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FAQs About Long-Term Disability Claims Answered

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FAQs About Long-Term Disability Claims Answered

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If you’ve been injured, are struggling with mental illness or are suffering from a chronic condition that is severe enough to prevent you from working, knowing what to do and how to support yourself can add stress to an already challenging situation.

It helps to speak with knowledgeable long-term disability insurance lawyers about accidents and medical conditions that disable you from completing substantial portions of your work. They can also advise you on your rights in the workplace related to disabilities and applying for benefits.

Keep in mind, these are general answers to questions asked by people applying for long-term disability benefits and not legal advice.

How Can I Increase the Chances of Getting My Claim Approved?

The first step is to refer to your insurance policy to learn its requirements for LTD benefits eligibility and information related to filing an application or claim for benefits.

Generally, your claim is stronger if your doctor or a specialist:

  • diagnoses your condition
  • provides details as to how your condition or symptoms prevent you from performing tasks essential to your occupation
  • provides a prognosis for the predicted course of your condition
  • includes treatments and expected outcomesand management.

You will also need records, tests and all the documentation possible to support those statements.

Unfortunately, even claims with all the required information are routinely denied by the insurance companies.

My Claim was Denied. What do I Do?

The denial letter will inform you of the reason(s) for the denial and the insurance company’s decision appeal process. It may include ways to rectify deficiencies in your claim application. It’s highly recommended you consult a disability lawyer at this point.

They can clarify the reasons for denial and whether it’s worth using their appeal process. The vast majority of the time, it’s better to file a lawsuit against the insurance company. Almost all lawsuits reach a negotiated settlement well before going to trial.

How Much Does it Cost to Hire an Employment Lawyer?

Most LTD lawyers work on contingency, so their clients don’t pay fees unless their lawyer gets them money from the insurance company. A lawyer’s contingency fee will be a percentage of the settlement or award. Many lawyers also fund lawsuit expenses until completion. You can learn more about lawyer contingency fees from the Law Society of Ontario’s guide.

Make sure to work with an LTD lawyer that offers fair, flexible and transparent pricing.

How Much Will My Claim be Worth and How Long Will it Take?

Every case is different. Insurance companies pay anywhere from 50 to 80% of an employee’s salary, subject to any maximums, while the employee is on LTD benefits. Lawsuits allow you to claim past benefits owed, interests, costs and claims for damages if the insurance company acted in bad faith.

Your lawyer will calculate how much you should have received in benefits, add interest and costs and claim the total. This is the amount of your lawsuit.

Settlements are negotiated based on the amount claimed in the lawsuit. Several factors can affect the amount your case settles for, including your age, the severity of your condition and how long it will take to treat, among other variables.

The length of time for your case to resolve depends on its unique circumstances, including the complexity of your case. The average LTD benefits settlement can take anywhere from 6 to 12 months.