Insurance Claims

Long Term Disability for Anxiety and Depression

Long Term Disability for Anxiety and Depression

Insights into Long Term Disability for Anxiety and Depression by Tim Louis

Long Term Disability for Anxiety and Depression

A claim for long term disability benefits may be made if you are disabled from work as a result of Anxiety or Depression. Both of these conditions can result in an inability to work. Many of my long term disability clients ask me what is the difference between Anxiety and Depression.

What is the difference between Anxiety and Depression?

Both Anxiety and Depression are types of mood disorders. Neither is necessarily disabling in the sense that if not severe, the individual may find that they are able to continue to work with either or both of these conditions.

However, both of these types of mood disorders can render an individual unable to work.

Anxiety can create feelings of worry, nervousness, or dread. Depression causes feelings of sadness, hopelessness, and reduced energy.

Although these two conditions are different, an individual can have both at the same time. In fact, depression and anxiety often occur together. Roughly 60% of people with anxiety also have symptoms of depression, and vice versa. The conditions themselves can also amplify the symptoms of the other, causing the symptoms to worsen or last longer.

Common Questions about Anxiety and Depression and Long Term Disability

Common questions clients of mine suffering from anxiety and/or depression ask me are:

  1. Is long term depression and/or anxiety a disability?
    The answer is yes. The federal government has long recognized these conditions as disabilities. Long term disability insurance companies also recognize these conditions as potentially disabling. However, a mere diagnosis does not in and of itself qualify you for long term disability benefits. Your condition must be so severe that it prevents you from working.

  2. Can depression cause permanent disability?
    Unfortunately, the answer is yes. Sometimes, although luckily rarely, depression can be so long term and extreme that it is permanently disabling. In this case, an individual will never be able to go back to work. Your medical team will be just able to let you know whether or not your depression is likely to be treatable or is permanent.

Suffering from Depression and/or Anxiety?

If you are suffering from depression and/or anxiety to the extent that it is preventing you from working, then in order to make a successful claim for long term disability for depression and anxiety, you should make every effort to bring your family doctor up to speed. They would need to know how your mood disorder is affecting your ability to work.

An example of how depression could affect your life could be an inability to get out of bed due to your depressed mood and fatigue forcing you to call in sick. Your symptoms might cause other problems such as inability to focus, concentrate, or pay attention during meetings or phone calls. Lack of interest in things you once enjoyed due to low energy and feelings of hopelessness can make even the most mundane tasks seem like mountains to climb.

On the other hand, with anxiety, it can affect your life in a completely different manner. You might feel so anxious that you feel physically ill, making you unable to go in to work. You might have panic attacks due to immense feelings of worry and fear. You could have social anxiety, meaning that social interactions themselves can cause you great stress and fear. There are many types of anxiety disorders, and each of them can impact your life in different ways.

Both of these mood disorders can put your life, career, and relationships in disarray.

It is also very important that you are aware of the fact that you are not eligible for long term disability benefits if your mood disorder is caused by the unique workplace environment of your current job. If a change of employers would likely leave you now no longer disabled, but rather able to work, then you do not have a valid claim for long term disability for anxiety and depression. It is for this reason that your application for long term disability benefits should not suggest that the root cause of your mood disorder is your work environment.

Making a Claim for Long Term Disability for Anxiety and Depression

Making a claim for long term disability benefits is relatively easy. Your employer will provide you with the form that needs to be filled out. One of these forms, the Attending Physician Statement, will need to be completed by your family doctor. If you are seeing a specialist such as a psychiatrist for treatment, you may consider having the specialist complete the Attending Physician Statement.

If you have been denied long term disability benefits and do suffer from depression and/or anxiety, contact me immediately for a no-fee consultation. 778-855-3494.

Further Reading

Anxiety, feelings of depression and loneliness among Canadians spikes to highest levels since spring 2020

Anxiety, depression, loneliness at highest levels among Canadians since early pandemic: survey

 

Long-Term Disability Claim


Long-Term Disability Claim

by Tim Louis

Long-term disability insurance is designed to protect you in the event of serious injury or illness. If your psychological or physical condition prevents you from being able to work, the insurance company should pay out a monthly benefit. This is designed to provide some financial support for your care and treatment.
Long-Term Disability Claim

However, Insurance Companies Deny Long-Term Disability Claims

Unfortunately, the reality is that insurance companies deny long-term disability claims. Sometimes rehabilitative therapy for people suffering from a long-term disability can be helpful, but it is not always the case. Permanent disability can sometimes be the result as well. However compensation of long-term disability benefits is the least you should expect if you have insurance.

Dealing with insurance companies can be very difficult, particularly if you are dealing with a serious illness or condition. Having a lawyer, like Tim Louis, to guide and protect you through the process is the key to getting the compensation you deserve. If your long-term insurance claim has been denied, call Tim Louis at (604) 732-7678 for a free consultation.

