Long-Term Disability Claim Lawyers in Calgary, AB

Long-term disability claims are frequently turned down by insurance companies in Alberta. Though this may seem unfair if you are suffering from a disability, there are ways to challenge these decisions and hold the insurance companies to their obligations.

This is seldom straightforward, as the burden is on you to prove that you are disabled and that your disability has caused an extended period away from work.

This can be challenging if you’re unsure what documentation to provide and who needs to sign what. Sometimes, a doctor’s report is not enough evidence for the insurance company to approve your claim.

The long-term disability lawyers at Taylor Janis LLP can assess and submit your claim, challenge a denied claim, and advise you on your legal rights and obligations at every step.

What is long-term disability in Alberta?

In the simplest of terms, long-term disability refers to an illness or injury that prevents you from working for a long time. For claims, “long-term disability” generally means you’re off work for 17 weeks or more, or it’s considered “short-term”.

Long-term disability benefits programs each have different eligibility criteria, but all require a serious disability that prevents you from working.

What conditions qualify for long-term disability?

Contrary to popular belief, to be eligible for long-term disability, you don’t need a doctor’s report to say that you’re “disabled”.

You do, however, need to prove that you cannot work, and a medical report will be the key evidence to support your claim. The list of potential conditions that can render an employee incapable of working are varied and differ from person to person.

Typically, however, we see the following conditions challenged by insurance companies:

• Depression
• Post-traumatic stress disorder
• Fibromyalgia
• Chronic fatigue syndrome
• Memory and concentration problems
• Headaches

Many of these conditions have few physical symptoms and may be difficult to prove, so they are often dismissed out of hand by insurance companies despite severely impacting the victims.

Common reasons long-term disability claims are denied

Long-term disability claims can be expensive for insurance companies. It’s not surprising, therefore, that claims are often denied by companies out to protect their own profit-based interests.

The following reasons are often cited by insurance companies when denying claims:

• The claimant is considered “able to work”
• Insufficient medical evidence provided to prove disability
• The claimant failed to follow appropriate medical treatment recommendations
• The claimant can work at a reduced capacity or in a similar role
• The disability is due to a pre-existing condition
• The claim or appeal was filed late

If your claim is denied for a reason you believe to be unfair or inaccurate, our long-term disability claims lawyers can ensure that the insurance company reviews your claim again and pays up if it is valid.

What is the Worker’s Compensation Board in Alberta?

Alberta’s Workers Compensation Board offers a program that provides another opportunity to claim long-term disability benefits if you are injured or fall ill as a result of your work.

Most employers in Alberta are required to be covered by Workers’ Compensation, so there’s a good chance you can claim this if you’re injured or sick due to work-related activities.

Successful claimants may receive wage replacement (up to the age of 65) and lifelong medical benefits.

How do you apply for long-term disability in Alberta?

If you hire one of our long-term disability lawyers, we’ll look after the paperwork for you. Otherwise, you’ll need to follow a series of steps to file a claim:

1. Determine which long-term disability benefits you are entitled to claim under which plan or program: this may depend partly on where your injury or illness occurred.
2. Seek a doctor’s approval to apply for long-term disability benefits, and start requesting supporting evidence to back up your claim.
3. Complete the required application forms: locate the required forms (usually with your insurance company or employer) and have them completed. Generally, you must complete the notice of claim form, while your doctor and employer may need to complete other forms.
4. Send a notice of claim form to your benefits provider.
5. Book an appointment with your doctor and obtain a medical report (complete the form during the appointment)
6. If you’re claiming workers’ compensation, meet with your employer and ensure that he/she completes and submits the employer’s report.
7. Write a cover letter detailing your claim and supporting documentation, and submit the full application.
8. Prepare for and attend an interview with the claim representative assigned to your case. This is usually over the phone, and you will be asked questions so that the representative can assess your claim. More information may be requested by the representative.
9. Submit any further information required by the representative and await a decision.

What supporting medical information will I need from my doctor before filing my claim?

Your doctor is key to your long-term disability claim in Alberta. Seek a medical report and a letter from your doctor explaining why you are unable to work due to your condition.

Request referrals from your doctor to relevant treatment providers and specialists for your condition as further evidence.

Be sure to follow all treatment advice recommended by your medical professionals. Otherwise, your claim may be denied, or you could be pressured to return to work sooner than you’re ready by the insurance company.

Why hire a workplace law firm as your long-term disability lawyer?

Long-term disability claims are challenging for anyone who has not had to file one before — even if you are clearly disabled.

The seasoned workplace lawyers at Taylor Janis LLP have helped many Calgary employees prepare and file such claims. We’re here to help prove that your claim is valid and that you’re only claiming what you’re entitled to.

We’ll communicate directly with the insurance company so that you can focus on recovering as best you can from your condition while we fight for the benefits that are rightfully yours.

We can start by advising you of your legal rights and options with long-term disability matters during a confidential telephone or video consultation.

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