Noohi Law is dedicated to helping you handle the challenges and obstacles you face when pursuing your disability claim – we can be your most powerful ally during this trying time! Accessing the benefits to which you are entitled can be a difficult process, further complicated by the injury you are facing, the healing process, and the financial burden attached to such a significant change in circumstances.  Let us help minimize the impact of these difficulties by taking care of your disability benefits claim. With 16 years of experience and thousands of successful short-term and long-term disability claims, we will take every step necessary to assert your legal rights. At Noohi Law, we appreciate the fact that any one of us can find ourselves in such dire circumstances. As such, we take each and every case very seriously, tailoring to the needs of our clients. We have the experience necessary to navigate the red tape and hurdles placed by insurance companies, and we can help you access the benefits that are rightfully yours.

Beware of the Fine Print

Canadian laws and regulations provide guidelines outlining the responsibilities of employers towards employees. In addition, various insurance policies and compensation packages may cover injury and disability related expenses. It is important to know your rights, the compensation that might apply to you and your dependents by your coverage or the common law, and to know how to obtain the maximum to which you are entitled. Like all legal matters, it is important that these claims go through the proper channels, and this is where many encounter obstacles. While you focus on your recovery, we, will navigate the steps necessary to obtain the maximum compensation for you.

Why was my claim denied?

Insurance companies have nothing to gain from paying out claims, and will usually not do so eagerly. Each document is a hurdle to overcome, every case is scrutinized to the last detail, and sometimes claims are rejected as “ineligible” without real cause. For example, an insurance company may require specialized tests to be done, but will set an unreasonably short time frame for the submission of result, knowing full well that the waiting periods for these tests (such as MRI’s) can be upwards of 6 months.

Why you should get a lawyer

Dealing with life altering injury or illness is difficult enough, but trying to recover while meeting the demands of the insurance company is infinitely harder. Having an experienced disability claims lawyer from Noohi Law by your side can save you time, money, and stress. Our experience has prepared us for the hurdles insurance companies like to place, and our skills and knowledge will ensure that your rights are not ignored.  Remember to consult with a lawyer before you speak to an insurance adjuster.

Short-Term Disability Claims

Defining Short-Term Disability Claims

If you are expected to return to work within 120-180 days then you should be filing for a short-term disability claim to get 50-100% of your weekly income.

The law does not require employers to provide paid sick leave.  Some employers may provide Short-Term Disability benefits through their insurance policy, and it usually pays benefits for up to 6 months during your injury or illness.  If benefits are provided, the claim must be made through your disability plan. If you do not have your own insurance and one is not provided by your employer, you might be eligible for Employment Insurance Sickness Benefits.  You will need a doctor to confirm that you are suffering from an illness or injury that prevents you from returning to work.

These are some of the requirements that generally apply to all short-term disability plans:

  • 3 month of continuous employment before being eligible, meaning on the first day of the first month after three full months of continuous employment;
  • or in some cases where you have multiple employers under the same union, the “hour bank principle” applies, where the employee needs to have banked 400 hours of active employment;
  • some plans will start paying you from the first day of hospitalization.  Some will not begin paying until 3 days later. Whatever the policy, it cannot delay paying out for more than 7 consecutive days from the start of the disability (i.e. from when you had to stop working). It means that you should start getting paid by no later than the 8th day;
  • the benefit pay must be equal to, or exceed, the amount the recipient would receive from Employment Insurance;
  • it cannot be combined with other benefits simultaneously; and
  • the plan covers the employee around the clock, so it applies if you are at your second job, or not at work at all.

Who is paying my claim?

It is important to know that the majority of these claims are funded by the employer, who hires an insurance company to administer the payout. As a result, most claims are rejected at the first opportunity. Keep in mind that at this point, the insurance company is allowed to share your medical information with your employer!

