Long-Term Disability Lawyer

Long-Term Disability BC
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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

BC Government – Persons with Disabilities (PWD) Benefit: https://www2.gov.bc.ca/gov/content/family-social-supports/services-for-people-with-disabilities/disability-assistance/on-disability-assistance#:~:text=For%20example%2C%20for%20payments%20issued,single%20parent%20with%20one%20child
Government of Canada – Canada Pension Plan Disability Benefit: https://www.canada.ca/en/services/benefits/publicpensions/cpp/cpp-disability-benefit.html

Legal Services in BC - Tim Louis
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BC Lawyer Tim Louis

Tim Louis Award for Pro Bono Service

BC Lawyer Tim Louis

Many people ask me why I became a lawyer. It all begins in the late 1970s. I was a student and a concerned about the lack of transportation for folks like me that could not access the public transit system. In those days, buses were not accessible – they did not have fold down ramps. I began lobbying Vancouver City Council to create what we now call HandyDART.

One city councilor, Harry Rankin, stood head and shoulders above all the others. His ability to stand up for the “underdog” was something to be seen. He was also a lawyer, and planted the seed in my mind – could I become a lawyer who committed himself to doing what Harry did?

A few years later – 1980, Harry wrote the letter that got me admitted to UBC’s School of Law. In 1983, Harry hired me as his articling law student. In 1999, I was elected to Vancouver City Council as a member of the party he founded – COPE.

I love being a lawyer. Fighting for justice inspires me. Winning cases that at first blush seem unwinnable gives me life. The last 38 years have been absolutely incredible and I hope to write a book soon about a number of my most exciting cases. Harry wrote a book – Rankin’s Law.

If you are ever interested in learning a bit more about the man responsible for who I am today, take a look at “The Rankin File: Legacy of a Radical”.

Disability Lawyer Vancouver BC

Many employers will provide Long Term Disability coverage for their employees. If an employee with LTD coverage becomes unable to work, they are entitled to LTD benefits. Typically, an insurance company collects the premiums every month that the employee is working and then pays the employee when they become disabled. In some cases, the employer will self-insure.

A self-insured employer collects the premiums and makes all LTD payments. One more important thing to be aware of – if the employee pays the premiums every month, any future disability benefits will be tax-free. If on the other hand, the employer pays the premiums every month, then any future disability benefits will be taxable.

I act for individuals denied their long term disability benefits no matter what the cause of their disability. If you are unable to work, and you have been denied long term disability benefits, I will act for you no matter what the cause of your disability.

Since 1984, I have acted for individuals unable to work as a result of many different causes. People with chronic fatigue syndrome, fibromyalgia and mental illness are just a few of the wide array of cases I take on.

Why hire a disability lawyer?

I am frequently asked – why hire a disability lawyer? The answer is very clear. Without a lawyer, you are at a significant disadvantage when dealing with your insurance company. There is a power imbalance between you and the insurance company’s representative.

Your insurance company will send you to a medical expert of their choosing. Typically this medical expert will be biased against you. When you hire a lawyer, everything changes. All communication must go through your lawyer. Your lawyer will refer you to one or more medical experts so that if your case goes to court, the judge will have medical expert reports from both sides.

What to do if you have been denied benefits

If you have been denied long term disability benefits, or if your long term disability benefits have been terminated, you should see a lawyer immediately. Some individuals are fooled by their insurance company’s invitation to appeal the denial or termination.

These appeals are all dealt with by the insurance company’s own staff. Almost all appeals are unsuccessful. The longer the appeal process takes, the longer it takes to start a lawsuit. The longer it takes to start a lawsuit, the longer it takes to get a trial date. Even worse, if you allow the appeal process to drag on for more than 2 years without starting your lawsuit, your case is finished. You are not allowed to sue more than 2 years after a denial or termination.

Why hire Tim Louis if your insurance claims have been denied?

I have almost 40 years of experience fighting insurance companies on behalf of disabled individuals. Insurance companies do not like me. I recognize that many people are fearful of going to trial, so I always aim to get my client what they would likely receive at trial in an out of court settlement instead. One of the best ways to decide whether or not a lawyer is the right lawyer for you, is to look at their online reviews. I am very proud of the over 100 online reviews I have received that have given me a 4.9 star rating. I only get paid if we are successful.

Personal Injury Claim

Personal Injury Lawyer Vancouver BC

If you have been injured as a result of someone else’s or a corporation’s fault, you are entitled to compensation for not just your pain and suffering, but also your lost income, including income you will lose in the future. You must start your lawsuit within 2 years of suffering your injury. If you fail to do so, your lawsuit is out of time. Many people are unaware of the fact that if they wish to sue a municipality, say for a trip and fall on a municipal sidewalk, there is a special requirement that they must serve the city clerk with written notice setting out the general details of what happened, including where and when. This written notice must be served on the city clerk within 60 days of the injury.

