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long-term disability claims

Long Term Disability BC

Maximizing Your Benefits: Why You Need a Long-Term Disability Lawyer in Vancouver

If you are dealing with a long-term disability in BC, it can be challenging to know how to navigate the legal landscape. You may be entitled to benefits from your employer, insurance companies, or government programs like the Canada Pension Plan and Persons with Disabilities. However, understanding these benefits and how to apply for them can be complex. In this blog post, we explore what long-term disability is, the types of benefits available, and how to apply for them. Additionally, we address common questions like how long you can be on disability in BC and whether your employer can terminate you while you’re on long-term disability. If you’ve been denied benefits, we also explain why insurance companies deny claims and the benefits of hiring a long-term disability lawyer to help you navigate the legal process.

Long-Term Disability BC

What is Long -Term Disability?

Many employers will provide their employees with long-term disability insurance coverage. Usually, this coverage is obtained by the employer from an insurance company. Each insurance company will have its own insurance policy. The policy will define long-term disability. In most long-term disability insurance policies, there are two types of disability – short-term and long-term. To be eligible for long-term disability, you must be unable to work for longer than the short-term benefits last. Typically, but not always, this is 17 weeks.

Once your short-term disability benefits come to an end, you are eligible for long-term disability benefits so long as you are unable to work in your own occupation. You are eligible for long-term disability benefits even if there are other occupations you can work as. However, this situation changes at the 2-year mark. Even if you remain unable to work at your own occupation for 2 years, your long-term disability benefits will come to an end unless you are unable to work at any occupation for which you are suited based on your education and experience. This 2-year mark is quite often referred to as the “own occ-any occ” transition.

What illnesses legally qualify for long-term disability?

Unless your long-term disability insurance policy specifically excludes named disabilities or illnesses, all qualify for long-term disability insurance benefits so long as you are unable to work at your own occupation for first 2 years and thereafter you are unable to work any occupation. It is very important that your family doctor is prepared to stand behind you. This means that they are willing to give evidence at trial. Under the rules of court, they are only permitted to give evidence at trial if they provide your lawyer with a Medical Legal Report (MLR) and your lawyer serves this report on the insurance company’s lawyer no later than 84 days prior to your trial.

It usually does not matter what type of illness or injury you suffer from. So long as you have the necessary medical evidence to prove that you are unable to work, you qualify for long-term disability benefits.

It is important to remember that your long-term disability benefits are not taxable if you were paying the premium yourself. If your employer was paying the premiums, then your long-term disability benefits are taxable. For this reason, most employees will want to pay all long-term disability insurance premiums themselves.

Understanding the Different Types of Benefits for Long-Term Disability
in Vancouver BC

  1. LTD Insurance

    Long-term disability insurance benefits are just one type of income a disabled worker may be entitled to. However, in almost all cases, these benefits are far superior than all other types of disability benefits. Your long-term disability benefits will typically be 66% of your pre-disability gross income. Given the fact that these benefits are not taxable so long as you are paying the premiums yourself, your long-term disability will be very close, if not equivalent, to what you were earning net of taxes prior your disability.

  2. CPP

    The Canada Pension Plan offers not just retirement benefits, but also disability benefits. There is no minimum age requirement for Canada Pension Plan Disability (CPP-D) benefits.

    You are qualified to receive the CPP-D benefits if you: • are under 65 • have contributed enough to the Canada Pension Plan • have a mental or physical disability that regularly stops you from doing any type of substantially gainful work • have a disability that is long-term and of indefinite duration, or is likely to result in death

    If you are eligible for long-term disability benefits, you will almost certainly also be eligible for Canada Pension Plan Disability benefits (CPP-D). Unfortunately, almost all long-term disability insurance policies make it a requirement that you apply for CPP-D. The policy will also say that all CPP-D benefits you receive are deducted dollar for dollar from your long-term disability benefits.

    Caution – do not be lulled into failing to apply for CPP-D knowing that it will not be money in your pocket, but only in the pocket of your insurance company. If you fail to apply for CPP-D, the insurance company will deduct from your long-term disability insurance benefits an amount equivalent to the CPP-D you would have received had you applied.