Long-term Disability Claim Denied

H.G. contacted me just over two years ago. She was referred to me by a previous long term disability client of mine who was very pleased with what I did for her. H.G.’s long term disability insurance company had just denied her claim for LTD benefits. H.G. had lost the ability to work at her very physically demanding position. She had developed Activity-Related Soft Tissue Disorder (ASTD) with myofascial injury to her cervical spine and shoulders. She had also aggravated her pre-existing degenerative disc disease.

She suffered from chronic joint and muscle pain, muscle spasms, numbness, neck pain, shoulder pain and pain and stiffness whenever she would bend, lift or walk.

I immediately obtained a copy of her insurance policy and then filed her lawsuit in the Vancouver Registry of the Supreme Court of B.C. Her insurance company filed a boilerplate response. They actually denied that she was disabled!

Insurance companies take me seriously and so it did not surprise me that fairly soon after the lawsuit had started they began to make offers of settlement. With my client’s instructions I rejected offer after offer.

The insurance company then conducted an Examination for Discovery of my client. At this step in a lawsuit there is no judge present. There is a court reporter who takes down a transcript of all the questions asked by the opposing lawyer and all of my client’s answers. I always prepare my clients extremely well before this step in the lawsuit. With H.G., this was no exception. While H. G. was a credible witness, I knew the insurance company lawyer might try to get her confused and then take advantage of the inevitable inconsistencies as she spoke.

A few days before the Discovery, I engaged her in a mock Discovery so she could practice what it would be like to be under a bit of stress. She did very well at the Discovery. H.G. came across as a likable, believable and reliable witness. After the Discovery, she told me how helpful our preparation together had been for her.

Shortly after the Discovery, the insurance company lawyer asked if we might be agreeable to Mediation. I recommended to H.G. that she accept the insurance company’s suggestion of mediation. Mediation is off the record, that is if settlement is not reached during mediation and the lawsuit proceeds to trial, nothing said at Mediation can be used against the client.

Mediation is a process whereby the parties engage in active negotiation with the assistance of a trained professional mediator. Throughout the day, the mediator will alternate between bringing the two parties together into the same room for face to face negotiations and separating the parties into two separate room shuttling back and forth between the parties. A mediator is different from an arbitrator in that an arbitrator makes a decision that is binding on both parties whether they liked the decision or not. Whereas a mediator only makes recommendations.

At the mediation, the insurance company slowly increased their offer of settlement – one-hundred thousand, one-hundred twenty thousand… two-hundred thousand and then finally two-hundred twenty-five thousand. I calculated that this was more than my client would receive at trial if she won. With great pleasure and a lot of relief, H.G. accepted the offer and we had a settlement. I had achieved the goal I aim for with all of my long-term disability clients – settle for nothing less than trial dollars without going to trial.

Has your Long-Term Disability Claim Been Denied?

If your long-term disability claim has been denied, call Tim Louis at (604) 732-7678 for a free consultation. Get the compensation you deserve.

Get the help you need. Give Tim Louis a call today at (604) 732-7678 for a no-fee telephone consultation, during which he will answer all your questions, no matter how complex. If you have received the insurance claim denial in writing, he will also review the letter and schedule a second no-fee telephone consultation to review and assess that long-term disability claim denial.

Don’t let the insurance company bully you into a settlement. Before you accept any decision, contact Long-Term Disability Lawyer Tim Louis.

Have a question? Use our convenient “Get Help” chat below.

Long Term Disability Plan Regulation

Tim Louis” target=”_blank” title=”Learn more about long-term disability plan regulation in BC”>Learn more about how the BC Government regulates long-term disability plans and long-term disability claims.

Workplace Injury – Can I sue my workplace for an injury?

workplace Injury

Workplace Injury – Can I sue my workplace for an injury?

If you are injured on the job, the law does not permit you to sue your employer. Instead, you must make a claim with WorkSafeBC. The good news here is that you do not need to be concerned about your employer’s financial ability to pay you for lost wages and/or permanent lost earning capacity. The bad news is that WorkSafeBC can be a nightmare to deal with. You do not ever get your day in court.

A workplace injury is any injury that occurs within your scope of employment. What this means is that your injury, in order to be covered by WorkSafeBC, does not have to occur at a specific worksite. If, for instance, you are driving and doing so as part of your employment, then you are covered. As example might be your employer asking you to leave your worksite to go on an errand. If you are running the errand as part of your employment and suffer an injury, you are covered by WorkSafeBC.

Serious Workplace Injuries

From 2010 -2019, there were over 63,000 serious workplace injuries reported in BC. (read more).

According to WorkSafe BC, workers in B.C. …”missed 3.2 million days of work due to work-related incidents and disease…”(Worksafe BC). The most common types of injury claims accepted by us were:

  • Strains and other than back strains
  • Back strains
  • Cuts
  • Contusions
  • Fractures

If you have been injured on the job, it is important to report the injury as soon as possible to Worksafe BC. It is also a good idea to contact personal injury lawyer Tim Louis to get the best legal advice regarding workplace injury to assist you in ensuring you get the compensation you deserve.

Reporting a Workplace Injury

Reporting a workplace injury is very easy. It can all be done over the phone (WorkSafeBC Teleclaim 1-888-967-5377).

