Denied Long-Term
Disability Benefits?

You paid the premiums and expected your insurance company to pay.

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Denied Long-Term Disability Lawyers in Hamilton, Serving Clients all over Ontario

If you’ve been denied long term disability benefits our Hamilton disability lawyers can help. Matt Lalande has been litigating disability cases for claimants province-wide since 2003.  We understand that being denied long-term disability benefits can send a claimant and his or her family rocketing into debt – and put into an aggravating position that causes finanical distress.

If you or a family member has had your disability benefits denied call us today. Our Hamilton disability lawyers have represented disability claimants against every major disability insurance company throughout the Province.

Understanding Long Term Disability Insurance

Typically disability policies are purchased by an individual or be part of a group employment package that is negotiated between employer and broker. Premiums are paid in one of three ways, by the policyholder individually, the employer solely or the employer and employee.

What is the qualifying period?

There is usually a qualifying or elimination period, which can range from 90 to 180 days, during which no benefits are paid but the person may cover their lost wages by drawing on an STD policy, EI or government sickness benefits, which may provide an additional 15 weeks of sick benefits. STD policies are sometimes  paid for by your employer and cover income replacement for the first 120 days of injury or illness.

How long will long-term disability cover me for?

A long-term disability policy generally pays a portion of your usual salary or income as a monthly benefit until you:

  • are able to return to work.
  • no longer meets the definition of being disabled.
  • reach retirement age (age 65), so long as you continue to meet the policy requirements.

Some policies only pay for a defined period (such as 5, 10 or 15 years). Other policies cover the person for life.

How do I qualify for disability benefits?

In order to qualify for long-term disability benefits you must satisfy the definition of “total disability” as set out in your long-term disability policy.

The definition of “todal disability” varies from policy to policy and impacts the level of coverage available.  Typically the definition of total disability differs between pre and post 24 months of disability.

For the first 24 months, the definition of total disability generally means that you are unable to work or, more specifically, unable to carry out the substantial duties f the individual’s usual job.

After 24 months there is typically a “Change of Definition” – meaning the test for total disability changes from your own occupation to any occupation. This change of definition requires you to be disabled from performing any occupation for which you are reasonably suited by reason of education, training or experience.

Has your disability insurance company denied or cut-off your long term disability benefits?

There are a variety of reasons why an LTD claim may be denied or terminated:

  • Insufficient investigation on the part of the insurer.
  • Lack of forms and necessary documentation.
  • Biased Insurance Company Doctor Medical Opinion.
  • Employer did not provide the proper documentation.
  • Misrepresentations on claims forms or other supporting documentation, such as a pre-existing condition that was not mentioned or not fully disclosed.
  • Adjuster did not request sufficient medical documentation.
  • Missed time limit for submitting claim.
  • Failure to have the injury or condition properly documented by the client’s doctors.
  • Failure to participate in treatment regimen.
  • Surveillance evidence contradicting the client’s claimed level of disability.

If you have been denied long-term disability benefits we can help. We have successfully represented disability claimants who have suffered;

  • serious injuries, fractures and bone breaks
  • brain injuries
  • breat cancer
  • cancer in general
  • schizophrenia
  • schizo-affective disorder
  • bipolar disorder
  • mental illness
  • depression
  • anxiety
  • chronic pain
  • chron’s disease
  • rheumatoid arthritis
  • meniere’s disease
  • severe nerve pain, disc bulges and sciatica
  • ptsd
  • complex regional pain syndrome
  • stroke
  • cardiomyopathy
Sometimes you can resolve the LTD claim for a reasonable amount without resorting to litigation – and we try out best to do this.
Typically, when a claim is denied, most policies provide for a right of appeal by submitting a written request for appeal within a certain amount of time, usually within 60 days. The insurer will then review the appeal and provide a decision by letter. If this decision fails, then you may commence an action against your LTD insurer for payment of past benefits and seek a declaration form a Judge that you are disabled and that your disability benefits should be reinstated.

Contact a Hamilton Disability Lawyer Today

If you are an employee that is unable to fulfill the substanbtial duties of your employment, call us today at 905-333-8888. We have been litigating disability claims since 2003. We retain the appropriate doctors, specialist, vocational specialists, psychiatrists, economists and any other professional required to discharge your burden of proving your total disability.
Alternatively, you can contact us by filling in a contract form or by chatting with out live chat agent 24/7.


We’re here to help.  Contact us confidentially at (289) 203-5991 or by filling in a contact form today.

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