There are many instances when you are left injured and disabled, without employment after an accident. To help you through this difficult time, plenty of insurance companies offer benefits of long-term disability which are a part of the employment benefit package.To ensure that you need to fulfill the eligibility criteria of ‘total disability’ before you can be compensated for the claim. This means that you are unable to fulfill the regular duties and go to work because of the injuries and illness. However, it does not mean you are incapacitated completely but it signifies that you need to rest and recover to lead a better quality life. This includes any employment even something that you can do.
The insurance company will conduct a complete examination apart from looking at the previous medical documents and reports to ensure that you do meet the total disability criterion. If the examination indicates that you are disabled for years or months, you will qualify for long term disability claims. You need to know that this claim benefit is different WSIB insurance that covers injuries and accidents.The disability claim ensures that you get a part of the wages till you return to work. Disability insurance ensures that it covers all illness and injury that prevents you from working, irrespective of when the accident occurred. As employment insurance covers your expenses in the first 119 days and the long term disability takes on from the 120th day.
Additionally there are many people that get access to benefits of short-term disability to tide over the period before the long term benefits start. This lasts till the individual is 65 years, but it is not necessary. Most of the recipients get evaluated every 2 years while the criterion of ‘total disability’ changes over the years.
Reasons to deny claim
There are number of reasons for a long term disability claim to be denied. These can lead to court cases and disputes. These are:
- Lack of evidence of disability: This ensures that the insurance company was not able to measure and diagnose the level of disability. As pain is not objective but subjective, it becomes a ground for such disputes.
- Lack of restrictive injury: This limits your ability to work and the insurance company assesses that your illness/disability does not have total disability. This can lead to error by the insurance company does not understand the nuances of your job.
- If you are not disabled: If the insurance company does not consider your disability as total, your claim will be rejected. Surveillance by insurance company can be an important reason to prevent fraud. It is important that personal injury lawyer, is consulted before the appeal process begins.
Most claims come under the purview of Statute Of Limitations which is two years from the time of disability or accident that led to the current health conditions. It is better to hire the services of an experienced lawyer before you file the disability lawsuit.