In order for you to be eligible for WorkSafe benefits, your injury does not need to occur at a specific time. A perfect example of this is carpal tunnel syndrome from typing. A worker who develops this syndrome will do so as a result of typing over a number of weeks if not years. Another example is lung cancer caused by exposure to asbestos. The “injury” would take place over many decades.

As soon as you suffer a workplace injury, you should immediately report it, not only to WorkSafeBC, but also to your employer and your family doctor. Failure to do so may seriously weaken your claim. Your doctor will be asked by WorkSafeBC to confirm your injury. If it is a very serious injury and you are taken to a hospital by ambulance, do not leave it to the ambulance crew or the hospital to report your injury to WorkSafeBC.

Most WorkSafeBC are relatively straight forward. However, sometimes, this is not the case. If you feel that you are not being treated fairly by WorkSafeBC, you should immediately hire a workplace injury lawyer familiar with WorkSafe claims.

Repealing Workplace Injury Decisions

Appealing Worksafe decisions to court is very difficult and rarely successful. In 2016 an injured worker, Anna Currie was successful. The chambers judge overturned Worksafe’s decision to refuse to provide retroactive vocational rehabilitation benefits to her. Sadly, Worksafe simply appealed the chambers judge decision to the BC Court of Appeal.

The BCCA reinstated the Worksafe decision to refuse to provide retroactive vocational rehabilitation benefits.

Read More

Workplace Safety

To keep everyone safe on the job, all employees should participate in workplace safety protocols. This group collaboration works to protect everyone, increase safety on the job, prevent workplace injury and helps with overall productivity.

In order to prevent workplace injury, it is important to:

  • Always report unsafe work conditions
  • Keep a clean workstation
  • Ensure you always wear protective equipment such as hard hats and steel shank/toe boots
  • Take breaks – workplace injury often occurs when people are tired
  • Don’t skip any steps to get the job done faster – follow workflow procedure for safety
  • Stay up to date with new safety protocols and procedures
  • Use proper posture and follow safe working and lifting procedures
  • Help the new employees – guide them on looking after their health, safety and the safety of the workplace

Injured on the Job?

If you have been injured on the job, contact Tim Louis today to get the best legal advice. As a seasoned personal injury and long-term disability lawyer, he will provide you with the best legal advice and help you navigate the complications of a WorkSafe BC claim. Give Tim Louis a call today at (604) 732-7678 for a no-fee telephone consultation, during which he will answer all your questions, no matter how complex.

Sources:

Provincial Overview by Worksafe BC. Free data visualization software. (n.d.). Retrieved January 16, 2022, from https://public.tableau.com/app/profile/worksafebc/viz/Provincialoverview/Didyouknow

Worksafe BC: Facts & figures. WorkSafeBC. (2021, March 12). Retrieved January 16, 2022, from https://www.worksafebc.com/en/about-us/shared-data/facts-and-figures

 

 

Client Reviews

Long-Term Disability Lawsuit

Long-Term Disability Insurance Lawsuit

Long-Term Disability Lawsuit:

Expert insights from long-term disability lawyer Tim Louis.

Many of my long-term disability clients are under the mistaken belief that if they win at trial the judge will order the insurance company to pay my client one lump sum equivalent to the amount of each monthly payment multiplied by the number of months from the trial to the date of my client’s retirement. Unfortunately, this is not the case. If you win your long-term disability lawsuit the court will order your insurance company to begin paying you monthly. There will be no lump sum representing what is referred to as “future benefits”.

With the above in mind, I was quite interested in the Court of Appeal decision in a case approximately three years ago. The Plaintiff, Nadine Lydia Gascoigne, had successfully sued Desjardins Financial Security Life Assurance Company for her long-term disability benefits. Her lawyer had asked the trial judge to aware a lump sum for Ms. Gascoigne’s future benefits. The trial judge refused to do so and instead ordered Desjardins to begin making monthly payments. Her lawyer appealed the trial judge’s decision not to award a lump sum for future benefits.

The BC Court of Appeal turned down Ms. Gascoigne’s appeal. Here are two paragraphs from the BC Court of Appeal Decision:

[29] In short, in my view, the trial judge correctly found he was bound by Warrington, as we are, to find that a non-contracting beneficiary of a group policy is entitled to enforce the payment of benefits, but not entitled to terminate the group policy or accept the insurer’s repudiation.

[30] The appellant did not advance any basis other than fundamental breach of the policy as a ground upon which she might be entitled to a lump sum award. It is not necessary, therefore, for us to determine whether such an award can be made for the breach of a disability insurance contract and breach of the duty of good faith. However, in this case, two obstacles stood in the way of such an award. First, the bad faith established was not found to be such as to preclude continuing performance of the parties’ contractual obligations, and second, the appellant’s own expert witness testified that she has “not yet reached the point of maximal medical improvement”. Some further interventions were contemplated, and she would suffer “some degree of vocational disability” for “an unknown period of time”. There was clearly a basis for the judge to say the evidence did not establish that the appellant would remain disabled from any occupation. He could properly regard that as a reason not to grant any relief other than the declaratory order made with respect to continuing benefits.

