Surveillance in the context of Long-Term Disability (LTD) insurance refers to the practice where insurance companies may conduct covert monitoring and observation of claimants to investigate the validity of their disability claims. This surveillance is typically carried out by professional investigators who gather visual evidence, such as photographs or videos, to assess the claimant's activities and functional limitations. Here are key points to understand about surveillance in LTD insurance:

• Purpose: The primary purpose of surveillance is to verify the extent of a claimant's disability and ensure that the reported limitations align with their actual activities. Insurance companies use surveillance as a tool to prevent fraud, confirm the accuracy of claims, and protect the integrity of the LTD system.
  
• Activities Monitored: Surveillance may involve monitoring various aspects of a claimant's daily life, including physical movements, interactions with others, engagement in recreational activities, and participation in events that could indicate the level of disability.
  
• Covert Nature: Surveillance is typically conducted covertly, meaning that the claimant is not aware that they are being monitored. This approach aims to capture the claimant's behavior and activities in their natural state without influencing their actions.
  
• Legal Compliance: Surveillance activities must comply with legal regulations and privacy laws to ensure that the rights of the claimant are respected. Investigators must adhere to ethical standards and obtain evidence lawfully.
  
• Impact on Claims: The results of surveillance can influence the outcome of an LTD claim. If the surveillance footage contradicts the claimant's reported limitations or suggests misrepresentation of disability, the insurance company may use this information to deny or terminate benefits.
  
• Frequency: Surveillance is not conducted continuously for all claimants but is often employed selectively based on specific factors, red flags, or suspicions raised during the claims process.
  
• Balancing Privacy and Investigation: While surveillance is a legitimate tool for insurance companies to verify claims, it raises concerns about privacy invasion and the potential misinterpretation of normal activities as evidence of fraud. Claimants have the right to challenge surveillance findings if they believe their disability status has been misrepresented.

Understanding the role of surveillance in LTD insurance can help claimants navigate the claims process effectively, ensure transparency in their interactions with the insurance company, and seek legal advice if they have concerns about the handling of surveillance activities in relation to their disability claim.

If surveillance has affected your claim, our team can review what happened and help you respond. You don't pay us anything upfront, we only get paid if we win your case. Concerned about how surveillance affected your claim? Bring your questions to a free consultation with our team.

The amount of money you can receive from Long-Term Disability (LTD) benefits in Ontario is influenced by various factors, including the terms of your specific LTD policy, your pre-disability earnings, and the duration of your disability. Here are key points to consider regarding LTD benefits in Ontario:

• Percentage of Pre-Disability Earnings: LTD policies typically provide a percentage of your pre-disability earnings as benefits. This percentage can vary but commonly ranges from 50% to 70% of your pre-disability income.
  
• Maximum Benefit Amount: Most LTD policies have a maximum monthly benefit amount, which caps the total benefits you can receive each month. This maximum amount is determined by the terms of your policy.
  
• Duration of Benefits: The duration for which you can receive LTD benefits varies and is specified in your policy. Some policies provide benefits until retirement age, while others have a limited benefit period (e.g., two years, five years).
  
  
• Integration with Other Benefits: LTD benefits may be integrated with other disability benefits you receive, such as Canada Pension Plan Disability (CPP-D) benefits or workplace pensions. The total amount you receive from all sources may be subject to offsets or reductions.
  
  
• Tax Considerations: LTD benefits in Ontario are generally considered taxable income. However, if you paid the premiums for the LTD policy with after-tax dollars, a portion of the benefits may be tax-free.
  
  
• Cost-of-Living Adjustments: Some LTD policies include cost-of-living adjustments to account for inflation, ensuring that the purchasing power of your benefits is maintained over time.
  
• Return-to-Work Provisions: Many LTD policies include provisions for partial disability benefits if you can return to work on a part-time basis or in a reduced capacity. These provisions may affect the amount of benefits you receive.

To determine the specific amount of money you can receive from LTD benefits in Ontario, it is essential to review your LTD policy documents, understand the terms and conditions of the policy, and consult with the insurance provider or a legal expert specializing in disability insurance claims. They can provide detailed information on benefit calculations, limitations, and any additional factors affecting the amount of LTD benefits you are eligible to receive.

We take these cases on contingency, so there are no upfront fees. We're only paid if we win or your claim settles successfully. Contact us to schedule a free consultation and get clarity on your options.