By contacting a lawyer at the very onset of the injury or illness, you are ensuring that any required deadlines are met. More importantly though, you reduce the likelihood that the insurance company will take advantage of your weakened state to deny the compensation allowed by your policy.  If you do not have a policy, we can direct you in completing the appropriate paperwork and satisfying any requirements the necessary to obtain compensation from government-funded programs. Noohi Law can provide efficient experienced representation, which guarantees that no deadline will be missed, no paperwork will be incomplete and your interests will be well cared for, while you focus on recovery.  Our extensive experience in disability claims means that we will not be intimidated by the complicated process of government-funded programs nor by the tactics of insurance companies. Let our knowledgeable and assertive team work for you.

Long-Term Disability Claims

Defining Long-Term Disability (LTD) claims

If you are still unable to work after 120-180 days, your coverage comes from long-term disability claims. If your condition is severe enough at the onset, then you should file a long-term disability claim at the earliest opportunity. You can be eligible to receive 50-85% of your monthly income.

Why is LTD so complicated?

Since the payout is larger, the process is further complicated and the paperwork more intensive than short-term disability claims.  This means that there is a higher chance that your claim be rejected for a variety of reasons such as minor mistakes, inadvertent inaccuracies, or missed deadlines, which are surprisingly not that uncommon. It is difficult to deal with your injury or illness as well as trying to meet qualifying periods, deal with pre-existing conditions, employer pressure, ignored medical evidence, and disabilities not fitting established definitions. Remember, you do not have to do this alone.  Put our experience to the test, and rest assured that you have our expertise and determination to support you during this stressful period of your life.

What kind of disabilities are covered?

Every policy is different. Based on their own criteria, each policy covers certain types of illnesses whilst inapplicable to other types of illnesses. This information is usually available in your insurance policy.

Occupation:

It is important to understand that you may be eligible for benefits only if you cannot work at any occupation for which you qualify.  It does not mean that you will receive benefits if you cannot return to the exact the job you had before the injury. You have to be unable to continue working in any field that you have the qualifications, education, or experience to work.

To the insurance company, this claim is not about your livelihood or your rights, it is about saving costs and calculating the bottom line. Insurance companies have entire legal departments at their disposal; government-funded programs have a great deal of bureaucracy and are staffed by people who are limited in their decision-making power.  Wherever you turn, you are faced with imaginary hoops and hurdles that seem geared at preventing you from getting the help you need. Meanwhile, your financial obligations need to be met, you need to heal, and you and your loved ones have to find a way to move forward despite the challenges you are facing. Do not take a chance with your future and your livelihood. Let us, take care of your interests and protect your rights.  Enjoy the benefits of having an experienced long-term disability claims lawyer by your side, and know that your rights and interests are our only priority.

Lawsuit vs Appeal: Why Lawsuit is Almost Always Better

Once your claim is denied the insurance company will offer you the chance for an appeal. Remember this: appeals are internal, and unless you have extremely compelling new medical evidence to present, the insurance company is unlikely to change their mind.  The law allows you up to 2 years of the initial denial date to start your lawsuit, before you lose the right to have the legal system determine your rights. As a result of the legal timeline, the appeal system for insurance companies reduces the likelihood that you will sue for your rights. The fact is that when insurance companies take you through up to 3 appeals, it reduces your time to create a compelling case with a lawyer.  Additionally, the insurance company will have multiple denials to draw upon in court or in negotiations.

Understanding which benefits you qualify for is complicated enough, but to do it within a specific period of time after dealing with a life altering illness or injury is even more challenging. Often, insurance companies will seize on any delays, missed deadlines, or misinformation inadvertently provided by you to reduce the instance for, or amount of, your payout.  Contacting a lawyer at the very initial stage can save you a great deal of additional grief. At Noohi Law, we will review your file and determine any the applicable deadlines and benefits you may be entitled to. We will work diligently to prepare the necessary documentation and help make this difficult process at least a little easier.  Let our years of experience work for you.

 

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