This means that the law remains as it always has been – if you successfully sue your long-term disability company, you will not be awarded a lump sum for future benefits, but rather begin receiving monthly payments.

Read more about the long-term disability lawsuit case here:

Gascoigne v. Desjardins Financial Security Life Assurance Co. (c.o.b. Desjardins Insurance), [2020] B.C.J. No. 1821, 2020 BCCA 316, British Columbia Court of Appeal, November 3, 2020, M.E. Saunders, P.M. Willcock and G.B. Butler JJ.A.

 

 

 

Client Reviews

Personal Injury: Understanding Whiplash

Personal Injury - Whiplash

Personal Injury: Whiplash
Seek medical attention right away and contact an experienced personal injury lawyer, like Tim Louis,
who has the background, compassion, and skill to help you receive the compensation you deserve.

 

Personal Injuries: Understanding Whiplash

Whiplash is a relatively common personal injury caused by a sudden and forced rapid
back-and-forth motion of the head. Most people associate whiplash with a vehicle crash,
however, a personal injury like whiplash can also happen at any time, such as at the workplace, in sports, or from any type of fall or physical trauma. All forms of neck injuries can cause an intense flexing and extension of the neck — and usually involve the muscles, discs, nerves, and tendons.

How Do You Know if You Have Whiplash?

Your doctor will conduct a physical exam, observing your range of motion, and may order an
X-ray, MRI, or CT scan if they suspect you have whiplash or any other injury that has caused
damage to your spinal cord or if you have any other broken bones. In many cases, the injury
occurs within structures too microscopic to be visible on these tests, resulting in relying on
symptoms to tell if a patient has whiplash.

Symptoms of Whiplash

Many people assume that one must be hit hard from the front or behind to experience whiplash,
but in reality, it only takes roughly 5-10 mph speeds to get a jolt hard enough to give you a
serious whiplash injury. Thankfully, whiplash is not life-threatening, but for some several
symptoms can appear days, months, or even years later — leading to a substantially lowered
quality of life for those who suffer from a severe form of whiplash. Common symptoms may
include:

  • Dizziness
  • Fatigue
  • Jaw pain
  • Headache
  • Shoulder stiffness
  • Vision issues
  • Muscle spasms
  • Head and neck pain
  • Decreased range of motion
  • Back pain
  • Insomnia
  • Tinnitus
  • Issues with concentration

If you have been involved in an accident, ensure that you seek medical attention right away.
Even if you do not experience any of the above symptoms, it can take 48 hours or longer for
whiplash symptoms to present themselves after an injury. In more severe and chronic cases of
“whiplash associated disorder” symptoms may include:

  • Depression
  • Frustration and anger
  • Anxiety and stress
  • Possible drudge dependency
  • Post-traumatic stress syndrome (PTSD)
  • Insomnia

How Long Will Your Neck Hurt After An Accident?

Most people recover from whiplash within a couple of weeks up to a few months. However,
there is no specific timeline with regards to how long symptoms will last after a whiplash or any
other personal injury. Everyone is unique, and healing times can depend on the severity of the
injury, and whether scar tissue has formed — leading to other chronic issues such as disc
herniation and lifelong pain.

While some people may never experience symptoms after an injury, others may live with excruciating pain for weeks, months, or even years. Any severe neck injury requires ongoing medical attention and care, which can get expensive and should be taken into consideration related to your injury claim.

How is Whiplash Treated?

Your doctor may prescribe muscle relaxers and or anti-inflammatories to manage pain and
inflammation. Ice is often recommended for the first 24 hours after injury, and later, applying
heat may help loosen up tightened muscles and knots. For more serious whiplash injuries,
physical therapy may be recommended to help regain strength and range of motion. Studies
have shown that stretching and rotating the neck muscles is a more effective form of therapy.
Medical professionals now recommend this form of controlled movement as opposed to
immobilizing the neck in a soft cervical collar, which was the recommended option in the past.

How Can Personal Injury Lawyer Tim Louis Help With Your Whiplash Personal Injury?

Patients with minor symptoms may find that whiplash pain goes away within days or weeks.
However, those with more severe symptoms may require medical attention and extensive
therapy for pain relief and recovery. If you or a loved one is suffering from whiplash, your injury
may be more serious than you expected. Seek medical attention right away and contact an
experienced personal injury lawyer, like Tim Louis, who has the background, compassion, and skill to help you
receive the compensation you deserve. Delaying your personal injury case may be detrimental
to your future.

Contact our team today by calling 604-732-7678 or email Tim Louis at timlouis@timlouislaw.com for a no-obligation, free consultation. We’re on your side.

 

 

Client Reviews

Undercompensation of Mental Distress Damages in Disability Insurance

disability insurance - mental distress undercompensation

Disability Insurance: Undercompensation of Mental Distress Damages

Insights into Disability Insurance undercompensation by Long-Term Disability Lawyer Tim Louis

Introduction

Disability insurance is contractual in nature. When a disability insurer denies benefits to a disabled claimant, the claimant may sue for breach of contract to recover the benefits. Additionally, the claimant may seek mental distress damages, punitive damages, and special costs. Mental distress damages are intended as compensation for the claimant’s psychological injury; punitive damages are intended to punish the insurer’s misconduct; and special costs are awarded only in unique circumstances.

