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What To Do If Your Long-Term Disability Claim Was Denied

Many Canadians with disabilities rely on long-term disability coverage, which is also known as LTD in Canada. LTD coverage provides eligible individuals with a percentage of their income (typically between 60% and 70%) if they are unable to return to work due to their illness, injury, or hospitalization.

Unfortunately, a large percentage of long-term disability claims are denied in Canada, leaving thousands of applicants without the benefits they need. If an insurance provider denies your LTD claim, you may have a right to appeal the denial. Consider contacting a long-term disability lawyer to discuss your options for an appeal.

Common Reasons for Long-Term Disability Denials

Insurance providers in Canada deny long-term disability claims for a variety of reasons, and not all of the reasons are legitimate and fair. Often, a consultation with a lawyer is necessary to determine whether or not the denial of an LTD claim is unjust and wrongful. Some of the most common reasons long-term disability claims are denied in Hamilton and elsewhere in Ontario include:

  • The applicant is not consider totally disabled by the insurance company (added ‘by the insurance company’)
  • The applicant is refusing to work even if they were cleared by their doctor to return to work (removed ‘despite the fact that’)
  • The applicant can work in another profession
  • The applicant failed to follow the prescribed treatment plan
  • The applicant breached provisions of the LTD policy
  • The applicant is not covered under the LTD policy because of a pre-existing condition

This is not an exhaustive list of reasons LTD claims are denied.

How to Appeal Your Denial

When your long-term disability claim is denied, you may want to explore your options for an appeal. Typically, appealing a denied LTD claim involves the following steps:

  1. Identify the deadline for filing an appeal. If you want to challenge the denial of your long-term disability claim, it is vital to pay attention to the deadline for filing an appeal.
  2. Analyze the denial letter. An insurance provider must send you an official letter explaining the reason for the denial of your long-term disability claim. Understanding why your claim was denied is essential when working on your appeal strategy.
  3. Gather documents. The success of your LTD appeal depends on your ability to present sufficient and timely evidence to support your case. Consider contacting an experienced long-term disability lawyer to help you gather the necessary documentation.
  4. Identify other benefits. Since the LTD appeal process could take months, you might want to identify additional sources of financial support while your case is pending.
  5. Prepare your appeal letter. Finally, you will need to prepare your appeal letter and submit it to the insurance provider along with the supporting documentation. The appeal letter should be submitted before the deadline.
  6. Consult with an experienced long term disability lawyer. Working with a lawyer may increase your chances of success and a lawyer with experience in long term disability claims can help collect the information required and develop a strategy for appealing the denial of the claim.

Looking for an Experienced Long-Term Disability Lawyer in Hamilton?

If your LTD claim was denied, consider getting legal counsel from an experienced long-term disability lawyer at Lamont Law. Working with a lawyer can increase your chances of success. Our LTD lawyers in Hamilton can help you develop a strategy for appealing the denial of your claim. Get a case review with our lawyers by calling 905.529.6668 or sending us an email.

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