3 months to change of definition date

[David_Brannen]

@Joanne

Thanks for the info David. The “gainful earnings” level (%) is often documented in the contract and sometimes in the employee LTD booklet. In the above case you cite, it sounds like the level during any occupation is 60%. Once an employee is on LTD, if the contract between the employer and the insurance company is changed and the gainful level is reduced, can this be applied retroactively to employees already on LTD? For example, if the gainful level is documented as 75% in the contract in effect when the employee starts his LTD claim, could the employer and insurance company change the contract several years later to a 60% level and then apply it to old claims and cut people off on that basis?

Sorry for the delayed response, but a person’s rights under an LTD contract or Policy are “frozen in time” to what existed when the claim arose. The person would not get the benefit or losses associated with any changes to the policy afterwards unless there were extraordinary circumstances. The existing policy would need to contemplate future changes being included, but that goes against basic rules of contract.

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David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.

[HereFishie]

IME was last week. Went well as can be expected. He is definitely on my side. I did audio record it secretly for my own use (and frankly because my memory is horrible) but I expect support from his report. I’m 2weeks until my 2 years is up.

Is it typical to do this right up to the deadline like this? What happens to my extended medical?

[jammer]

Your extended medical is probably a group insurance plan through your employer.
It would only be affected by your employment status.

Your Ltd is separate from your employer.

As to whether it is normal to wait until closer to 2 years before sending you to an ime, I’ve never seen one and I have no idea.

[HereFishie]

Approved through change of decision! They called this morning. The stress has been so bad I haven’t been sleeping. Now I wait on Cpp-d

Thank you to everyone on this forum, I knew what to expect through all of this. I did get a copy of my file from the insurance company just before the IME. 1000+pages ending with their “health partner” INDICATING they think I’m lying! If they experienced half of what I did, they’d be curled in a ball! C-Ptsd diagnosed I think helped my case.

[jammer]

Congrats.
I hope you get CPP-D.

[HereFishie]

I did! Pretty quickly too frankly. Psychiatrist won’t sign off on sending DTC paperwork though. He said I wouldn’t qualify