This article focuses on mental distress damages. As these damages are compensatory, they are comparable in nature to damages for psychological injuries in tort; yet, mental injuries have given rise to substantially higher quantum awards in tort claims than in disability insurance cases. This disparity is only partially explained by disability insurance claimants’ pre-existing conditions. In this article, we examine this disparity and the case law through which it has arisen, and propose that this disparity has no principled basis.

Contract and Tort Law: Similar Compensatory Principles

Hadley v. Baxendale (1854), 9 Ex. 341 [Hadley], a decision of the Court of Exchequer Chamber, provided that where one party had breached a contract, the other party could claim compensatory damages arising “from such breach of contract itself, or such as may reasonably be supposed to have been in the contemplation of both parties, at the time they made the contract, as the probable result of the breach of it.”

In Fidler v. Sun Life Assurance Co. of Canada, 2006 SCC 30 [Fidler], the court applied the principles of Hadley to a disability insurance contract. The court reasoned that disability insurance contracts are “peace of mind” contracts: the insured party has entered the contract for the tangible benefit of financial payments if disabled, but also for the intangible psychological benefit of having a reasonable expectation of income security. Both parties would have reasonably contemplated these benefits at the time they made the contract. As such, if an insurer wrongfully withheld disability benefit payments, the insured’s mental distress arising from their loss of income security would be compensable, following the principle set out in Hadley.

Psychological injuries are compensable in tort claims through non-pecuniary damages. The courts have implied that the mental distress damages arising from breach of contract should be the same as those arising through a tort claim. In Mustapha v. Culligan of Canada Ltd., 2008 SCC 27 [Mustapha], the court stated with respect to damages that “[w]ith regards to Mr. Mustapha’s psychiatric injury, there is no inconsistency in principle or in outcome between negligence law and contract law.” This was followed in Lau v. Royal Bank of Canada, 2017 BCCA 253 [Lau], with the court stating “[t]he test for mental distress damages is, in principle, the same in contract and in tort.”

In Saadati v. Moorhead, 2017 SCC 28 [Saadati], the court determined that a psychiatric diagnosis was not a prerequisite for compensation for psychological injuries in tort law. The court reasoned that the damages awarded for mental injury are not based on the injured party’s diagnosis, but rather on that party’s symptoms and their effects (para 31). While Saadati was based on a tort claim, its reasoning was adopted and applied in Lau for mental distress arising from a breach of contract.

Contract and Tort Law: Similar Tests for Psychological Damages

Where an insurer has wrongfully denied disability benefits, the test for whether to award mental distress damages is provided in Fidler at paragraph 47:

The court must be satisfied: (1) that an object of the contract was to secure a psychological benefit that brings mental distress upon breach within the reasonable contemplation of the parties; and (2) that the degree of mental suffering caused by the breach was of a degree sufficient to warrant compensation

The test for whether to award damages in negligence is set out in Mustapha at paragraph 3:

A successful action in negligence requires that the plaintiff demonstrate (1) that the defendant owed him a duty of care; (2) that the defendant’s behaviour breached the standard of care; (3) that the plaintiff sustained damage; and (4) that the damage was caused, in fact and in law, by the defendant’s breach.

These are very similar tests. Firstly, there must be a breach, whether of a contractual duty to pay disability benefits, or of a common law duty.

Secondly, there must be sufficient damage sustained to warrant compensation. In the tort claim in Mustapha, the court set stated that for psychological injury to be compensable, it must be “serious and prolonged and rise above the ordinary annoyances, anxieties and fears that people living in society routinely, if sometimes reluctantly, accept” (para 9). Similarly, the court in Fidler stated it must be “of a degree sufficient to warrant compensation” (para 47). As noted in Saadati and Lau, this will not necessarily require expert medical evidence.

Finally, the damages must be caused in fact and in law by the breach. In Mustapha, the court found that the plaintiff’s psychological injuries must be a reasonably foreseeable result of the defendant’s breach of its duty of care in order to meet the test for legal causation. The court in Fidler, applying the principles of Hadley, applied a test of whether damages arising would have been in the reasonable contemplation of the parties; this is quite similar to the reasonable foreseeability test in Mustapha.

Contract and Tort Law: Different Quantum Ranges

In Asselstine v. Manufacturers Life Insurance Co., 2005 BCCA 292 [Asselstine], the court reviewed previous awards for mental distress damages in disability insurance, and found they typically ranged between $10,000 – $20,000. The court upheld the trial judge’s award of $35,000, finding this amount to be at the upper end of the range for mental distress damages.

In contrast to Asselstine, tort cases in BC have provided a significantly wider range of damages for psychological injuries. In Hans v. Volvo Trucks North America Inc., 2016 BCSC 1155, the plaintiff in a motor vehicle accident claim suffered debilitating and long-lasting PTSD and Major Depressive Disorder, though he did not sustain any physical injuries. He was awarded $265,000 in his tort claim. In Saadati, the plaintiff in a motor vehicle accident was awarded $100,000 in non-pecuniary damages for his tort claim for psychological injuries alone, despite having significant pre-existing chronic pain and minimal pre-accident income.