Insurance companies may deny Long-Term Disability (LTD) claims for various reasons, some of which are legitimate while others may involve errors, misinterpretations, or disputes. Here are common reasons why insurance companies deny LTD claims:

1. Insufficient Medical Evidence: If the medical documentation provided does not sufficiently support the severity or duration of the disability, the insurance company may deny the claim due to a lack of evidence.
   
2. Pre-Existing Conditions: Some policies exclude coverage for pre-existing conditions or conditions that existed before the policy came into effect. If the disability is deemed to be related to a pre-existing condition, the claim may be denied.
   
3. Policy Exclusions: Certain policies have specific exclusions for certain types of disabilities, treatments, or conditions. If the disability falls under an exclusion listed in the policy, the claim may be denied.
   
   
4. Failure to Meet Criteria: Insurance policies often have specific criteria that must be met to qualify for LTD benefits. If the claimant does not meet these criteria, such as the definition of disability or waiting period requirements, the claim may be denied.
   
   
5. Incomplete Documentation: If the required documentation, forms, or information are incomplete, missing, or not submitted within the specified timeframe, the insurance company may deny the claim due to insufficient information.
   
   
6. Discrepancies in Information: Inconsistencies between the claimant's statements, medical records, and other documentation can raise red flags and lead to the denial of the claim.
   
   
7. Failure to Follow Treatment Plans: If the claimant does not follow prescribed treatment plans, attend medical appointments, or comply with rehabilitation efforts, the insurance company may deny the claim on the basis of non-compliance.
   
   
8. Occupational Duties: If the disability does not prevent the claimant from performing the essential duties of their occupation as defined in the policy, the claim may be denied.
   
   
9. Surveillance Results: Insurance companies may conduct surveillance to investigate the validity of a claim. If the surveillance results suggest that the claimant's reported limitations are inconsistent with their activities, the claim may be denied.
   
   
10. Fraud or Misrepresentation: If the insurance company suspects fraud, misrepresentation of facts, or intentional withholding of information by the claimant, the claim may be denied.

Understanding these reasons for denial can help claimants navigate the LTD claims process more effectively, address any issues proactively, and seek recourse if they believe the denial is unjustified. It's advisable to consult with legal counsel specializing in disability insurance claims to explore options for disputing a denied LTD claim.

We get paid only when your case succeeds. Contact us to schedule a free consultation and get clarity on your options.

Long-Term Disability (LTD) insurance typically covers a wide range of medical conditions that significantly impact an individual's ability to work and perform daily activities. While the specific criteria for qualifying for LTD benefits may vary depending on the policy and insurance provider, here are common medical conditions that often qualify for Long-Term Disability coverage:

1. Musculoskeletal Disorders: Conditions affecting the muscles, bones, joints, and connective tissues, such as chronic back pain, arthritis, osteoporosis, and fibromyalgia.
   
   
2. Mental Health Disorders: Including depression, anxiety disorders, bipolar disorder, post-traumatic stress disorder (PTSD), schizophrenia, and other psychiatric conditions that impair daily functioning.
   
   
3. Neurological Disorders: Such as multiple sclerosis (MS), Parkinson's disease, epilepsy, Alzheimer's disease, and other conditions affecting the brain and nervous system.
   
   
4. Cardiovascular Disorders: Including heart disease, congestive heart failure, arrhythmias, and other cardiovascular conditions that impact physical functioning.
   
5. Cancer: Various forms of cancer, including leukemia, lymphoma, breast cancer, lung cancer, and other malignancies that require extensive treatment and cause disability.
   
6. Autoimmune Disorders: Such as lupus, rheumatoid arthritis, Crohn's disease, ulcerative colitis, and other autoimmune conditions that result in chronic symptoms and limitations.
   
7. Chronic Pain Syndromes: Conditions leading to persistent pain and discomfort, such as migraines, complex regional pain syndrome (CRPS), and neuropathic pain disorders.
   
8. Respiratory Disorders: Including asthma, chronic obstructive pulmonary disease (COPD), emphysema, and other lung conditions that impact breathing and physical exertion.
   
9. Endocrine Disorders: Such as diabetes, thyroid disorders, adrenal insufficiency, and hormonal imbalances that affect overall health and functioning.
   
10. Degenerative Diseases: Conditions like osteoarthritis, degenerative disc disease, muscular dystrophy, and other progressive diseases that result in physical decline over time.

It's important to note that each LTD policy may have specific definitions, limitations, and exclusions regarding covered medical conditions. To determine if your medical condition qualifies for Long-Term Disability benefits, consult your policy documents, speak with your insurance provider. Our disability claims lawyers can also help you understand your options.

