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Short term disability (“STD”) benefits are intended to provide a source of income while you recover from an illness or injury. These are often provided by your employer pursuant to a group benefits plan, and may be assessed and paid by an insurance company such as Sun Life, Manulife, Canada Life, or Desjardins. Other times companies such as Morneau Shepell or Reed Group administer claims on behalf of your employer. STD claims often provide benefits ranging from 17 weeks to six months, and sometimes for up to one year.
Short term disability claims can be denied at the initial application stage, or after benefits have been paid for a period of time. The insurance company or administrator should provide written reasons for the denial, and explain the option to appeal.
If you are planning to return to work, an appeal may be the most efficient dispute resolution mechanism. Michael Jordan can assist with your appeal at no cost to you.
If you have been denied STD, and there is no immediate prospect of returning to work, you should know your legal rights, including the right to free legal advice, the right to appeal, and the right to take legal action.
Insurance companies and administrators often make mistakes when assessing eligibility for short term disability benefits. Take advantage of your right to free legal advice by contacting Michael Jordan, disability insurance lawyer, who can guide you through the process. There is no fee for the initial consultation.
You can appeal the STD denial. Unfortunately, most appeals are not successful, since they are not decided by an independent decision maker, but rather the same company that denied the claim decides the appeal. However, if you have new and compelling evidence, an appeal might be the best route, especially if you plan to return to work soon and there is a relatively small amount of money in dispute.
If your short term disability claim has been denied, and you do not see yourself going back to work in the near future, long term disability benefits will likely be denied as well. It is therefore important to ensure you protect yourself in the event of a prolonged period away from work.
Michael Jordan can guide you through your options, at no cost to you.
QUADRIPLEGIA
$1,950,000
Our client sustained serious injuries in a motor vehicle accident. She advanced claims against her insurance company for income replacement benefits, medical expenses, and cost of care. The claim settled for close to $2 Million dollars.
BIPOLAR DISORDER
$575,000
Our client was a successful business person. When his long term disability claim was denied, he retained Michael Jordan to take legal action against the LTD insurer. Expert medical evidence that was instrumental in resolving the case.
DEPRESSION
$400,000
Our client was unable to work due to debilitating depression and anxiety. The disability insurer denied the claim, but when faced with litigation, a settlement was achieved allowing the client to focus on his recovery.
CANCER
$400,000
Our client was diagnosed with life threatening cancer, which resulted in a severe psychiatric response. The claim was denied based on an exclusion in the policy. The exclusion, however, was poorly drafted and the case quickly settled.
LONG COVID
$275,000
Brain fog, fatigue, and inability to focus and concentrate were the main symptoms. The LTD insurer denied the claim due to lack of "objective medical evidence", even though there was no requirement in the policy to provide objective evidence, and the nature of the impairments were inherently subjective. The case settled after litigation was commenced.
PSYCHOSIS
$270,000
The claim was denied because our client was not participating in appropriate treatment, but his mistaken belief that he did not need treatment was a symptom of his disability. An expert psychiatrist was retained to provide opinion evidence that the failure to participate in treatment was a symptom of the underlying illness. The case quickly settled.
CANCER
$267,000
Our client had surgery to remove the tumour, but was left with severe chronic pain and anxiety. An opinion from an expert oncologist supported disability and a fair settlement soon followed.
VERTIGO AND NAUSEA
$255,000
The long term disability insurer did not believe our client’s self reported symptoms. During the litigation, extensive medical records and reports were obtained that supported disability.
CHRONIC FATIGUE
$250,000
The claim was denied because there was no medical explanation for the sudden onset of chronic fatigue syndrome. Two expert reports were secured, and the case settled at mediation.
ANXIETY
$250,000
Our client suffered from severe anxiety that made work impossible. Despite this, her LTD claim was denied. It settled shortly after a lawsuit was commenced.
CHRONIC PAIN
$250,000
Our client was involved in a motor vehicle accident many years ago. He continued to suffer chronic pain, but the LTD insurer denied his claim. Expert opinion evidence helped secure the settlement.
MIGRAINE HEADACHES
$240,000
The insurance company denied the claim after the two year “own occupation” test of disability changed to “any occupation”. Evidence was secured that the client could not work in any job, and the case resolved.
Previous results are not necessarily indicative of future results. Contact Michael Jordan, long term disability lawyer, for an assessment of your claim.
Michael Jordan
Jordan Honickman Barristers
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