In claims for mental distress damages in disability insurance cases, there is the obvious hurdle that the plaintiff will have significant pre-existing conditions – enough to be disabled from working. However, even accounting for this, the courts in BC have awarded quite conservative damages.

In Gascoigne v Desjardins Financial Security Life Assurance Company (Desjardins Insurance), 2019 BCSC 1241, aff’d on other grounds 2020 BCCA 316, the plaintiff initially developed a physical disability. The insurer denied her disability benefit payments. The plaintiff eventually developed depression and anxiety, largely “related to the financial pressures she and her family felt when the plaintiff stopped bringing home an income” (para 36). As a result of the denial of disability benefits, the plaintiff went from being happy and optimistic to withdrawn and distressed about finances. She became less able to cope with the demands of daily life. She separated from her husband and was expecting to divorce. Despite these significant impacts on her life, largely brought about by the insurer’s breach of contract, she was awarded only $30,000 for mental distress.

In Tanious v. The Empire Life Insurance Company, 2016 BCSC 110, aff’d on other grounds 2019 BCCA 329, leave to appeal to SCC refused, the plaintiff was denied disability benefit payments. She had significant disabling conditions, including multiple sclerosis, depression, and anxiety, and she had used illicit methamphetamines to try to cope with her disabling conditions. The insurer’s denial of her disability benefits made her living situation substantially worse. She could not afford good housing or food, and at times could not even have her soiled clothes washed. She had worked hard and paid for her insurance, and she felt she was being looked upon as a liar and a criminal when the insurer rejected her claim. She was awarded a mere $15,000 in mental distress damages.

There may be room to expand the range of mental distress damages in disability insurance claims. The court in Godwin v Desjardins Financial Security Investments Inc., 2018 BCSC 99 stated at paragraph 169:

Had the defendant been responsible for the entirety of the plaintiff’s psychiatric symptoms, an appropriate award may have been in an amount somewhat higher than the $70,000 to $80,000 contended for by the plaintiff. In the present case, the award must reflect the fact that Desjardins’ conduct only marginally aggravated Ms. Godwin’s illness. I award damages for mental distress in the amount of $30,000.

This judgment reflects that future awards for mental distress in disability insurance may come closer to those in personal injury torts. Additionally, in Greig v Desjardins Financial Security Life Assurance Company, 2019 BCSC 1758 the court awarded $50,000 in mental distress damages, though the case is currently under appeal. The majority of cases, however, continue to assess damages within the range set out in Asselstine, despite acknowledging that this range is “modest” (C.P. v. RBC Life Insurance Company, 2015 BCCA 30 at para 65).

Conclusion

The gap in psychological damage awards between disability insurance claims and tort claims is worthy of further examination in the courts. Both areas of law aim to provide compensation for the same types of injury, and the courts have recognized that damages in contract and tort should be similar. To prevent arbitrary distinctions, previous case law setting out a “modest” range of damages in disability insurance cases should not be given undue weight. Instead, case law on psychological damages in both disability insurance and in tort should be considered of equal precedential value with respect to future awards of damages for mental distress.

 

 

Client Reviews

Why You Should Hire a Long-Term Disability Lawyer

Long-Term Disability Lawyer

Why You Should Hire a Long-Term Disability Lawyer

Disability insurance is an affordable option to protect you financially if you have an accident at work and become injured or ill. If you cannot perform your job due to injury, you should receive a monthly benefit resulting from a psychological or disabling physical condition. Sadly, employees are often denied or cut off from receiving benefits before they are able to continue employment. Every insurance policy is unique and outlines conditions that must be met. Although these conditions are outlined, sometimes satisfying these conditions can be challenging.

 

An experienced Long-Term Disability lawyer can help.

If you have applied for long-term disability benefits and your claim has been wrongfully denied, we strongly advise that you hire an experienced Long-term disability lawyer.

 

Why You Should Hire a Lawyer for Long-Term Disability Benefits

  • Communicating with insurance companies can be challenging and stressful. Your lawyer will reduce your stress by handling all the details; so you can focus on your health and well-being.
  • Insurance companies commonly use wording in their policies that can be confusing and may lead to the possibility of damaging your case. A long-term disability lawyer will take charge and will ensure you avoid any pitfalls.
  • Some insurance companies hire Private Investigators to build a case against you by conducting surveillance; documenting your activities and capabilities. They may also edit this footage to discredit you. These are all ways insurance companies can prove to a judge that you are capable of more significant activities than your claim indicates. Your long-term disability lawyer has seen it all before and will guide you through the process and gather evidence to support your claim accurately.
  • Your lawyer will know the information required and the specific questions that need to be asked of your doctor — ensuring that all possible evidence is presented to support your appeal.
    •  

      When You Should File a Claim

      There are statutes of limitations in British Columbia, meaning that there are strict deadlines you must adhere to when you file a disability claim. An experienced lawyer in this area of expertise will ensure that your doctor(s) have provided an adequate amount of information or anything else required to support your appeal. You will want to contact your lawyer as soon as possible to ensure you do not miss any crucial deadlines during the process.