    There is no asset limit that would prevent eligibility. Your assets will not disentitle you.

  3. PWD

    In British Columbia, the provincial government provide a form of income assistance referred to as “Persons with Disabilities” (PWD). As distinct from CPP-D above, if your assets exceed $100,000, not including your home or your vehicle, you are not eligible for PWD benefits. Even worse, these benefits are not tied to any income you may have previously been earning. Instead, the provincial government arbitrarily sets the amount.

    For example, you could get up to:

    • $1,358.50 if you are single
    • $2,423.50 if you and your spouse have Persons with Disabilities designation and have no children
    • $1,703.50 if you are a single parent with one child
    • $2,143.50 if you or your spouse have Persons with Disabilities designation and one child

    If you are receiving long-term disability benefits, you are not eligible for PWD. If you are receiving CPP-D, it will be deducted dollar for dollar from your PWD.

  4. WorkSafe

    WorkSafe benefits are only payable if you are unable to work due to an injury you suffered while working. WorkSafe benefits are not taxable. If you are curious about how much you may be eligible to receive, please see this page for more information.

  5. Disability Tax Credit

    The disability tax credit (DTC) is a non-refundable tax credit that helps you, or your supporting family member, reduce the amount of income tax they may have to pay.

    If you have a severe and prolonged impairment, you may apply for the credit. If you are approved, you may claim the credit at tax time.

    By reducing the amount of income tax you may have to pay, the DTC aims to offset some of the extra costs related to the impairment.

    You may be eligible for the Disability Tax Credit if a medical practitioner certifies that you have a severe and prolonged impairment in 1 of the specified categories, significant limitations in 2 or more of the specified categories, or receive therapy to support a vital function. To learn more about these categories and your potential eligibility, please see this page.

How to apply for Long-Term Disability Benefits?

Your employer will have a specified process for applying for long-term disability benefits. Typically, your employer will provide you with the application form. Separately, your employer must fill out a form and send it to the insurance company. Finally, you must have your family doctor fill out and provide a form called an Attending Physician’s Statement (APS). The APS is sent directly to the insurance company by your doctor.

I would strongly recommend that you ask your doctor if you could work on the APS together. You do not want the APS to contradict what you are saying in your application form. Most doctors will be very agreeable to this reasonable request.

Why do insurance companies deny claims?

There can be several reasons why insurance companies deny long-term disability claims.

It’s important to note that insurance companies have a financial incentive to deny claims, as it saves them money. However, if a claim has been denied, it is possible to appeal the decision and pursue legal action if necessary.

In my opinion, insurance companies always put the interests of their shareholders ahead of the interests of people making claims.

Why hire a long-term disability lawyer?

Long-term disability insurance companies do not like lawyers. They do not like being held accountable. They do not like the threat of going to court. Over my many decades of practice, I have had many cases where the insurance company flatly denied my clients claim for long-term disability benefits. Then, after my client hired me and I started a lawsuit, they do an about face and pay the claim. If your claim for long-term disability benefits has been denied, I would strongly urge you to hire a lawyer familiar with suing long-term disability insurance companies.

How long can you be on disability in BC?

So long as you remain unable to work, either at your own occupation for the first two years or at any occupation thereafter, you remain eligible for long-term disability benefits until you are 65 years of age.

Can you terminate an employee on long term disability in BC?

Unfortunately, the answer is yes. An employer is entitled to terminate an employee if there is no reasonable prospect of a foreseeable return to work. If your employer is considering terminating you, you may wish to obtain a letter from your doctor providing an estimated return to work date. The downside to this letter is that your insurance company may then use it to terminate benefits if you fail to return to work by that date.

People Also Ask

What is the difference between short-term and long-term disability insurance?

Far far away, behind the word Mountains far from the countries Vokalia and Consonantia, there live the blind texts. Separated they live in Bookmark

What is CPP-D and who is eligible for it?

