What to do if your long-term disability claim is denied

This article was originally published by The Hamilton Spectator.

Q: My Long-Term Disability claim has been denied. What happens next?

A: If your claim for Long-Term Disability (LTD) benefits has been denied, your first step is to get the insurer’s denial in writing. A denial letter will outline the reasons for the insurer denying your benefits and allow you to know the case you have to meet.

Next, you should contact a lawyer who specializes in fighting denied LTD claims. These claims are complicated and technical, so it’s important to have someone to guide you through the process.

You and your lawyer should review your LTD policy, which will set out certain parameters for your claim, including:

Whether you fall under the “own occupation” or “any occupation” definition of disability;

  • The amount of your benefit;
  • The time limit on your benefits;
  • Exclusions which may apply to your specific case; and
  • Timelines for any appeals process.

After reviewing the policy, you should submit a written appeal to your insurer in writing, addressing the reasons for the denial and include supporting medical documentation. This documentation may include a description of your disabling symptoms, impairments and the impact on your ability to work.

At this stage, the insurer may decide to change its mind and approve your LTD benefits. However, if your appeal is not successful, it will likely be necessary to start a legal action to protect your rights. Keep in mind that there are very strict time limitations within which to start a legal action – so do not delay.

NOT LEGAL ADVICE. Information made available on this website in any form is for information purposes only. It is not, and should not be taken as, legal advice. You should not rely on, or take or fail to take any action based upon this information. Never disregard professional legal advice or delay in seeking legal advice because of something you have read on this website. Ross & McBride professionals will be pleased to discuss resolutions to specific legal concerns you may have.

Francesca Rollo
Francesca Rollo
P: 905.572.5825