       

      What You Should Do If Your Claim Has Been Denied

      There are several reasons why an insurance company would deny disability benefits:

      • The medical condition does not fall under the definition of ‘disability.’
      • An inadequate amount of evidence to support the injury.
      • The claim was not filed on time.

       

      We highly suggest that you contact your disability lawyer as soon as you find out that your claim has been denied. Even though your claim was denied, this does not necessarily mean your case is closed. A trusted disability lawyer will review your policy and ensure that all information required is submitted to help prove that your condition meets the definition of ‘disability’ according to your insurance policy.

       

      Talk to a Long-Term Disability Lawyer for a No-Obligation, Free Consultation

      You do not have to handle this alone. If your long-term disability claim has been denied, speak with Tim Louis & his compassionate, trusted team of experts by calling 604-732-7678 or email timlouis@timlouislaw.com for a free consultation, and we will provide you with the best possible options.

       

       

       

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Addiction & Long-Term Disability: Are You Covered for Benefits?

long-term disability and addiction

Addiction & Long-Term Disability: Are You Covered for Benefits?

Addiction resulting from prescription medication, gambling, or other substances, can be mentally and physically debilitating. While some individuals can walk into a casino and gamble a few times a year, others can become chronically addicted. According to the Centre for Addiction and Mental health, 1 in 5 Canadians experience a mental illness or addiction problem in any given year.

Now More Widely Understood, Addiction is No Longer Considered a Choice

Unlike the United States, Canada views addiction as a disease. Human rights legislation protects individuals on the grounds of disability and includes those who suffer from drug and alcohol dependency.

If You Struggle With Addiction, You May Qualify for Long-Term Disability Benefits

Whether or not you qualify for long-term disability benefits from an insurance carrier depends on your employer’s group insurance policy. Specific requirements must be adhered to concerning rehabilitation and or treatment programs to qualify. It is important to distinguish between addiction regarding legal substances (alcohol, cannabis, prescribed medication) and illegal substances (cocaine, meth, heroin).

You can count on the team at Tim Louis Law to thoroughly review your private or group insurance policy to ensure that your rights are protected — providing you with peace of mind that in turn allows you to focus on treatment.

Insurance Companies Routinely Deny Claimants with Substance Abuse Issues

Insurers do not always make it easy to claim disability benefits since many companies do not consider addiction a disability. A qualified long-term disability lawyer can help. Your lawyer will challenge the insurer’s decision on your behalf, as many individuals do not realize that substance abuse is considered a disability in Canada.

Medical Evidence is Integral

Medical documentation as evidence is integral for any disability claim. The claimant must show that their addiction has inhibited their ability to function. The medical evidence must also meet private or group policy standards that dictate the criteria for eligibility.

Treatment Options

Addiction treatment is almost always long-term as relapse is common if undergoing short-term treatment.

Typical treatment options are as follows:

  • Detox
  • Counseling
  • Medication if required
  • Mental health evaluation
  • Treatment for any mental health conditions if necessary
  • Follow-up care for relapse prevention

Gambling as an Addiction

Just as serious of a condition as other more common addictions, compulsive gambling is on the rise in Canada and just as destructive. Gambling addiction leads to a range of personal and social harms such as depression, bankruptcy, anxiety, suicide, and abuse. Unfortunately, in Canada, compulsive gambling may not qualify as a disability.

Compliance Is Key

Compliance is key with regards to disability benefit eligibility. The individual seeking insurance benefits must proactively participate in treatment and/or rehabilitation programs to continue to receive compensation. Failure to do so will result in being disqualified or denied the claim.

Most policies have time limitations that can be difficult to interpret. If your application for disability benefits has been denied by an insurer, do not give up hope. We strongly encourage you to obtain legal advice from a trusted and experienced long term disability lawyer to discuss your dispute case to help navigate your way to a fair and equitable resolution of your claim.

Contact an Experienced & Empathetic Long-Term Disability Lawyer

If you are suffering from an addiction and are unsure if you qualify for long-term disability benefits through an insurer, our trusted and compassionate team at Tim Louis and Company will protect your rights so you can focus on treatment and recovery. Reach out to us by calling 604-732-7678 or email timlouis@timlouislaw.com for a free consultation, and we will provide you with the best possible options.

Source: https://www.camh.ca/en/Driving-Change/The-Crisis-is-Real/Mental-Health-Statistics

 

 

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Disability Claims for Self-Employed Professionals

Disability Claims for Self-Employed Professionals

disability claim for self-employed
If you are self-employed and have purchased a disability insurance policy, you have assumed that this policy serves as income replacement if you are unable to run your business for a period of time due to injury or illness.

Private disability insurance is commonly more expensive than group insurance, and generally, the type of coverage it provides is usually more valuable as it often provides benefits in the event you are unable to work in your regular occupation. Unfortunately, just because you have purchased an insurance policy, this does not necessarily mean that the insurer will not make it challenging for you to receive benefits after you have submitted a claim. Insurers often heavily scrutinize claims submitted by independent, self-employed individuals – this is because of the sometimes-large benefit amounts provided by some of these policies.