Canada Pension Plan Disability (CPP-D) benefits are offered by the Canada Pension Plan and are available to anyone under the age of 65 who has contributed enough to the Canada Pension Plan and has a mental or physical disability that regularly stops them from doing any type of substantially gainful work. The disability must be long-term and of indefinite duration, or is likely to result in death.

Are long-term disability benefits taxable?

Long-term disability benefits are not taxable if you were paying the premium yourself. However, if your employer was paying the premiums, then your long-term disability benefits are taxable.

Why would someone need to hire a long-term disability lawyer?

If a claim for long-term disability benefits has been denied, it may be helpful to hire a lawyer familiar with suing long-term disability insurance companies. Insurance companies may put their interests ahead of those making claims, and a lawyer can help hold them accountable and work towards getting the benefits deserved.

Experienced Long-Term Disability Lawyer in Vancouver, BC – Tim Louis

Looking for a long-term disability lawyer in Vancouver, BC? Tim Louis can help. With over 40 years of experience, Tim Louis provides personalized and compassionate legal guidance to clients dealing with long-term disabilities. From filing claims to appealing denied claims, he has a track record of success in achieving positive outcomes for his clients. Contact us to learn more about how we can help you with your long-term disability case in Vancouver.

Further Reading

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

 

Chronic Fatigue Syndrome

chronic fatigue syndrome

Chronic Fatigue Syndrome and Long-Term Disability

by Tim Louis

Chronic Fatigue Syndrome is considered by some to be an orphan illness. This is because there is no cure for the disease and because there is no accepted medical test to diagnose it. In fact, many doctors do not recognize it. However, for the individuals suffering this debilitating condition, it is very real. Even what they call it is in dispute. Most patients prefer “myalgic encephalomyelitis,” or ME. However, the medical literature uses “chronic fatigue”.

Chronic Fatigue Syndrome is profoundly disabling. It renders individuals unable to get out of bed for days at a time. Sleep is no longer ever refreshing. It also strikes very quickly – one day the individual is healthy, and the next day the individual wakes up with the sensation of a bad flu. However, the “flu” never goes away. In some cases, it is so disabling as to paralyze a limb or even cause temporary blindness.

It is not unusual for individuals to believe they are going crazy when they first get Chronic Fatigue Syndrome.

Figures for Canada are not available, but it is thought that CFS afflicts between 836,000 and 2.5 million Americans.

For many years, a number of doctors believed the disease was all in the patient’s head.

Chronic Fatigue Syndrome – Denied Long-Term Disability Benefits?

I have represented many individuals suffering from Chronic Fatigue Syndrome. When denied the Long Term Disability Benefits they are entitled to, they hire me to sue their insurance company. One thing I noticed is that “good days” were always followed by “bad days”. In fact, because the “good day” was a gift from heaven, my client would do everything she or he wanted to do on that day. The sad result is that they would then be much much worse the following day. The trick was to always limit their activities on “good days” to half of what they felt they could do. This would result in a much better day the following day.

Long-Term Disability Benefits for Chronic Fatigue Syndrome Denied?

Long Term Disability insurance companies typically reject applications from CFS patients because the patient is unable to objectively prove the presence of the condition. I address this problem head on. I rely on witnesses who give evidence as to my client’s day to day activities. If my client has witnesses that confirm an inability to get out of bed for days on end and an inability to carry on a normal life, then my client’s lawsuit is much stronger.

I also warn all of my Chronic Fatigue Syndrome long-term disability clients that their insurance company will almost certainly hire a private investigator to capture them on video on a “good day”. Insurance companies think this will be devastating at trial. However, as I mentioned above, witnesses who give evidence that my client simply has good days and bad days, will usually outweigh the video evidence.

I have encountered this many times, representing Chronic Fatigue Syndrome long-term disability clients. In one case, one year into the lawsuit, the insurance company hired an actress to knock on my client’s door. When he opened the door, she told him that her car has stalled in front of his house. He willingly agreed to her request that he push her car out of the way. Unbeknownst to my client, all of this was captured on video by the private investigator. Fortunately my client’s landlord was an RCMP officer who was witness to the fact that my client literally spent days on end in bed. The case settled out of court with the insurance company paying my client over $300,000.