I have acted for individuals suffering from all types of personal injuries including slip and fall, dog bite(s) and burns. Many of my slip and fall cases occur inside retail establishments where my client slips on water or produce. I have acted for clients who have suffered very serious dog bites. Injury from burns may occur in a restaurant where boiling water or other liquid(s) is accidentally poured on my client. I have acted for individuals who were burned by the hot water coming out of their residential tap as a result of the landlord setting the hot water tank at too high a temperature.

When to hire a personal injury lawyer?

If you have suffered a personal injury, you should hire a lawyer, specifically one with a proven track record. In most cases, the party responsible for your injury will have insurance. The insurance company will assign an adjustor to your case, whose specialty is reducing the amount of money you receive. A lawyer will level the playing field.

What to do if you have been injured?

If you have been injured, and the party at fault has insurance, you should not talk to anyone from the insurance company. Instead, you should hire a lawyer with a proven track record. You should keep track of all of your out of pocket expenses, including medical expenses. If, due to injury, you are unable to apply for a job you had been planning on applying for, you should keep a record of the name of the potential employer and what the pay would have been. You should see your family doctor on a regular basis, so that there is a record of your symptoms in your medical file.

Why hire Tim Louis?

As my over 140 online reviews confirm, I get results, while at the same time providing accessible client-centered legal representation. I have been acting for injured individuals for almost 40 years. I am known for moving my client’s file along without unnecessary delays. As many clients are reluctant to go all the way to trial, my goal, whenever possible, is to get my client an out of court settlement equal to what they would have achieved at trial.

Wrongful Termination or dismissal

Employment law in BC – Tim Louis

Most employees are governed by provincial legislation. However, employees working in industries that are federally regulated such as airlines and banks, are governed by federal legislation. If you have been terminated without adequate notice by your employer, then you are entitled to compensation unless your employer had just cause for the termination. Theft, chronic tardiness, and insubordination are a few examples that would give an employer just cause to terminate without notice.

If your employer terminates you alleging they have just cause, that does not necessarily mean that they do. I have acted for many clients whose employer terminated them alleging just cause, but I was able to demonstrate that the ‘just cause’ did not actually exist. If you sue your employer for termination without cause, then you may be entitled to pay in lieu of notice in the range of 4-5 months of pay per year of employment.

When to hire an employment lawyer?

If you have questions about any of the above areas, then you are better off hiring an employment lawyer who will provide you with the legal advice you need to make informed decisions. Most employers know much more about employment law than their employees. When the employee hires a lawyer, the employee is no longer at a disadvantage.

Why work with employment lawyer Tim Louis?

I have almost 40 years of experience representing employees. I never act for the employer. I have a proven track record of winning victories for my clients. Clients that want to hire me on a percentage basis know that they will only pay me if I win for them.

BC Lawyer TIm Louis

Estate Litigation Law in BC

The Wills, Estates and Succession Act (WESA) came into force in 2009 replacing the Wills Variation Act. WESA gives any child, including an adult child, and the spouse of a deceased person the right to apply to court to vary the will of the deceased person. The court will look at many factors, including the size of the estate and the financial situation of the applicant.

I have acted for minor children, adult children, and the spouse of a deceased person who left a will that did not make adequate provision for my client. I have also acted for individuals named in an earlier will, but not named in the deceased’s last will where the deceased person did not have the mental capacity to make the last will.

When to hire an estate litigation lawyer

If your parent or spouse has passed away and you feel that they do not make adequate provision for you in their will, you should see a lawyer immediately. You may have a very strong case on an application to court to have the deceased’s will varied. You should also see a lawyer immediately if you were named in an earlier will but the deceased did not put you in the current will, and you feel the deceased lacked the mental capacity to make the last will.

Why work with Tim Louis?

I have almost 40 years of experience helping the disinherited contest wills and transfers – and win. As my countless online reviews will attest, I provide the very best client-focused service.

Tim Louis Law Testimonials and Google Reviews

Vancouver Lawyer Tim Louis

When to contact a lawyer?

If you have a legal concern, it almost always pays to consult a lawyer. Most lawyers will provide the initial consultation for free, or for a very low fee. This is well worth the investment as you may fail to exercise your rights without getting legal advice.

The benefits of working with a trial lawyer

Managing a lawsuit all the way up to, and if necessary trial, is a complex matter. The rules of court are complex. A trial lawyer knows how to properly prepare your case. This actually reduces the likelihood of the matter going to trial, as the other side sees how well prepared you are. If it does go to trial, your case will be properly presented to the judge.

First steps? Free consultation

Your first step is to find a lawyer experienced in your area of law. You might try talking to friends or acquaintances. Many people looking for a good lawyer will choose instead to do an online search, which will give a much wider list of potential lawyers. It will also provide an opportunity to read about the lawyer on their website. Finally, it will provide an opportunity to read online reviews.

Many lawyers will offer free consultations. Some individuals looking to hire a lawyer will choose to interview two or three lawyers before choosing the one they are most comfortable with.

Contact Tim Louis

If you are looking for the advice of an experienced lawyer, call me. I have been practicing law for almost 40 years, and I have the results to show why I’ve been in the business for so long.

My law firm phone number is 604-732-7678.