Yes, you can dispute a denied Long-Term Disability (LTD) claim if you believe that the denial is unjustified or incorrect. Disputing a denied LTD claim involves challenging the decision made by the insurance company and presenting additional evidence or arguments to support your claim for disability benefits. Here are steps to effectively dispute a denied LTD disability claim:

1. Understand the Reasons for Denial: Review the denial letter from the insurance company to understand the specific reasons for the denial. This will help you address the issues raised in your dispute.
   
2. Gather Additional Evidence: Collect any new medical records, test results, physician statements, or other relevant documentation that strengthen your case for disability benefits. Ensure that this evidence directly addresses the reasons cited for the denial.
   
3. Consult with Legal Counsel: Consider seeking advice from a lawyer specializing in disability insurance law. A legal expert can assess your case, provide guidance on disputing the denial, and represent you in negotiations with the insurance company if needed.
   
4. Prepare a Detailed Dispute Letter: Craft a comprehensive dispute letter outlining the reasons why you believe the denial is incorrect. Clearly present the additional evidence, explanations, and arguments supporting your claim for disability benefits.
   
5. Submit the Dispute: Send your dispute letter and supporting documentation to the insurance company within the specified timeframe outlined in your policy. Use a method that provides proof of delivery to ensure your dispute is received.
   
6. Engage in Dialogue: Stay in communication with the insurance company throughout the dispute process. Be prepared to provide further clarification, answer questions, or provide additional information as requested.
   
7. Consider Alternative Resolution: If direct negotiation with the insurance company does not lead to a resolution, explore alternative dispute resolution methods, such as mediation, to seek a mutually acceptable outcome.
   
8. Legal Action: If all attempts to dispute the denial prove unsuccessful, you may consider taking legal action against the insurance company by filing a lawsuit. Your legal counsel can guide you through the litigation process and represent your interests in court.
   

Our long-term disability lawyer can review your denial and help you build a stronger case. Schedule a free consultation to go over your options with our team. We take these disputes on a no upfront fees basis, and payment only comes if we win your case.

When faced with a denial of your Long-Term Disability (LTD) claim, appealing the decision is a crucial step to seek reconsideration and potentially secure the benefits you are entitled to. Here are the steps to effectively appeal a Long-Term Disability denial:

1. Review the Denial Letter: Carefully review the denial letter from the insurance company to understand the reasons for the denial, the policy provisions cited, and any additional information or documentation required for the appeal.
   
2. Gather Supporting Documentation: Collect all relevant medical records, test results, physician reports, and any other evidence supporting your disability claim. Ensure that this documentation addresses the reasons for denial outlined in the letter.
   
3. Understand the Appeals Process: Familiarize yourself with the specific appeals process outlined in your LTD policy. Note any deadlines for submitting an appeal and follow the prescribed procedures to ensure your appeal is considered.
   
4. Draft a Comprehensive Appeal Letter: Prepare a detailed appeal letter addressing each reason for denial, providing additional evidence, explanations, and arguments supporting your claim for disability benefits. Be clear, concise, and organized in presenting your case.
   
5. Seek Legal Advice: Consider consulting with a lawyer experienced in disability insurance law to guide you through the appeals process, review your appeal letter, and provide legal representation if needed.
   
6. Submit the Appeal: Send your appeal letter and supporting documentation to the insurance company within the specified timeframe. Use certified mail or another method that provides proof of delivery to ensure your appeal is received.
   
7. Follow Up and Maintain Communication: Keep track of your appeal timeline, follow up with the insurance company to confirm receipt of your appeal, and maintain open communication throughout the appeals process.
   
8. Consider Alternative Dispute Resolution: If the appeal is unsuccessful, explore alternative dispute resolution options, such as mediation or arbitration, to resolve the dispute outside of litigation.
   
9. Legal Action: If all appeals are exhausted and your claim remains denied, you may consider pursuing legal action against the insurance company through a lawsuit with the assistance of legal counsel.

By following these steps and seeking professional advice where necessary, you can navigate the appeal process effectively and increase your chances of overturning a Long-Term Disability denial.

If your appeal feels overwhelming, our long-term disability lawyer can prepare the appeal with you from start to finish. Talk through your appeal options in a free consultation with our firm. You can pursue an appeal with no upfront fees, since our fee only applies if we recover benefits for you.

Disability is a broad term that encompasses physical, cognitive, sensory, or mental impairments that may limit an individual's ability to engage in certain activities or perform tasks compared to the general population. Disabilities can be temporary, permanent, or episodic, and they vary in severity and impact on daily functioning.

