LTD benefit cut off after 2 years mark

First, thank you David for providing such a great useful forum for us.

I had a car accident and has been on LTD for 2 years now. I just receive a email from my case manager that my LTD benefit will be cut off in a week. The reason is I refused to go back to the modified work which is provided by my employer.

Actually, I am still suffering a lot of pain and depression. The treatments are going on and none of my doctors suggested me to go back to work. Recently, my GP sent them my updated medical info told them that my condition getting worst because some of the treatments have to stop due to COVID-19.

A couple of months ago, my case manager told me that according to a report from their own consultant, I can work with some limitations. Then they contact my HR and told them i can work with some restrictions. They just ignore my doctor’s suggestion and never really care about my health condition. Just ask my HR to arrange a position for me.I just don’t understand how their consultant who never called me never met me and just jump to the conclusion that I am ready to work?

Last month, I had a TSA by the third party. After they receive the TSA report,my case manager told me that based on my TSA report, you are still meet the definition of disability, so the benefit will continue and the next step is Rehabilitation program. I said I am really appreciate and will cooperate with this program. I really want to improve my working skills thought this program and give myself more time to finish my treatment plan. But later on, he send me another email said they will hold the Rehabilitation program up because my employer provide a position for me. I told them I am not ready for work due to my bad medical condition. Then they cut me off right away.

I feel so helpless with this bad news. Will be no income in a week! Beside suffering chronic pain and depression, now there is an extra financial pressure on me. They just put me on edge suddenly.

I don’t know what to do next. Take legal action?or appeal like they told me?
Any input would be greatly appreciated.

English is my second language,hopefully I made my case clear.

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The 2 year mark is a big deal in the world of LTD. It is when the definition of your disability changes and you need to meet stricter requirements to continue to qualify for benefits. After 2 years, you need to meet the definition of “total disability” which basically means your existing job no longer matters. Even if you can’t do your old job, as long as you can do ANY job that exists in your province (even if it not available, it just has to exist) then they can claim you are no longer eligible. It is quite a difficult level to meet, especially with a physical disability. It sounds like you have developed depression, and if this is preventing you from working then you need to reinforce that with your LTD company because they are probably treating you as a physical injury patient. It is not uncommon for benefits to be terminated at this point and for the LTD company to basically require you to submit updated medical information proving you meet the new eligibility requirements. You should get a letter from the LTD company outlining how you can appeal their decision. Basically you need to disprove whatever they are saying. So if they are saying you can go back to work, you need to send them info countering that and proving your disability.

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Thank you so much for your time.

I am following your suggestion and working on that.

I encourage you to reach out to us for a private free consultation with our support team. We can review your situation and give you a plan or ideas for next steps. As a former occupational therapist, I can tell you that many of these so-called TSA reports are not worth the paper they are written on. Not hard for us to poke holes in them or even get them disregarded completely.

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.