long term disability insurance

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.

 

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.

       

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 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

Surveillance: How You Can Lose Your Long Term Disability Compensation

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

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

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

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

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

Surveillance May Work Against You

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

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

Be Specific On Your Application for Long Term Disability Compensation

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

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

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

Why Surveillance is Not Reliable

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

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

Fighting Against Surveillance Evidence

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

Denied Long Term Disability Coverage? Hire an Experienced Lawyer

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

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

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

Contact Tim Louis and His Team Today

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

Long-Term Disability Coverage: How Long Will Benefits Last?

Long-Term Disability Coverage

Long-Term Disability Coverage

Some insurance policies issue payments for a certain amount of years, while other policies may stop payments after up to a decade. The question, unfortunately, does not have a definitive answer, as every insurance policy is unique.

When you read over your employer’s group benefits package, or even if you purchase your own private insurance, ensure that you read through the policy carefully to ensure that you understand the long-term disability requirements. Understanding the requirements, application deadlines, waiting periods and duration of benefit payouts is important.

While every insurance policy handles long-term disabilitycoverage and benefits differently, there are certain aspects to these policies that are mandated by law – this depends on your ability to return to work before your injury and your ability to work, period. There are certain policies that will stop benefits indefinitely after 2 years if you are able to return to any full-time work (regardless if it pays the same as your pre-injury job), while some insurance policies will continue paying out benefits at a reduced rate if you end up securing a new position that pays less than your previous employer. If however, you are unable to return to work, long-term benefits could last for a number of years.

What is Long-Term Disability Coverage?

If you become disabled during employment, Long-term disability insurance coverage pays benefits. Under most LTD policies, in order to qualify for these benefits, you would need to prove that you are unable to continue working as a result of a medical condition. These medical conditions can include physical, psychological, cognitive, and emotional – or a combination of any of the above. If you qualify for LTD coverage, the payout for benefits ranges between 60%-70% of your pre-disability income. There are certain policies that cover less, but most policies will pay benefits for qualified individuals up to age 65.

When Does Long-Term Disability Start?

Long-term disability payments are never available immediately and considered a last resort after short-term disability options have been exhausted. Before you can be approved for LTD payments, you must go through short-term options first – even if following a serious, catastrophic injury. Short-term options may include sick leave and short-term disability benefits.

How Do I Know If I Have Long-Term Disability Coverage?

If you are fortunate enough to have an employer that has provided you with a group medical benefits package, it is likely that you have insurance for Long Term Disability (LTD) coverage, which may also grant you coverage if you have been laid off or terminated from your job. If you do not have group benefits through your employer, you have the option of purchasing a private LTD plan.

Meeting Important Deadlines

There are strict deadlines that go along with long-term disability claims, so it is important to carefully read through your policy to understand the time limits. Failure to submit a claim on time can result in your claim being denied.

What if My Long-Term Disability Claim is Denied?

If you submitted an LTD application and your claim is denied, you will not receive any payments and will be expected to return to work. Claims can be denied for numerous reasons, such as incomplete information, unclear or improper medical treatment or diagnosis etc. Keep in mind, diagnosing mental health can be complex, but insurers are very specific in their guideline requirements. If your claim is denied, you have the right to appeal the decision – an appeal process will commence, which is why it is important that you contact a trusted lawyer that specializes in such long-term disability cases.

How a Long-Term Disability Lawyer Can Help

When understanding the length of your LTD policy, it is important to understand the language and the integral details you should be aware of. At Tim Louis Law, we are experienced with the process of filing long term disability claims and look forward to discussing your unique situation with you. Contact us today for a free consultation by
calling (604) 732-7678 or email timlouis@timlouislaw.com

Source:
https://www.bclaws.ca/civix/document/id/loo69/loo69/13_409_97

Repetitive Strain Injuries: What You Need to Know

When we think about workplace injuries, we often think about slip-and-fall accidents, injuries resulting from falling objects or the various back and neck strains that come with the territory within many workplaces. However, some work-related accidents are often far less dramatic.