Know the Terms & Conditions of Your Insurance Policy

To protect your rights, it is integral that you understand the limitations and restrictions outlined in your disability insurance policy. The definitions of certain disabilities can change over time, so it is important to keep up to date and understand these changes that may apply to you.

Know Your Rights about Disability Claims

Once you have purchased your insurance policy, be sure you are aware that although you have coverage, this does not mean you should “rest easy.” In reality, what you are really buying are rights that you can enforce against your insurer if they fail to provide the protection that was sold to you.

Know the Strict Time Limitations

 Many people do not realize that there are strict limitations with regards to filing a lawsuit against insurers, and oftentimes they are missed. If you do miss a limitation period, the insurance company is not required to pay your claim, and therefore your right to sue them is null in void.

Here some common red flags you should be aware of:

  • The claim is taking an unusually long time to resolve
  • Irrelevant information is asked of you
  • A claim has been denied

Hire An Experienced Disability Lawyer

In many cases, filing a lawsuit is not necessary. The first step involves a demand letter, outlining any discrepancies, pointing out the facts, and the law – with the demand that an insurer complies with the terms and conditions of the insurance policy. Insurance companies are often fully aware when they are not in full compliance, and take advantage of policyholders because most people do not know the law in-depth, and are privy to any red flags before signing off on their policy.

Contact Tim Louis & Company

Insurance companies may deny legitimate disability claims, as the majority of individuals will give up instead of fighting for the monetary compensation they deserve. If you are self-employed and an insurance company has denied your long-term disability claim, the team at Tim Louis and Company is on your side and will fight in your corner.

For a free, no-obligation appointment, contact us today by calling 604-732-7678 or email timlouis@timlouislaw.com

 

 

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Surveillance: How You Can Lose Your Long Term Disability Compensation

long term disability surveillanceHow You Can Lose Your Long Term Disability Compensation

Have you applied for Long Term Disability coverage and have the feeling you are being followed while out in public?

If you have submitted an application for disability or are collecting disability compensation, your intuition may be accurate, as there is a good chance an insurer has hired a professional private investigator to conduct surveillance on you, seeking an excuse to save money and attempt to deny your claim.

Insurance companies, like all businesses, are profit-based and lose money if they approve too many claims — so it is in their best interest to prove that you can work without the need to receive compensation for your reported medical condition.

Disability claims are on the rise, and surveillance is an efficient way for insurance companies to gather evidence against you – intending to prove that you are fully capable of fulfilling your job duties and do not require financial support.

Surveillance May Work Against You

Insurance companies may hire a private Investigator, follow you, or set up surveillance in front of your home to observe your daily activities.

Suppose you applied for Long Term Disability due to back pain and then observed via surveillance moving or twisting your body in a way that contradicts what you detailed in your claim. In that case, your credibility may be diminished and lead to a denial of your Long Term Disability insurance benefits claim.

Be Specific On Your Application for Long Term Disability Compensation

Detailing your injuries and being specific about your abilities on your Long Term Disability application is essential. Provide context and be mindful about anything observed via surveillance that may be used against you.

Such that if you are observed merely walking down the street for a more extended period than you mentioned you were able to in your claim, you could be at risk of losing your Long Term Disability insurance coverage.

The same goes for mental health disability claims. For instance, if you claim that you are chronically depressed and unable to leave your home and then observed via surveillance leaving your home on a daily basis, you may be questioned and risk losing your coverage.

Why Surveillance is Not Reliable

Context is everything when it comes to surveillance with regards to Long Term Disability insurance claims. As mentioned in the example above, surveillance is not a reliable measure to understand one’s abilities.

Video evidence does not present the aftermath of the activity, such as the stiffness and pain you may experience immediately after or the next day resulting from specific activities such as reaching, carrying grocery bags, or shovelling snow.

Fighting Against Surveillance Evidence

  • Ensure that you are truthful regarding your disabilities and injuries from the start. Do not stretch the truth because you think it will be more believable.
  • Take extreme caution when posting on any social media channels. Any comments, videos, or images involving events, activities, sports, or vacations, can be used as evidence to affect your disability claim. Be mindful before you post.

Denied Long Term Disability Coverage? Hire an Experienced Lawyer

If you have Long Term Disability coverage, and if you’re suffering from a debilitating illness or injury, then you deserve compensation, and that’s where Tim Louis and Company can help.

When dealing with a Long Term Disability claim, it is essential that you have an experienced, reputable lawyer on your side that specializes in Long Term Disability cases.

Long Term Disability Lawyer Tim Louis has been representing those who suffer from LTD for over 25 years and has successfully sued some of the world’s largest insurance companies on behalf of deserving clients.

Contact Tim Louis and His Team Today

You owe it to yourself to explore your options. Contact Tim Louis and his compassionate and experienced legal team today by calling 604-732-7678 or email timlouis@timlouislaw.com for a no-obligation consultation. We will make sure to evaluate your situation and advise the best possible options for your unique situation.

 

 

Client Reviews

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