Disability Lawyer Toronto

If you’re fed up fighting with your insurance company about a long-term disability claim—and have been denied, unfairly—you’re not alone. “Disability claim denied” are hard words to hear for anyone who has a disability and was counting on their LTD insurer.

Long-term disability benefits are frequently a type of legal claim that people seek legal advice for from a personal injury lawyer at Verhovets Law. There are a number of reasons for this: 1) an insurance company typically starts off denying certain long-term disability claims because insurers doubt the injury or disability; 2) to obtain long-term disability benefits, you need to provide medical evidence for a disability claim; and 3) an insurance company is never in a hurry. Frequently, an insurance company will complicate matters and revert to stall tactics for a disability claim. Lawyers who work in Personal Injury Law are very familiar with these tactics.

It’s estimated more than half of the long-term disability claims in Canada are turned down at the application stage. If that happens don’t try and go it alone; it’s important to have the right disability lawyer handling your case who will appeal and, if necessary, sue the insurer as a civil matter in the Superior Court of Justice. Let us fight the insurance company while you focus on getting well again.

Each Toronto disability lawyer at Verkhovets Law understands your frustration and has sympathy for your plight. We also know how to deal with a disability insurer that wrongly denied a disability claim, to get the long-term disability benefits you need to get your health back.

Every disability lawyer at Verkhovets Law knows that an LTD claim is an uphill battle for the average person, especially when you have chronic pain, chronic illness, or have been suffered a personal injury in an accident. To also deal with a long-term disability claim when you’re unwell simply becomes too much. Or worse, perhaps you had your disability benefits terminated? Plus, an insurance company can be notoriously difficult to deal with even when you’re healthy and well.

The long-term disability benefits in your disability insurance policy provided by an insurer are supposed to be your safety net. Disability insurance is meant to financially cover you in the event of a personal injury or illness that prevents you from working. Let us fight the insurance company for you, to get the long-term disability benefits you need now.

We hear essentially the same story from our clients: “I paid for an insurance policy, through work or privately. Then, I suffered a personal injury. I need the replacement income, but the insurer won’t accept my long-term disability and won’t pay.”

We will review your long-term disability policy, whether you bought them through work or privately. If this is your situation, contact Call or email a disability lawyer at Verkhovets Law about your disability claim. Free consultation.

A disability lawyer at Verkhovets Law, Toronto, will tell you that litigating a disability claim is an extremely complicated process: many specialists to see about your accident or injury, many forms to fill out, and a lot of waiting time in between. Talking to us before you make a claim is the best way to avoid being wrongly denied in the first place.

Us personal injury lawyers are used to decoding policies written in such deliberately convoluted language it’s no wonder they’re often misunderstood.

Disability insurance is lucrative (and pricey) and insurers are in business to make money – not pay you – even if you make an honest mistake completing an LTD benefits claim form.

Would your insurer really deny your disability claim based on a technicality, or an improperly filled-out form?

Yes, they would.

And, yes, they do.

Our Toronto disability lawyers have gone to battle with an insurance company that relishes at the prospect of someone slipping up on their disability claim and denying them their coverage.

When your long-term disability claim has been dismissed by an insurance company, don’t get angry and don’t give up. Get the right lawyer: a Toronto disability lawyer at Verkhovets Law can help. Our personal injury firm has helped hundreds of people successfully obtain their long-term disability benefits.

Don’t assume you understand everything the policy is saying. Our Toronto disability lawyers will translate it for you into plain English. We know how insurance companies think and act. And what we need to do, to help you with your denied long-term disability claim. We help you get a fair settlement.

Toronto disability lawyers will tell you when it comes to LTD policies, it’s not an “if it quacks like a duck” situation. For example, each LTD policy has its own definition of what is a disability.

Some long-term insurance policies cover you no matter the type or severity of condition so long as you are unable to perform all or the core duties of your job. But others exclude some illnesses. And some may deny conditions covered by Workplace Safety and Insurance policies – in Ontario, it’s the WSIB.

If it’s established that your illness or personal injury type is covered, the insurer will typically arrange an Independent Medical Examination which you are required to attend if you want to collect LTD benefits. This medical professional’s role is to give an objective opinion on your level of disability, possible treatment, and prognosis – not to treat you. Verkhovets Law, Toronto disability lawyers, will strongly advise you to be co-operative and honest as everything goes in the report. It’s not unusual for a claim to be denied if the IME finds you aren’t or are no longer disabled.

