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The ABCs of LTDs: Breaking down the Basics about Long-Term Disability

admin • Jun 03, 2020

The ABCs of LTDs: Breaking down the Basics about Long-Term Disability

 

In the event of an injury or illness where you are not able to return to work, long-term disability insurance offers some protection by providing you with a portion of your income that can go towards keeping things financially afloat. It is there to offset any financial hardship you might suffer as a result of being unable to return to work due to a medical condition.

Most policies provide benefits for the first 2 years if you’re unable to meet the requirements for performing your own occupation. However, after 2 years, you must be unable to perform the tasks required by any occupation for which you are reasonably qualified by education, training or experience in order to retain long-term disability benefits. 

The Difference between Short-Term Disability & Long-Term Disability Insurance:

Short-term disability insurance can provide you with replacement wages in the event that you are temporarily unable to work. This can apply to instances where you may be ill/disabled for a few weeks. Short-term disability insurance only covers income replacement for the first 120 days.

In contrast, long-term disability insurance provides a more permanent income replacement if your medical condition prevents you from working over a longer period of time. It is a form of protection in the event that an illness or disability leaves you totally or completely unable to return to work. It provides you with a portion of your income that can go towards living expenses which may also include medical treatment and rehabilitation. For the first 2 years if you are unable to meet the requirements of performing your own occupation then you are eligible.



After 2 years, you must be unable to perform the tasks required by any occupation for which you are reasonably qualified, or could become qualified for, by reason of education, training or experience, in order to retain long-term disability benefits.

It is important to note that disability benefits are different from workplace insurance benefits , as disability benefits arise from an illness or injury which is not required to occur on the job, whereas workplace compensation benefits are given as a result of being in the course of your employment.

Who pays for long-term disability coverage?


Long-term disability insurance can be purchased privately by individuals through an insurance broker or directly through an insurance company. Long-term disability insurance can also be made available for purchase through your employer through a group disability insurance policy . In cases of group insurance through your employer, the insurance premiums could be paid by the employer, the employee or shared between the employer and the employee. Depending on what applies to you, there are different implications for tax purposes.

If the employee pays premium for the long-term disability insurance, then disability payments are not taxable . If the employer pays for the disability premiums, then the payments made to the disabled employee are taxable .

What type of disability qualifies for long-term disability benefits?

Most long-term disability policies cover you regardless of the severity or type of illness or injury you are suffering from that prevents you from working. However, some policies exclude certain illnesses, and others may exclude injuries or illnesses which are compensable under a Workplace Safety Insurance Board claim, if it is available through your workplace.

 

The rule of thumb is, if you are not able to do all or substantially all of the tasks required by your current job then you will qualify for long-term disability benefits. The threshold is that your disability prevents you from being able to work.

However, depending on your policy, it may state that in order to qualify for the disability benefits, you must prove that it is not only your job that you are unable to do, but any job that you may be qualified to do . This varies from policy to policy, so read the terms of your policy.

Will I have to file a claim in order to receive long-term disability benefits?

If you want to receive long-term disability benefits, then yes, it is required that you file a claim. If you are receiving coverage from your employer, contact your company for instructions on how to file your claim. Otherwise, contact your insurance provider. You will be required to fill out a claims form which will be provided to you by your employer or your insurance company.

 

Are there deadlines when making a claim for long-term disability insurance benefits?

Yes, there are deadlines or time limitations which can affect your ability to assert your claim. Don’t delay in contacting a disability insurance lawyer who will guide you through the process and notify you of any deadlines .

 

What if my employer terminates my employment while I am on long-term disability? What will happen to my long-term disability entitlement?

As long as you were actively employed at the time you became disabled then your termination of employment should not affect your long-term disability entitlement . However, any termination and/or severance payments may be deducted from your long-term disability entitlement.

 

After being unable to work at my own job for two years, can my insurance company stop paying me my benefits?

For most policies, you’re entitled to claim long-term disability benefits for the first 2 years of being unable to perform the essential duties of your own job. This is called the “Own Occupation Test”. After the 2-year period, your eligibility for long-term disability may change. It will then be based on whether you are unable to perform any occupation for which you are reasonably qualified, or could become qualified for, by taking into consideration education, training or experience. This is called the “Any Occupation Test”.