A number of injuries occur over time, through constant repetition of daily tasks, which negatively impact the body causing strain to sensitive joints and muscle groups. These repetitive strain injuries, or RSI, can have a long-lasting effect on our health and daily life.

Injuries Resulting From Repetitive Motion

A Repetitive Strain Injury, whether it is temporary or permanent, will need rest or a change in daily habit that provides time to heal. It is crucial to see a medical professional right away to prevent any further damage to the muscles, ligaments, nerves or tendons through continuous, repetitive motion.

Most Common Repetitive Strain Injuries

typingRepetitive Strain Injuries (RSI) can result from a buildup of damage to muscles, tendons, and nerves from repetitive motion or strain on specific parts of the body. Repetitive Strain Injuries are quite common and may be caused by a variety of common work activities, including:

  • Using a computer mouse or trackpad
  • Excessive typing (data entry)
  • Swiping items at a supermarket checkout/cash register use
  • Grasping and manipulating tools
  • Working in an assembly line environment
  • Training for sports or other athletic activities

Some commonly diagnosed Repetitive Strain Injuries are:

  • Tendonitis (inflammation of the tendon)
  • Pertendonitis (inflammation of the sheath of a tendon)
  • Trigger finger (difficulty bending or straightening any of the fingers which is caused by inflammation and thickening of the tendon)
  • Tenosynovitis (inflammation of the fluid-filled sheath that surrounds a tendon causing joint pain and stiffness)
  • Carpal Tunnel Syndrome (numbness, tingling and pain in the hand or arm resulting from compression of the median nerve which is squeezed as it travels through the wrist
  • Epicondylitis (inflammation of tendons surrounding an epicondyle)
  • Bursitis (inflammation of the bursa sac which is common around the elbow, hips, knees and shoulder)

Repetitive Strain Injuries

What Are the Symptoms?

There are many possible causes of repetitive strain injuries and a wide range of symptoms that result. Tenderness or pain the affected muscle or joints are common, a throbbing or pulsating sensation in the affected area and or tingling in the hands or arms. Any other symptoms will depend on which part of the body is affected.

It’s important that you visit a medical professional for a proper diagnosis as soon as you experience symptoms to prevent any further damage over time.

Repetitive Strain Injury Prevention

The primary ways in which you can reduce the risk is to stop or limit the intensity of the activity. If the activity cannot be stopped, tips for reducing the risk may include:

Taking breaks: Taking regular breaks from any repetitive task may help reduce the strain on your body.

Stand up: Standing up, stretching and frequently moving your limbs may reduce the risk. Stretch your back, arms, fingers and legs regularly.

Vision break: Rest your eye muscles by looking up and staring for a moment at objects in the distance or simply looking around the room. The key is to give your eyes a regular break from screen time.

exerciseOverall health: Eat healthy and get regular exercise to keep your body as resilient as possible, and try to avoid smoking, as this reduces blood flow and oxygen in the body.

Posture: Try to keep yourself from slouching. Ensure your desk, chair and computer screen are aligned as much as you can in an ergonomic setting.

Wrists: Avoid bending or overextending your wrists, and keep the arms, wrists and fingers aligned when typing as much as possible.

Typing: Try to touch type as much as possible and avoid hitting your keys too hard.

Keyboard Shortcuts: Try to use keyboard shortcuts whenever possible, as this can reduce the amount of typing needed.

Mouse or Track-pad: Do not grip too tight or press too hard, and try to slow your speed in order to reduce muscle tension in your hand and wrist.

Temperature: Keep an eye on the temperature of your work area and regulate where necessary.

Phone Use: If you need to use a phone while working, try wearing a headset as this will keep you from needed to grip the phone for long periods or needing to clamp the phone between your head and shoulder.

You can trust Tim Louis & Company to ensure the best possible outcome for your personal injury case

These common RSI injuries can have a lasting impact on one’s health and quality of life. If you or a loved one has experienced a serious injury while on the job, contact Tim Louis and his compassionate and experienced legal team today by calling 604-732-7678 or email timlouis@timlouislaw.com.

