Providing Evidence in Long-Term Disability Claims

In this context, being disabled means your physical or mental condition stops you from performing most of the tasks of your job. This is why to help prove that your condition qualifies for long-term disability benefits, your doctor will be asked to provide medical information to prove that you are disabled, such as:

• Lab Results;
• Surgery Records;
• Clinical Notes;
• MRI Results;
• X-Rays; or
• Other Treatment Provider Records

This information is used to determine if your condition is a medical illness covered by your benefits plan agreement. If your claim for long-term disability is denied, this may be due to incomplete information, unclear diagnosis, or improper treatment according to the insurer’s standards. However, you have the right to appeal this decision; we can help you prove that your absence from work is medically justified.

Your Long-Term Disability Benefits Have Been Denied – What’s Next?

By law, insurance companies are required to put a denial of benefits in writing. If you’ve received a denial of benefits letter from your LTD insurer, don’t lose hope; if your doctor says you are disabled and you cannot work, the insurance company is obligated to pay out your claim. If you have a legitimate claim, it is possible to collect the compensation you are entitled to from your insurer.

If you have received a denial of benefits letter we strongly recommend that you seek the assistance of a disability lawyer immediately. If involved early on, our team of lawyers can lay the foundation needed to appeal your claim to the insurance carrier, negotiate a settlement, or take your case to court.

CPP Eligibility Criteria – Do you Qualify?

To qualify for Canada Pension Plan (“CPP”) disability benefits, you need to meet three basic criteria. You must (1) be under 65 years of age, (2) have made the required amount of contributions to CPP in the years before you became disabled, and (3) have a “severe and prolonged” disability as defined in the legislation. If your application for CPP disability benefits has been denied, you have the right to appeal.  Acheson Sweeney Foley Sahota, LLP can help you with this process.

Appealing Your CPP Disability Denial

The first step in the appeal process is the reconsideration request. Before preparing your request for reconsideration, it is very important that you have a clear understanding of why your application was denied. The denial letter will set out specific reasons why you do not qualify. The most common reason people are denied is that the Ministry does not accept that the applicant’s disability is sufficiently severe and prolonged. Occasionally an application will be denied because the applicant has not contributed enough, or because the applicant did not apply for disability benefits soon enough after becoming disabled.

A request for reconsideration must be made in writing within 90 days of receiving your denial letter. On reconsideration you are allowed to provide new information that you think will help your case, such as letters from your doctor and other health professionals that address the reasons why your application was turned down. You can also include letters from family or friends who are familiar with your medical condition. The review of the reconsideration can take several months. If you are successful and your denial is overturned, you could receive a lump-sum payment, as well as monthly CPP disability benefits.

If your request for reconsideration is denied, you have the right to appeal your CPP disability claim. The appeal must be submitted within 90 days of receiving the results of the reconsideration. There may be a number of reasons why your appeal was not successful. You will need the advice of a lawyer to find the best way to proceed, and we have the expertise to assist you.

Parter With a Team of Lawyers You Can Trust

As part of our commitment to assisting and empowering disabled individuals, we offer free, confidential consultations by telephone, in-person or by video conferencing. Although our practice is located in Victoria, we represent clients throughout BC. Please feel free to contact us directly by email or telephone if you need our assistance or if you have any questions about CPP Disability appeals or another type of disability insurance claim.