Why has my long-term disability claim been denied/terminated?

You may be denied for a variety of reasons, which may be as simple as filing all of the necessary paperwork and documentation. Other reasons may be more complex and will require the assistance of a lawyer to help you in your claim to get the benefits that you are entitled to .

Issues may arise if you’re not examined by insurance company approved doctors, you exceeded the time limitation in submitting a claim, there was a misrepresentation on the application as you had a pre-existing condition that you did not mention, there is surveillance evidence that contradicts your claim, a failure to have your injury or condition properly documented by your physician, you have not ‘mitigated your losses’ by maintaining your treatment regimen.

When I sue the insurance company for disability benefits, what do I sue for?

You are suing for the payment of the disability benefits to which you’re entitled. If you and your lawyer decide that the insurance company acted unfairly when they denied your claim, you may also sue for “bad faith”. Your lawyer will also make a claim for pre- and post-judgment interest on the amounts claimed along with a financial contribution from the defendants which will go towards your legal fees.

 

If you are disabled and cannot continue to work due to your disability, and have been denied the benefits to which you’re entitled, it is important to have an experienced and diligent lawyer by your side, representing you. At Noohi Law, we pride ourselves on our exceptional client service, thorough knowledge of the law, and innovative solutions.

Contact us today with your long-term disability inquiries at 416-907-7364 ext 1 or at info@noohilaw.com .