Sources:
https://www.enjuris.com/workplace-injury/repetitive-strain-injuries-work.html

https://my.clevelandclinic.org/health/diseases/17424-repetitive-stress-injury

https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/overuse-injury/art-20045875

Fibromyalgia & Chronic Pain

Fibromyalgia & Chronic Pain

Fibromyalgia & Chronic Pain – we can help!

Fibromyalgia is a neurological condition that causes widespread musculoskeletal pain that can be triggered by physical trauma to the body from an accident or from the mental stress of dealing with an injury. 

For years, Fibromyalgia was often misdiagnosed. Today, medical professionals recognize Fibromyalgia & Chronic Pain as a chronic medical condition that can cause extreme pain for both men and women. According to the Arthritis Society, Fibromyalgia affects 2% of Canadians with 80 to 90% of patients with Fibromyalgia being women. 

Fibromyalgia is not life-threatening; nor is it damaging to muscles, joints or organs. However, it does impact one’s quality of life. Living with chronic pain can prevent patients from working, socializing and even completing day-to-day tasks. 

If you or a loved one is suffering from Fibromyalgia resulting from an accident, contact our trusted and experienced team at Tim Louis & Associates.

Fibromyalgia Symptoms 

Fibromyalgia & Chronic Pain - Get the help you needPain is the most common symptom of Fibromyalgia. Patients may experience widespread or specific pain in certain areas of the body, which may include the neck, back, chest, arms and/or legs. Often the pain is felt when firm pressure is applied to muscles, tendons and or soft tissue. 

Other symptoms may include: 

  • Headaches 
  • Extreme sensitivity to touch 
  • Stiff muscles 
  • Irritability 
  • Widespread pain all over the body, with some areas worse than others 
  • Fatigue 
  • Cognitive issues also known as ‘brain fog’ 
  • Irritable Bowel Syndrome (IBS)
  • Disturbed sleep 
  • Abnormal temperature regulation 

Other Symptoms 

  • Restless leg syndrome 
  • Depression and or anxiety 
  • Painful periods 
  • Occasional dizziness 
  • Extreme sensitivity to temperature and scents 

Fibromyalgia Causes 

The exact cause of fibromyalgia is still unknown. For certain people, FM can be the result of a stressful, traumatic event such as a vehicle collision or can be triggered as a result of repetitive injuries, certain diseases, or illness. Research studies have also found that there is a genetic component to Fibromyalgia. 

Diagnosis 

While there are no lab tests to confirm a Fibromyalgia diagnosis, there may be other illnesses that present the same symptoms. A doctor may want to order blood tests to rule out other conditions that may include:

  • Cyclic sedimentation rate test 
  • Complete blood count test 
  • Rheumatoid factor test 
  • Thyroid function test 
  • Erythrocyte sedimentation rate 

Additional tests may be ordered depending on symptoms, which may include X-rays or an EMG to test the muscle’s electrical activity.

Treatment 

Although there is no cure for Fibromyalgia, certain medications that can help reduce and manage pain or other symptoms associated with FM. Your doctor will recommend the best options for your unique needs. These medications may include: 

  • Pain relievers (over-the-counter or prescription) 
  • Anti-seizure medication 
  • Anti-depressants 

Fibromyalgia & Chronic Pain Relief

Research has shown that Fibromyalgia patients can reduce symptoms with proper self-care and lifestyle changes. Adequate sleep, managing stress and practicing low impact exercises such as water therapy and aerobics can help reduce symptoms over time. It’s important to consult with a medical professional that can recommend the right treatment to benefit a Fibromyalgia patient’s unique needs. 

We Will Help Get You Compensation for Your Fibromyalgia & Chronic Pain 

Fibromyalgia is a painful illness that can affect one’s quality of life and cause chronic pain. If you or a loved one is suffering from Fibromyalgia resulting from an accident, contact our trusted and experienced team at Tim Louis & Associates. Our goal is to help you get the compensation you deserve. Book a free consultation with us today by contacting us at 604-732-7678 or email: timlouis@timlouislaw.com 

Sources: 

https://www.mayoclinic.org/diseases-conditions/fibromyalgia/diagnosis-treatment/drc-20354785 

https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/fibromyalgia 

 

 

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