While your long-term disability benefits policy’s checklist is the one that applies, there are common injuries and illnesses that usually satisfy insurers as a disability:

• Arthritis, Rheumatoid Arthritis
• Back injuries
• Brain injuries
• Cancer
• Cardiovascular disease and Stroke
• Diabetes
• Fibromyalgia and Chronic Fatigue Syndrome
• Fractures

• Gastrointestinal illness (Crohn’s, Colitis, Diverticulitis, Irritable Bowel Syndrome)
• Infection
• Lupus
• Mental health problems
• Mood disorders, including Bipolar, Anxiety, or Depression
• Multiple Sclerosis
• Nervous System disorders (ALS) and Seizure

Total disability – Toronto disability lawyers see this all the time; an insurer is chomping at the bit to deny your LTD benefits, so they claim you’re not totally disabled. The Supreme Court of Canada set out the definitive meaning of the term in Paul Revere Life Insurance Co. v Sucharov that you are unable to reasonably perform the essential duties of the work you do. The court said, it’s not an “absolute physical inability to transact any kind of business pertaining to one’s occupation.” It’s about not being able to do the core duties for two years.

Any occupation – Our disability lawyers warn this hurdle comes after two years and the definition changes. Now a claimant is totally disabled if they can’t perform the essential duties of any job for which they are reasonably suited. So, the example of the surgeon in the preceding paragraph – who still can’t operate but works as a doctor, would have to be disabled to the point of not being able to work as a doctor due to a personal injury or illness. This is the ‘any occupation’ test. If you qualify, payments end if you can work; die; or hit 65 when you move to the Canada Pension Plan (CPP).

Own occupation – This means you are unable to perform the essential duties of the job that you did before the onset of an illness or injury. Our disability lawyers use the example of an orthopaedic surgeon who crushes his hand. Cutting into a patient and repairing their spine is his own occupation – and he can’t do that anymore. This is the ‘own occupation’ test. So, he qualifies to collect benefits for the next two years, his ‘own occupation’ period, even though he can work as a doctor performing other duties.

• Change of definition
• Insufficient medical evidence beyond just a diagnosis.
• Not showing up to the independent medical examination
• Not showing up to or complying with rehabilitation or treatment
• Operating a small business at home under the radar
• The M word: misrepresentations in a claim, including not revealing everything about a condition or any pre-existing issues
• Unmet time limits for forms submissions including proof of claim or notice clauses
• Wrong documentation supplied by employer
• Your lack of communication with the insurer

Our Toronto personal injury lawyers also handle these types of claims:

Our Toronto long-term disability lawyers handle these types of disability claims:

Over many years, we at Verkhovets Law have seen all the maneuvers and machinations LTD insurers use to avoid paying long-term disability benefits to personal injury victims or victims of illness. The main one is that time is on their side. So, they delay, delay, and delay some more. When they do finally agree to pay long-term disability benefits, most typically provide a monthly benefit at rates of 80%, 70%, or 66% of your net pre-disability income. 

Insurance companies aren’t in any hurry to cut your cheques, either. Without a talented and experienced long-term disability lawyer to press your case, delays from disability insurance firms tend to continue. Delays can sometimes drag on for months (or even years) before you see any money. Insurance companies stall even if you cleared all hurdles.

Here is a mistake that many people make when they don’t hire an experienced long-term disability lawyer: they settle for pennies-on-the-dollar. It plays out like this: if you have not been able to work due to a disability or personal injury and have exhausted your savings, your inclination might be to accept less than the amount you’re entitled to on the grounds that some money is better than none. Insurance companies know this, too.

The tortoise approach is also in their favour if you sue them. The Ontario civil court system is notoriously slow, so time is in the insurer’s favour because they don’t have to pay while you wait. When a long-term disability lawyer from Verkhovets Law handles the matter successfully, you could have your benefits reinstated and awarded past denied benefits, damages for stress, some of the legal fees, and punitive damages in addition.

Meanwhile, most insurers demand you apply for CPP Disability (CPP-D) after the first two years of LTD payments. They can deduct that amount from the gross of your CPP-D monthly payment. If CPP-D is halted, LTD payments will increase back in full.

Most LTD policies will do the same with any other benefit payments you are receiving including from:

Our Toronto disability lawyers know it’s a nightmare scenario – you have an illness or injury and can’t work. But your insurer wrongfully denied your claim, and you don’t understand why.

Contact us now and we’ll start work on your behalf.

(905) 910-1440