Acute respiratory distress syndrome (ARDS) can turn everyday tasks, including one’s job duties, into nearly impossible feats—even with appropriate treatment.
For Canadians who can’t work due to this debilitating respiratory condition, short-term disability (STD) and long-term disability (LTD) benefits are designed to provide financial peace of mind.
Sadly, the path to securing LTD benefits is rarely smooth. It’s not uncommon for insurance companies to deny legitimate claims, including in cases involving ARDS.
READ MORE: 4 reasons long-term disability claims in Canada are denied
If your insurer prevents you from accessing LTD benefits, here are three things you need to do.
1. Request a denial letter
In the event that you didn’t receive one, denial letters force insurance companies to “lock in” their rationale for turning down an individual’s disability claim.
If your insurer denied you access to LTD benefits without a legitimate reason, this document will make it very difficult for them to pivot to a different explanation at a later date.
READ MORE: Invisible illnesses: Can I still get long-term disability even if I don’t look sick?
Once you have the denial letter in your possession, connect with an experienced disability lawyer at Samfiru Tumarkin LLP. We can review your situation, assess your legal options and help you secure the compensation you deserve.
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Even if you don’t have this document, it’s still in your best interest to contact my firm. We provide LTD consultations at no cost to you.
2. Discuss the decision with your treatment team
Another important step after you’ve been prevented from accessing disability benefits for ARDS is to bring the denial letter to your treating doctor.
Schedule a meeting with your physician. During the appointment, ask them if they agree with the insurance company’s decision. In the event that they disagree, have them explain in writing why your condition prevents you from resuming your job duties.
If other medical professionals are involved in your care, gather their opinions as well. The more supporting documentation you can provide, the better.
READ MORE: ‘Get full support from your doctor’: Disability lawyer’s guide to making insurance claims
In some cases, insurers cut individuals off LTD benefits on or around the “change of definition” date. This usually occurs two years after a claim was approved.
If this situation applies to you, make sure your treating doctor clearly outlines in writing why your condition prevents you from doing any work—not just your own occupation.
3. Contact us
For many of my clients, having their legitimate LTD claim turned down was devastating. They had no idea how they were going to support themselves or loved ones financially without access to disability benefits.
If you’ve been denied or cut off LTD, contact an experienced disability lawyer at Samfiru Tumarkin LLP. It’s crucial that you get the right legal advice before appealing your insurance company’s decision.
Our compassionate team regularly resolves issues involving LTD, STD, life insurance, critical illness and mortgage insurance claims across Canada.
We provide free consultations for these types of matters and don’t get paid unless we get results.
Since 2007, my firm has helped tens of thousands of Canadians, including Julie Austin, Mitchell Murphy and Sandra Bullock, secure the compensation they’re legally entitled to.
READ MORE: Insurer being difficult? 3 reasons you should hire a long-term disability lawyer
One client that I’ll never forget, a construction worker, was diagnosed with ARDS after struggling to breathe while repairing a building damaged by a wildfire.
Following the approval of his LTD claim, the individual never thought his access to disability benefits would suddenly be taken away from him.
Unfortunately, that’s exactly what happened. The construction worker received a denial letter from his insurance company on his change of definition date—informing him that he was no longer considered “totally disabled” under their policy.
A fan of the Disability Law Show and aware that Samfiru Tumarkin LLP offers free LTD consultations, the construction worker wanted me to take on his case. Certain that he’d been wrongfully cut off disability benefits, I told him to get the denial letter reviewed by his treatment team.
The construction worker’s treating doctors couldn’t believe they weren’t consulted before the decision was made. They clearly outlined in writing why his condition prevented him from doing any work—even on an hourly basis.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
With full support from the medical professionals involved in his ARDS care, the construction worker contacted me again.
Given the strength of my client’s case, his insurer provided him with an extremely favourable amount of compensation—knowing they’d lose if the matter went before a judge.
Denied or cut off long-term disability? Asked if you want to appeal your insurance company’s decision?
Contact the firm or call 1-855-821-5900 for a FREE consultation with a disability lawyer. We help Canadians across all provinces (excluding Quebec). Get the advice you need and the compensation you deserve.
Sivan Tumarkin is a disability lawyer and co-founding partner at Samfiru Tumarkin LLP, Canada’s most positively reviewed law firm specializing in employment law and long-term disability claims. The firm provides legal insight on Canada’s only Disability Law Show on TV and radio.