Whether you are an employer or an employee in Mississauga, we will cut through the red tape to find the answers you need and deserve. Contact us to see how we can be of service.

What is Total Disability in an LTD Claim?

Total disability is a term used in most long-term disability insurance policies to discourage workers from making a claim unless their injury or illness fulfills the definition of the term. Though the meaning of total disability may vary depending on the policy, it’s generally used to mean that the insured is unable to work any occupation in the long term.

However, you may also be considered totally disabled if:

  • You are unable to work your regular job in the short term
  • You currently work part-time at your current job
  • You only work part-time at another job
  • You perform some tasks of a job but not all
  • You cease to work to improve your quality of life or prolong your life

There’s a wide range of injuries that may satisfy the test of total disability. The insurance adjuster will often examine your loss of use or function and grant up to 100% total disability depending on the extent of your injury or illness. Since disability claims can be complex, you’ll need sound legal advice to get the best outcome. A long-term disability law firm like Walter Law Group in Oakville can help you understand your limitations and advocate for your right to greater compensation.

Has your Long-Term Disability Claim Been Denied? We can Help

Why Choose Our Long-Term Disability Lawyers?

If an insurance company has just denied your claim for disability benefits, we can help you file an appeal. The appeal process can be complex and overwhelming for anyone. Our disability lawyers come with decades of experience to review your claim and determine the reasons it was denied. We will help gather the necessary information that was missing to prove that you have a disability and deserve to be paid benefits. Our long-term disability lawyers will aggressively fight for your rights to have your benefits established or re-established.

Long-Term Disability

Canadian workers who have been unable to work due to an illness or injury for six months or longer may be entitled to long-term disability benefit payments.

Disability Insurance FAQs

We cover commonly asked questions regarding disability benefits programs or any other necessary information in our FAQ section.

What is Total Disability

Every long-term disability policy has the “total disability” clause, which may have a different meaning. It’s important to understand the definition of this term in your policy.

Harassment and Discrimination

If you’ve suffered harassment, discrimination or bullying at work due to an illness or injury, we can help. No individual should suffer harassment at work because of their disability.

Disability (LTD) & Employment – We Do Both

Our law firm handles both disability and employment matters. Whether you’ve been denied disability benefits or you’re facing employment issues that need experienced litigation, you can count on us to deliver. We help you navigate complex legal matters.

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Long-Term Disability Insurance

If you are suffering from a physical, mental, or emotional impairment that has prevented you from working for a period longer than six months, you could qualify for long-term disability benefits. Long-term disability coverage protects workers by providing them with an easy and affordable way to get the financial support needed when they can no longer work. Insurers will receive a monthly benefit only if they can prove that their condition is considered a disability. An unfortunate reality for most workers is that their disability insurance claim may be denied, often because they provided insufficient information to prove that the condition meets the insurance provider’s definition of disability. There are also exclusions that could prevent the insured from collecting benefits.

Most long-term insurance benefits will only replace 60% to 70% of your normal income. You may also qualify for long-term disability benefits for up to two years, and after that, you can only receive benefits if you prove that your condition doesn’t allow you to work at any job. There are disability plans that may require you to enroll in a rehabilitation program which can help you resume work. It’s important to contact your insurer and request your policy information which will help you understand if you qualify for benefits, how much you are entitled to and how long you will receive the payments.

Insurance policies have variations that indicate what qualifies as a long-term disability. Generally, the most common qualifying medical conditions for long-term disability insurance coverage include visual or hearing loss, mental illnesses, various kinds of cancer, immune system disorders like lupus and kidney disease. Working with an experienced disability lawyer will help enforce regulations and protect your rights as an injured worker in Oakville.

Short-Term Disability Insurance

With short-term disability insurance, you will receive benefits for up to 6 months when you’re sick or injured. Short-term disability plans are provided by some employers as part of employee benefits. You can reach out to your human resource department for details on your short-term disability plan.

If your employer doesn’t offer any short-term disability coverage, you may still be eligible for Employment Insurance (EI) sickness benefits. To qualify for this form of coverage, you must usually have exhausted all your paid sick leave days and have worked enough hours. Your long-term insurance benefits will only begin once you stop receiving short-term and EI benefits.

What’s the Difference Between Short-Term Disability Insurance and Long-Term Disability Insurance?

If you’d like to pursue a disability insurance claim, our lawyers can help you understand what options are available depending on your circumstances. Even though each policy is different, there are general factors that distinguish short-term and long-term disability insurance coverage.

Short-term disability coverage is designed to cover the insurer’s expenses for a short period, typically not more than 6 months, after their sick leave is exhausted while they’re still employed. This is best suited for those who are sick or injured and cannot work temporarily. In most cases, short-term disability benefit payments are about 70% of the injured worker’s regular earnings.

Long-term disability coverage, on the other hand, will be paid after the injured worker is no longer receiving short-term disability benefits. To qualify for long-term disability benefits, the insured has to prove that they are completely unable to return to work. These benefits will be paid for much longer, typically at least 2 years. Injured workers can receive long-term disability benefits until the age of 65 if they can prove that they cannot work at any job. Long-term benefits can cover medical costs, rehabilitation as well as income replacement, but this will depend on the policy.

If Your LTD Benefits Have Been Cut Off, We Can Help You

It’s not uncommon for employees to be denied long-term disability benefits even when their short-term benefits have run out and they are no longer physically or mentally ready to resume work. Every policy specifies what conditions need to be met in order to qualify for benefits but proving that you meet these requirements can be a long and tedious process.

Our Oakville long-term disability lawyers will handle the entire claim, so you don’t have to deal with insurance companies. Oftentimes, insurance companies will deny your claim or offer an amount that is lower than what was asked for. We take the stress out of the equation by making sure that your rights are protected, and you can receive the benefits you are entitled to after your injury or illness.

Applying for Denied LTD Benefits

If the insurance company has denied your claim for LTD benefits, you have every right to file an appeal. You will receive a denial letter that has information on why your application was denied together with instructions for appealing the decision. The process of applying for denied LTD benefits can be complicated and confusing. Our Oakville LTD lawyers will handle every aspect of your case.

When you hire us to handle your denied LTD benefits, we will begin by reviewing the denial letter to determine if the reasons for refusal are valid. We will then review a copy of your claim file and begin a fresh application to be submitted to the insurance company. Our lawyers will work tirelessly for you to collect all necessary evidence that was missing from your initial filing. We will ensure to submit the appeal before the deadline (which is 180 days from the denial date). We specialize in LTD claims and will work diligently to get you a favourable outcome and recover the benefits you deserve.

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    Since 1995

    We are proud to be lawyers in Mississauga since 1995.  We live here and we work here and we are proud to be a part of this community. 

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    Mississauga Law Firm

    We are a Mississauga Law Firm, successfully helping clients and their families in Mississauga, Oakville, Brampton and across the GTA, since 1995.

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