My cell is 778-855-3494.

chronic fatigue syndrome
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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
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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
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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

 

 

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Long-Term Disability Insurance Lawsuit
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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.

 

 

 

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Chronic Pain and Long-Term Disability Claims
disability insurance Injury Claims Long-Term Disability Law Long-Term Disability Lawyer

Chronic Pain & Long-Term Disability Claims

Chronic Pain and Long-Term Disability Claims

Chronic Pain & Long-Term Disability Claims – Contact Tim Louis

Suffering injuries from an accident or mishap can be a frustrating experience. Ongoing chronic
pain some individuals experience is a general term but is a reality that numerous accident
victims have to learn to cope with even after fulfilling their medical treatments.

If you find it challenging to get through the workday and cannot fulfill your daily work-related
duties or function day-to-day, you are not alone. According to the Canadian Pain Task Force
Report (Sept 2020), an estimated 7.63 million, or 1 in 4 Canadians aged 15 or older, live with
chronic pain.

What is Chronic Pain?

Chronic pain is the result of changes within the nervous system. The nerves continue to fire and signal, leading to pain that remains long after an injury has healed. It may take weeks, months,or even years to completely heal. Lingering chronic pain can take control of your life and causefurther damage, especially to your mental state. Chronic pain can result from a musculoskeletal
injury, nervous system dysfunction, chronic diseases, and autoimmune disorders.

In 2019 chronic pain was recognized by the World Health Organization (WHO) as a disease inits own right for the first time, resulting in updates to the latest (11th) version of the InternationalClassification of Diseases (ICD-11). This distinction is significant as it validates the struggle forthe millions of people around the world who are living with chronic pain.

Chronic pain is classified as chronic primary pain or chronic secondary pain. Acute pain is short-lived and typically lasts no more than 30-60 days, whereas chronic secondary pain can range in intensity and lasts from 6 months or longer.

Chronic Pain Education & Support

For more information, we highly suggest visiting Pain BC, a non-profit, helpful organization that
works to reduce the burden of chronic pain for individuals in BC. They empower people who live
with pain; providing them with a wide variety of helpful, informative resources and the support
required to enhance their well being: https://www.painbc.ca

The Most Common Claims Associated with Chronic Pain

Several injuries are commonly associated with long-term disability claims:

  • Neck pain
  • Lower back pain
  • Shoulder pain
  • Pain stemming from Fibromyalgia
  • Recurring headaches and migraines
  • Cancer pain
  • Arthritic pain
  • Musculoskeletal pain
  • Chronic migraines and headaches
  • Pain associated with Lupus
  • Chest pain
  • Abdominal pain

Symptoms of chronic pain include:

  • Burning sensation
  • Sensitivity to touch, cold, heat, and more
  • Flare-ups
  • Dull Ache
  • Throbbing
  • Soreness
  • Stiffness

What Causes Chronic Pain?

  • Repetitive stress injury, including carpal or cubital tunnel problems
  • Respiratory problems
  • Complex regional pain syndrome (CRPS) and fibromyalgia
  • Neurological problems
  • Loss of hearing and vision
  • Chronic pain after a motor vehicle accident

Filing a Long Term Disability Claim for Chronic Pain

If chronic pain has affected your ability to continue working, you may have the option of
receiving long-term disability benefits if you are covered under such a policy through your
employer. You must however present verification that chronic pain has resulted in the inability to
continue working. The evidence required depends on the nature of your condition and any other
associated ailments.

What You Need to Provide for Filing a Long-Term Disability Claim

To file a disability claim for chronic pain, you must document your symptoms and experiences
and discuss them with a medical professional. Your doctor will assess your medical history and
order x rays, tests, and/or scans to determine if there is joint or tissue damage that may explain
your pain.

Examples of documentation that may be required:

  • Any physician statements and an official diagnosis
  • A journal documenting your pain over time
  • Test results
  • Information about your history of treatment
  • Witness statements from family, friends, and or co-workers who can attest to your
    condition affecting your ability to work and function day-to-day.
  • Any accidental reports

Our Law Firm Provides Results-Oriented Representation for Even the Most Complex Cases.

Do not give up hope if your long-term disability benefits have been denied. If you have been
experiencing chronic pain that has affected your ability to function personally or professionally
and would like to discuss legal options, the compassionate team at Tim Louis Law & Company
will provide you with a free, no-obligation evaluation. We represent clients in a broad range of
injury claims and will take all necessary steps to obtain fair and full compensation for injuries.

Contact us today by calling 604-732-7678 or email us at timlouis@timlouislaw.com

Sources:


https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/ext
ernal-advisory-bodies/canadian-pain-task-force/report-2020.html

https://www.iasp-pain.org/PublicationsNews/NewsDetail.aspx?ItemNumber=8340

 

 

Client Reviews

disability insurance
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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.

 

 

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Hire a Long Term Disability Lawyer
Injury Claims Insurance Claims Long-Term Disability Law Long-Term Disability Lawyer

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.

       

       

       

      Client Reviews

long term disability addiction
Insurance Claims Long-Term Disability Law Long-Term Disability Lawyer

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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