. Short-term benefits might begin immediately, a week or two after the disability begins, or after the recipient runs out of paid sick leave. Conversely, the waiting period for long-term benefits is often several months and typically won’t begin until the recipient uses all of their short-term benefits.
STD benefits are usually available as long as a worker can’t perform their own occupation. However, for LTDs, the definition of disability and a person’s ability to access these benefits usually changes after a defined time period – often around two years after the disability claim.
LTD benefits might start when a person is unable to perform their own occupation, they often can’t continue to access benefits unless their illness or injury impairs their ability to perform any job.
In order for the disability beneficiary to continue receiving these payments, they usually must attend rehabilitation or treatment programs ordered by the insurance company. They must also provide regular updates to the insurer to show they are still suffering from their disability.
In certain cases, the insurance company might send a private investigator to spy on people receiving benefits to ensure they are truly unable to work. They might take videos and pictures to try to prove the person’s disability is not as severe as they claim. Shockingly, insurers are legally allowed to perform surveillance on disability benefit recipients as long as they are in a public space.
The amount of money a person can receive and how often they receive payment often varies between short-term and long-term benefits. With STDs, the person might receive up to 100 percent of their income in weekly or biweekly payments, depending on their particular insurance policy. However, with LTDs, recipients often get only around 60 to 70 percent of their income paid in monthly installments, plus insurers often cap the monthly amount at a certain amount.
My Disability Benefits Have Been Denied, What Do I Do?
If your disability benefits were denied or terminated, you have the right to file an appeal. The first step in an appeal is to pay close attention to your denial letter, which outlines why your claim was denied, the timeline for filing an appeal, and other information on how to appeal.
For CPP benefits, the timeline to appeal is typically only 90 days. For a reconsideration, people can appeal to Service Canada, but for a Tribunal appeal, applicants must file with the Social Security Tribunal.
The appeals process with the Social Security Tribunal has strict requirements and deadlines. It’s critical for applicants to work with a disability lawyer in this type of appeal process because the Tribunal is usually the last opportunity to appeal for CPP benefits.
For short-term and long-term disability, appeal timelines depend on the insurance company that provides these benefits. The deadline might be very short – sometimes even just 30 days to file an initial appeal. However, with STD and LTD, applicants often have multiple opportunities to petition for benefits.
For example, the first level appeal for LTD and STD is an internal appeal, where an employee at the insurance company who is different from the employee who issued the denial takes a second look at the application. Applicants can typically file two or three rounds of internal appeals for STD and LTD benefits.
If these internal appeals are unsuccessful, then the applicant may either pursue an appeal hearing with an arbitrator or file an appeal with a lawsuit. The appeal options available depend on the applicant’s insurance company and their specific disability plan.
Appeal hearings are often only available with employment-related plans involving unions. If an applicant’s appeal fails in this hearing, this is typically their final option for appeal. Meanwhile, insurance-based and nonprofit disability plans typically allow applicants to appeal a disability benefits decision through a lawsuit.
In the suit, the applicant may request compensation for damages beyond those outlined in their original disability benefits application. This might include compensation for things like legal costs or emotional distress caused by the denial of their original application. In these types of cases, a judge or jury considers the appeal, and their decision usually stands as the final determination in the disability application.
Another option available in some cases is to settle out of court with the insurance company, where the insurer offers to give the disability benefits applicant a one-time lump-sum payment in exchange for dropping the suit.
Contact an Experienced Disability Lawyer at Valent Legal
Don’t wait until it’s too late to fight for the disability benefits you’re owed. If you have questions about your benefits and your right to appeal an insurer’s decision, call Valent Legal right away.
To set up your free case evaluation, call us today or contact us online.