I received my change in definition letter from the insurance company. I qualified for CPP Disability. My employer sent a status update request form as my 2 years were up and my doctor wrote that I would not be returning to work on July 22.
Canada Life stated my doctor didn’t say anything about me *not returning after the 22nd even though my employer’s form specifically stated this and they were copied on it. Feels like a bit of a game. These same notes/forms triggered my employer to start the non culpable termination process.
Canada Life will be requesting all of my chart notes again and have their internal doctor review to determine if I qualify till 65.
Questions…Is this common practise once you get to the end of the 2 years?
If denied by the insurance company doctor what are the next steps I should take?
I can’t comment on the two year mark as I never got that far. I was recently required by manulife to return to work, after one year, even though I had doctors letters stating otherwise. Bottom line is, if their doctors say there isn’t enough medical evidence for you to remain off, insurance will force you back. As I have been told, they cannot unanimously force you back, however I had went to my union and spoken with a disability lawyer. My choices were, appeal the decision and not get paid while awaiting a decision or make an attempt to return in good faith. Or you can try to sue them which would take years as well. Financially I had to choose the attempt, to return to work option. I did however request my claim file, which I just received. If you haven’t already done so, I recommend doing it. They are very dirty! I have caught them in several lies which I intend to file complaints on. I have no idea where my complaint will end up but I will proceed regardless. I am struggling with my gradual return and it’s only been 3 half days so far. But the way I see it, I’d rather struggle at work than deal with the insurance company. I’m nearing close to my retirement dates, so I just have to get to the finish line somehow. Good luck.
It’s common practice for an insurer to do an internal paper review of your file before the change of definition which usually happens at the 2 year point. They often hire a doctor or nurse practitioner to do them. Sometimes they will ask the claiment to attend an independent medical assessment in person.
When I asked for my claim file I saw they did a paper review a couple months before my change of definition. It was nice to see in the notes that the doctor the insurance company hired agreed completely with my own doctor(s) on almost everything.
Usually these reviews are done to confirm that you currently meet the any occupation definition, but it doesn’t have to mean you will meet it until you are 65. The insurance company doctor who did my paper review said there was a very good chance I could return to work in the future if I continue my treatment plan, and I still met the change of definition at the 2 year mark.
That said, if you get denied LTD, have the full support of your doctor to be off work , then I would file a legal claim against the insurance company. In our disability support group the handful of people who were wrongfully denied LTD at the change of definition and sued all had their LTD benefits reinstated within 10 months, I believe one person was put back on benefits within a couple weeks of the lawyer filing the legal claim. Now is a great time to have a free consult with a lawyer who specializes in LTD, emphasis on specializes in LTD.
Wondering if there is “influencing” from employer to LTD?
Certainly, when I was on STD (different insurer), the employer was ‘dictating’ follow ups for medical appointments, etc… (imo, constituted harassment and bullying)
The guy at Morneau Sheppell (now rebranded) even contacted me demanding I schedule follow up dr. appointment for the next week… his “request” was the day after my previous appointment… to me, was contrived… in collusion with disabilities coordinator at workplace hr department…
…among other things, that incompetent person at MS faxed a completed medical document to a local cafe, instead of my dr.s office… whole screw up there, as my dr. had moved offices and form stamp had wrong fax number!
However, MS firm HAD AN OBLIGATION to VERIFY FAX numbers prior to sending sensitive personal private health information to anything other than intended recipient…
Whole bunch more to this story about what happened when I complained to MS STD claim agent…