If you have Chronic Fatigue Syndrome and your Long-Term Disability insurance company has denied you the benefits you are entitled to, call me for a free initial consultation. I have been suing Long Term Disability insurance companies for over three decades.

Learn More about Chronic Fatigue Syndrome

What is Chronic Fatigue Syndrome?

What is myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)?

Chronic fatigue syndrome and fibromyalgia in Canada

 

 

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.

Fibromyalgia and Long-term Disability Claims

Fibromyalgia and Long-Term Disability Claims

 

Fibromyalgia – Getting the Long-Term Disability Claim You Deserve

by Tim Louis

Fibromyalgia is a painful medical condition that many people in Vancouver and British Columbia face, and it is often misdiagnosed. About 2% of the population is affected by this very painful disease, and it has many side-effects that can make it very difficult to work or go about daily life. Going to work everyday and dealing with its symptoms of pain, fatigue, depression, sleep issues, memory troubles, headaches and even digestive problems can become extremely difficult. The chronic pain alone makes getting through a day of work impossible. While this is a long-term disability insurance issue, many insurance claims are denied. A long-term disability lawyer, like Tim Louis, can help you get the compensation you deserve if you are unable to return to work because of your diagnosis.

Fighting with your insurance company for long term disability benefits is an uphill battle no matter what your disability. This is why many people will choose to hire an experienced lawyer. However it is even more difficult if you have fibromyalgia. Bad enough that it causes pain throughout the entire musculoskeletal system and is known to cause mental problems such as issues with memory and maintaining a stable mood. Even worse is the fact that the symptoms are subjective. There is no objective way of testing fibromyalgia as there is with say a broken bone – an x-ray. This gives your insurance company an unfair advantage – you have no way of proving that you have this disabling condition.

There is no question that fibromyalgia can be profoundly disabling and is a disability. The federal government recognizes this. Canada Pension Plan disability benefits are awarded to many people with fibromyalgia every year.

Fibromyalgia and Chronic Pain

As fibromyalgia causes chronic pain, it can be impossible for individuals who suffer from it to continue working. In Vancouver and all over British Columbia, I have acted for many fibromyalgia clients whose long-term disability benefits have been denied by their insurance company. I will always collect evidence from collateral witnesses. For instance a spouse that gives evidence that the insured is in pain all day can be decisive.

Many people with fibromyalgia will have good days and bad days. A good day is a gift from heaven, and my client will be tempted to do all the things they cannot do on bad days. Unfortunately this is not just a gift for my client, but also can be a gift from for my client’s insurance company. If they can obtain video surveillance of my client on this good day, they will try to use it to destroy my client’s case.

I once had a fibromyalgia client who heard a knock on his door one evening. He opened the door and a very charming woman told him her car had stalled and asked him if he could push the car. He was having a good day and kindly did so. Unbeknownst to him it was all a set up – he was filmed pushing the car. I am very proud of the fact that I still obtained $300k for him.

Long-Term Disability Claims

Living with such a painful disease as fibromyalgia can be difficult, and you deserve long-term disability benefits. If you have fibromyalgia and your insurance company has denied your claim for long term disability benefits you should retain an experienced lawyer. By working with Tim Louis & Co, our team will carefully gather the evidence, make a case and help you get the long-term disability benefits you deserve. Get started with a free consultation.

Hire a Long-Term Disability Lawyer to get Long-Term Disability Benefits for Fibromyalgia

When you need a long-term disability lawyer to truly represent your best interests and not the interests of a big law firm’s bottom line, you need Tim Louis in Vancouver BC.

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. He will gather the information about your condition of fibromyalgia needed to make a case for your need for long-term disability coverage, and answer all of your questions.

Tim Louis’ goal is to obtain for his clients an out-of-court settlement equal to what the client would achieve by going to trial. He does this by thoroughly preparing for trial, even though the goal is to settle before trial.

Contact us at (604) 732-7678 or send us an email at timlouis@timlouislaw.com.

Learn More

Fibromyalgia – Learn More
Symptoms of Fibromyalgia
Fibromyalgia Association of Canada

 

 

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