Just got another sunlife update approval. Been off 6 years now. I’m terrified when I get mail from them. So far I’m still on but I’m 46. They’re gonna cut me off right?
For the vast majority of LTD policies, as long as you have symptoms that prevent you from working, your doctor/specialist support fully support you, are under the age of 65, and DO the recommended treatments advised by your medical team then Sun Life can’t legally cut you off. If they do they will open themselves up to losing an embarrassing legal battle.
If they do decide to cut you off (and you’re doing all the above) a decent LTD lawyer will take your case on for free (commisioned based). A good LTD lawyer will have things resolved in 6-12 months (it’ll likely go a mediation settlement, not court).
Has Sun Life asked if you to apply for CPP-D yet? If you are already getting CPP-D, and Sun Life cuts you off then their case to do so would be ridiculously weak and a decent lawyer would mop the floor with them.
Also, make sure you have a 8-12 month living expense nest egg built up for if they ever do cut you off and it takes that long to win the settlement.
Every time I get an update request I just copy the same information from the previous forms and never hear from them about it. I get a request about once a year. It’s just something that they have to do in case someone does get better.
Does the LTD insurer request only you to fill out the once a year form or do they require one from you and one from your doctor?
Yes I’ve been on cppd for several years.
It was both me and the doctor for several years which I think is the standard approach. I just copied over the previous form, updated anything different and had an appointment with my GP to sign it. I believe it is now just coming to me after I threatened litigation if they kept screwing up processing my payments.
Do they ask frequency of doctors appointments by you or your doctor. Right now I see my specialist a lot but hopefully the appointments slow down a bit in the future.
Yes they do. Most policies require you to be under the care of a physician but depending on your condition the frequency can vary a lot. I only see some of my doctors once a year for a check-in…
I get one every year.
I get worried when I DON’T get it.
Yes. My psychiatrist indicated its important to see him quarterly for them. My gp is kinda 2nd tier
I’m always worried that’s the last. How long have you been off
It is hard to say who will get cut off and who keeps getting benefits. There are things in your control that you can do to minimize the risk of having the LTD insurer stop your payments:
Always fill out the annual form
Make sure you continue to be “under the care” of a physician. That is an ongoing requirement even if you don’t have to attend every month. People on approved claims have been denied when it was discovered they no longer had a doctor for the past few years.
Don’t do any volunteer work or attempt a return to work without advising the insurance company. They will always assume the worst if they discover it before you tell them.
Don’t travel outside of the country without checking the rules for your policy and letting the insurer know when appropriate.
If you get a more detailed “activity form” out of the blue, this usually means they have you under surveillance. They wan’t to compare what you say on the form with what they have on video or see on your Facebook. If there are “discrepancies” that can give them a reason to stop payments.
Don’t unilaterally alter your treatment without having it being supported or directed by your doctor. For example, stopping medications or other treatment. Certainly you can’t be faulted if the treatment become unaffordable, but in those cases you must be able to show you looked into all other alternatives for funding.
Be careful what you put on facebook or other social media. Be careful how you show your lifestyle. It is now more widely know that what you see on social media is not “real life”, but many judges are older and more likely to believe a false lifestyle.
That is all I can think of off the top of my head!
Disability Lawyer with Resolute Legal
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I’ve been of 5+ years so I would expect it to be ok but there is always doubt.
Thank you David. I do most of this anyway but I will step it up.
Plus, if I were to train with a company for my own service dog, would that be considered acceptable?
I don’t know.
Assuming nothing you do at the company contradicts ANYTHING that was written to support your disability claim and how hard the insurance company wants you off their books.
See what David says.
Yes there would be no issue there.