Disabilities can result from various factors, including congenital conditions, illnesses, injuries, accidents, or age-related changes. The effects of a disability can manifest in limitations related to mobility, communication, cognition, sensory perception, or self-care, affecting an individual's independence and quality of life.

In the context of insurance, such as Long-Term Disability (LTD) coverage, disabilities are typically assessed based on their impact on an individual's ability to work and earn income. Insurance policies define disability criteria to determine eligibility for benefits, considering factors such as medical evidence, functional limitations, and the individual's capacity to engage in gainful employment.

If your LTD claim has been denied or delayed, our team can help you understand your options. You don't pay us anything upfront, we only get paid if we win your case. Reach out for a free consultation to discuss your claim.

Understanding the nature of disabilities, their diverse manifestations, and the challenges they pose to individuals is crucial for creating inclusive environments, providing appropriate support and accommodations, and promoting equal opportunities for individuals with disabilities in various aspects of life.

If you believe you or a loved has suffered a serious or fatal injury that may be linked to a recalled drug or if the drug recall notice suggests you may be at risk of future harm, a knowledgeable, skilled and experienced personal injury lawyer can launch a preliminary investigation into the circumstances around your case. If there is sufficient evidence to argue you or your loved one has suffered damages or losses linked to the recalled drug, the product liability lawyer may be able to help you make a claim for compensation.

Our team can review your medications and medical history to determine if you have a claim. We work on contingency, so there's no fee unless we win. Schedule a free consultation to learn more.

As an "invisible" disability, diagnosing and assessing the severity mental illnesses often requires medical providers to consider an individual's self-reported symptoms. Insurers seeking to validate disability claims may their own doctors to review an individual's medical history, require new testing or assessments, and may conduct surveillance to determine if an applicant is as disabled as they claim. Sometimes insurers will use information or alternative opinions in these new findings as a basis to deny a claim.

If your mental health claim has been denied, our long-term disability lawyers can help you challenge the insurer's decision. You don't pay us anything upfront, we only get paid if we win your case. Don't face this alone, schedule a free consultation with our team to discuss your options.

Among the product liability cases we pursue are:

• Dangerous or toxic foodstuffs;
  
• Unsafe toys;
  
• Unsafe children’s products;
  
• Unsafe household appliances;
  
• Defective autos, airbags and car parts;
  
• Defective safety equipment;
  
• Toxic or unsafe house-building materials;
  
• Defective machinery;
  
• Defective recreational vehicles.

A long-term disability insurance policy should be something you can rely on, although this is not always the case. If you or a family member is unable to work for an extended period due to an accident, illness, or injury, we recommend that you consult with a long-term disability lawyer as soon as possible. A lawyer can help determine if you have a potential long-term disability claim against your insurer and advise you on how best to appeal if your long-term disability insurance claim is denied.

You don't pay us anything upfront, we only get paid if we win your case. Reach out for a free consultation to find out where you stand.

In some cases, a lawsuit against the disability insurer may not be available to you. The only recourse you may have is to file a formal grievance if you are a union member. Therefore, it is important to advise our long-term disability lawyers whether you belong to a union as part of your employment. If you do, the terms of the collective agreement between your union and your company will need to be reviewed to determine whether the grievance procedure is the ‘exclusive remedy.’

If the collective agreement appears to make your employer the party responsible for payment of long-term disability benefits, the long-term disability claim will likely have to be ‘litigated’ using the union grievance apparatus.

On the other hand, if the terms of the collective agreement require only that your employer pays the long-term disability insurance coverage premiums to a disability insurer, or if the collective agreement is silent regarding long-term disability insurance, the likelihood is greater that you will be able to bring a lawsuit against the disability insurer for its denial of long-term disability benefits.

Union rules can make this more complicated, but our team can help you figure out the right path forward. You don't pay us anything upfront, we only get paid if we win your case. Get in touch for a free consultation to talk through your situation.

When you have filed your claim, your insurance company may give you the green light to receive your long-term disability benefits. However, it is important to know that long-term disability insurance benefits may terminate because you now fall under a change in the definition of disability after a certain period of time has passed.

A two-year period is the general cut-off mark, signalling a change from being unable to work “your own occupation” to being unable to work in “any occupation”. The moment your long-term disability benefits stop, you need to call a lawyer. It is not up to your long-term disability insurance company to ultimately decide when your long-term disability benefits end. You don't pay us anything upfront, we only get paid if we win your case. Don't wait to find out where you stand, schedule a free consultation with our team today.