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What happens If I’m Hit by an Uninsured Driver?
by admin 29 Oct, 2021
What happens If I’m Hit by an Uninsured Driver? An uninsured driver is a driver who is operating a motor vehicle without having motor vehicle insurance When these drivers get involved in motor vehicle accidents, they place a great burden on all Ontario residents. Approximately 2,100 uninsured motor vehicle accidents occur annually in Ontario. And, despite the high fine of driving uninsured ($ 5000 in Ontario), there are still many individuals who wrongfully choose to take the risk. It also doesn’t help that we Ontarians have some of the highest insurance premiums in the country. However, the equally high fine of driving uninsured is still not enough of a deterrent. This is also in addition to lack of adequate systems to verify insurance coverage on routine traffic stops. So, what happens if you fall victim to a motor vehicle accident with an uninsured driver? Insured drivers in this situation are covered under the “no fault” statutory accident benefits of their motor vehicle insurance policy. All motor vehicle policies in Ontario include coverage for damages caused by both insured and uninsured drivers. If you are involved in a motor vehicle accident with an insured driver, you will be covered under your insurance . The maximum amount that can be paid out for a Plaintiff’s claim for damage is $ 200,000 for unidentified motorist coverage and uninsured motorist coverage. This is significantly less than the maximum pay-out for most auto insurance policies! Victims can file lawsuits against liable uninsured drivers for injuries and damages. If all parties involved in the accident lack insurance coverage, the victims still have access to coverage for their damages through Ontario’s Motor Vehicle Claims Fund (MVCF) . The MVCF compensates victims of uninsured drivers in a car accident up to a maximum of $ 200,000 in damages including property damage, if for example, an uninsured pedestrian is hit by an uninsured driver. This coverage is only available to residents of Ontario for accidents that occurred within the province . The MVCF is the last resort option when there is no insurance coverage for the damages. What happens if you’re uninsured and you fall victim to a motor vehicle accident? Uninsured drivers do not have the same ability to sue . Under Ontario’s Insurance Act , an uninsured driver who was injured in a motor vehicle accident cannot sue for injury compensation .  Ontario has a long way to go to improve its problem of uninsured drivers. Better monitoring and deterrence of uninsured drivers can be effective tools if the police are provided direct access to a database that records a driver’s insurance history, allowing this information to be easily accessible to the police during routine traffic stops. Please contact Noohi Law for a free consultation if you suffered a personal injury. Our team of experienced lawyers will provide you free legal advice and will assist you with your potential claim. We will ensure the disclosure of all relevant facts and evidence to obtain the benefits you are reasonably entitled to, so that you can focus on your recovery. Contact us at (416) 907-7364 or send us an email with your inquiry at info@noohilaw.com
Motor vehicle insurance companies lowering insurance rates
by admin 22 Apr, 2021
Motor vehicle insurance companies lowering insurance rates: It’s not a surprise that we Ontarians pay a lot for our motor vehicle insurance. Insurers have a well-established reputation of overcharging Ontario drivers. As many people are practicing social distancing and self-isolating, there are fewer and fewer drivers on the road. As such, some insurance companies are offering relief to drivers by lowering their premiums or deferred payments. Premier Doug Ford also announced on April 30, and asked insurance companies to lower or defer payments for Ontarians, because people are not driving as frequently as before. Specifically, there will be insurance relief for those who have been laid off or lost their jobs, the sick or elderly, as well as for those who are working from home and have reduced kilometers traveled. Drivers are now reaching out to their insurance companies and have made requests for refunds on premiums, payment deferrals, premium adjustments, the waiving of missed payment fees or extended existing coverage. Some insurance companies have extended savings to all their clients whether or not they have experienced financial hardship due to COVID-19. For example, Allstate Insurance Company has announced that it will spend $ 30 million on rebates for its customers with stay-at-home payments. Every client will receive a one-time payment of 25% of their monthly auto premium. Allstate customers do not need to apply for the rebate and they should receive a cheque in mid-May.  Contact your insurance company to see if you’re eligible for a break on your insurance. Savings may vary depending on individual factors. Please contact Noohi Law for a free consultation if you suffered a personal injury. Our team of experienced lawyers will provide you free legal advice and will assist you with your potential claim. We will ensure the disclosure of all relevant facts and evidence to obtain the benefits you are reasonably entitled to, so that you can focus on your recovery. Contact us at (416) 907-7364 or send us an email with your inquiry at info@noohilaw.com
Occupiers Liability
by admin 16 Jul, 2020
Occupiers Liability An occupiers’ liability claim in Ontario is filed against a property owner or occupier who was somehow negligent in preventing injuries on his or her property. Such claims commonly arise from incidents such as a slip-and-fall on icy stairs, or a trip-and-fall on uneven ground or pot hole. A successful claim may result in compensation that addresses pain and suffering, medical costs and missed income. The Occupiers’ Liability Act: Ontario’s Occupiers Liability Act was established in 1990 and serves as the basis of all occupiers’ liability claims in the province. The Act outlines such crucial aspects as: Who may be considered an occupier for the purposes of liability (this would be the defendant in an occupiers’ liability claim); The definition of a premises; A definition of an occupier’s duty to maintain a reasonably safe premises; Exceptions to an occupier’s liability (such as in the case of trespassing or an injury that occurs during the pursuit of a criminal activity); How special contracts may or may not affect liability; and, A landlord’s obligation as an occupier. The Act also calls for occupiers to take steps to inform the public of potential dangers in cases where the occupier otherwise enjoys exemptions to the duty of care. Common Hazards that May Lead to an Accident/Injur Claim: Accidents of such nature may occur on: Stairs Private parking lots Ramps Sidewalks Driveways Aisles Common hazards may include: Uncleared snow/ice Uneven surfaces, cracks in sdiewalks Poor lighting Improperly waxed floors, spilled fluids that have been left uncleaned Loose debris in a walkway Broken steps on stairways An occupier is legally obligated to take reasonable measures to discover and fix these hazards. Or, at the very least, they’re required to put a sign/notice, warning the public of such dangers. Who is liable in an occupiers’ liability claim? The occupier may be: A store owner A landlord Hotel owner/property manager Home owner Restaurant owner Grocery store manager If you have been injured and/or disabled as a result of serious slip-and-fall incident, it is important to have an experienced and diligent lawyer by your side, representing you. At Noohi Law, we pride ourselves on our exceptional client service, thorough knowledge of the law, and innovative solutions. Contact us today with your personal injury inquiries at 416-907-7364 ext 1 or at info@noohilaw.com .

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