Home Visit required for LTD?


#1

I am currently on LTD with Sun Life since April 2017. Was told in acceptance letter that this was for two years, at which time would have to prove that I am completely unemployable in any capacity at any job. Got a phone call last week that they are sending someone out to my home next week to do a “back to work plan”. Do I have to allow them to come into my home? I am willing to meet with them at another location, but am afraid they will cut off benefits if I refuse to meet with them at my home.


#2

No-you do not need to meet them in your home! Offer to meet them at their office or somewhere public-like a coffee shop.

Do not be alone-make sure you take someone with you!

Related links IME/Function Capacity? Rehab etc


#3

I think you should run any back-to-work plan by your doctor.


#4

At home insurance visit - LTD This is a good review too


#5

The lawyers do not agree with me to secretly record these meetings and phone calls. Very easy to do with voice memo on an iphone or digital recorders and such.
My view is to record—as it makes it easier to make your notes of what happened. If you are ever challenged on your notes of what occurred at the meeting or any doctors or rehab peeps that your Insurer sends you too-then you can always prove your records are correct.

In Canada it is legal for anyone to record a conversation as long as at least one party provides consent. In other words, if only one person in a room or during a group telephone conversation provides consent for the conversation to be recorded, then the recording is legally made. There is no requirement to notify the other persons that you are making a recording of the conversation.


#6

I would let them meet you in the home…why not? I did everything they asked, and believe me the tried to get me back to work, but I just kept doing what I was told. Been off work on LTD for close to 7 years. They don’t really push it anymore. I always say do what they say, no reason not to. Also, if you don’t have a lawyer, and don’t agree to their requests, they can deny you for that.


#7

Why would you meet them in your personal space–to comment on your home, and to give them opportunity for a psychological advantage. Even unions advise against meeting them in your home. They can not cut off your benefits for that!

I would love an Insured to say —how about we meet in your home to the Insurer’s rep…LOL! :yum:


#8

Digital voice recordings are your best friend. When permitted in law, turn on the recorder, put it in your pocket and leave it on anytime you will be interacting with the rehab peeps and providers. Today’s technology is cheap, small and will continuously record for the entire day. Why not have a reliable and independent witness with you anytime the law says you can?

Just a thought :thinking:


#9

They have no right to come to your home. Many people agree to this, but you are not required to do so if it makes you uncomfortable. Request that the meeting be held in a neutral location or at the assessor’s office. You are right to be concerned that they may cut off payments. This is a situation where you can enforce your rights, but the insurance company may view it as a refusal of an assessment. You can argue against this…and will likely be successful, but in the meantime they are not paying you.

If you ask in a professional and polite way most insurers will not require a home visit and will set it up elsewhere.


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 reliabile 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.


#10

Yes, they want to get you back to work within the 2 years; therefore, they will try many avenues to do so. It depends on who is doing the “back to work” plan. If your doctor still supports you going back to work then you may not have any choice. If your doctor agrees with you that you are not ready or never will be ready (“guarded”) to return to work, then let the LTD company know that making a plan at this time is futile and causing you further stress and symptoms. Your focus, tell them is to get better, not to return to work too early only to have a more significant relapse and jeopardize your future employment. If you go back to work and are not ready for it, work gets peeved off and cites one for a case for dismissal. Ask to put off the “plan” until your doctor says it will be ok. The doctor steers this boat and the LTD insurance would jeopardize their position to go against that. It would be helpful to ask the company what is involved with the back to work plan, how long will it take and what is the expected outcome. Sometimes they will want to also get an occupational therapist to assist in writing a report which assesses your abilities to return to work at your own occupation or any occupation. But don’t forget that you must be capable of not just performing any job, but one that pays at least 66.66% of your previous salary (should be in contract). Therefore, sure you may be able to work at “any” job for a lot less money/stress/responsibility but you are not required to give up LTD unless it pays you the 66% of your original salary. :):grinning:


#11

The above refers to what is often referred to as the “gainful income threshold”. While it can be 66.66 % of your disability income, the actual amount can vary from 50-66%. In many cases the policy is silent on it and insurers will argue there is no threshold at all. Don’t assume its 66% as every policy is different.


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 reliabile 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.


#12

So true-my spouse’s policy is 50% of his previous income.


#13

Thank you to everyone who has responded to my concern about a home visit, and in particular to David Brennan and Resolute Legal for providing this very informative and helpful forum. I believe this home visit was triggered because I have been trying to follow the recovery plan developed through therapy sessions I am attending. I am trying to restore activity levels and social function through exposure therapy and I was honest with the caseworker about it. It appears that this was interpreted that I am able to return to work. I am now paranoid about pursuing the activities required in order to regain my mental health. If I don’t work at restoring my ability to function, I will never recover, and that is not a life worth living. In order to save my own life, I am selling my home so I can use the equity to work freely on recovery without fear and crippling anxiety of what the insurance company might do.


#14

Good luck.

Maybe your work and health condition are such that you could go back to work part time, that would probably appease the insurance company.

I question whether selling your home is a good idea.
I know how you feel but maybe you should get other opinions (a lawyer and social worker),