No. Even if your employer terminates your employment, your entitlement to long-term disability benefits will continue as long as you remain eligible since your disability arose while you were covered as an employee.

In contrast, your right to participate in group benefit plans may end if your employer terminates you. However, this is separate from your right to continue receiving long-term disability benefits.

If your insurer disputes your ongoing entitlement, our long-term disability lawyer can step in on your behalf. Reach out for a free consultation with our firm to get clarity on your rights after termination. Our firm represents these claims on a no upfront fees basis, with payment due only if we succeed.

There are generally two broad restrictions on how long an insurance company is obligated to continue to pay you long-term disability benefits.

• The first is based upon entitlement.
  To receive benefits, you must continue to meet the disability tests under the applicable own occupation or any occupation provisions.

• The second restriction is related to time or age.
  Every contract for long-term disability insurance is different. Some contracts are time-limited; that is, they will only provide benefits for two years, or five years, or ten years, regardless of your age. Almost all contracts are also age-limited. Nearly every agreement in Canada provides for the entitlement to continue to receive long-term disability benefits as long as you qualify for benefits or until you reach the age of 65, whichever comes first.

Every policy is different, and it's easy to misunderstand when your benefits are supposed to end. Our long-term disability lawyers can review your specific contract and explain what applies to you. We take these cases on contingency, so there are no upfront fees. We're only paid if we win or your claim settles successfully. Contact us to schedule a free consultation and get clarity on your options.

Whether or not your long-term disability benefits are taxable depends on who pays the premiums. In cases where an employee pays the premium by having it deducted from his or her paycheque, any future disability benefit that is received should not be taxable. However, if an employer pays the premium for your long-term disability benefits, the government and the courts will generally consider that benefit a taxable one.

Tax treatment is just one factor that can affect your long-term disability claim. Our long-term disability lawyers can help you sort through the details specific to your policy. You don't pay us anything upfront, we only get paid if we win your case. A free consultation with our team is a good first step.

Long-term disability insurance typically pays a percentage of your wage, subject to a specified maximum. A common percentage is somewhere between 60% and 70% of your regular pre-disability salary.

As there are many different kinds of long-term disability insurance policies, it is essential to understand the terms of your specific coverage. For instance, some policies will include coverage for overtime you worked before you became disabled, while others will only pay you a percentage of your regular wage.

Understanding your policy can be confusing, our long-term disability lawyers can review your coverage. You don't pay us anything upfront, we only get paid if we win your case. Talk to our team in a free consultation to see how your policy applies to you.

You can generally apply for disability insurance benefits by yourself. If you are worried that there might be some reason that the insurance company will dispute or deny your claim, such as a pre-existing medical condition, or disputed diagnosis, it may be beneficial to consult with a long term disability lawyer early on to discuss how to best present your claim.

You don't pay us anything upfront, we only get paid if we win your case. If you're unsure where you stand, a free consultation can help you decide your next step.

Every long-term disability insurance policy is different. However, most policies require that you satisfy the “own occupation” test to qualify for the first stage of benefits, usually lasting one to two years. Generally speaking, you meet the own occupation test if you are unable to perform substantially all of the important elements of your regular occupation. Because every policy is different, a free consultation with our team can help you understand where you stand.

After one or two years, again depending on the policy, the test to qualify for benefits usually changes to what insurance companies refer to as the “any occupation” test. Under that test, you may be entitled to continue to receive benefits if you can establish, on the strength of the medical evidence you submit to the insurer, an inability not only to perform your own occupation but any other occupation for which you are reasonably suited by education, training, or experience.

It is not unusual for claimants to have their benefits terminated once the policy transitions from the “own occupation” to the “any occupation” standard. It is essential to consult with a long-term disability lawyer as soon as you receive a letter from an insurance company indicating that it intends to terminate your benefits due to the change in entitlement definition from own to any occupation. You don't pay us anything upfront, we only get paid if we win your case.

Most insurance companies do not pay such additional benefits under a long-term disability plan. However, your employer’s group benefits plan will often cover drugs and dental.

After you have been away from work for an extended time, employers may either discontinue your participation in the group benefits plan or require you to pay the premiums for your coverage. If your employment is terminated, your eligibility to participate in the group benefits plan will typically end.

Losing group benefits on top of dealing with a disability can add financial strain at the worst time. Our long-term disability lawyers can help you understand your options if your coverage changes or ends. There's nothing to pay upfront, our fee only comes from a successful outcome. Contact us to schedule a free consultation and get clarity on your options.