I applied for LTD 3 weeks ago with Equitable life after being on STD for severe anxiety that has gotten worse over the last year that I had to leave work , anyways I had my doctor fill out all the paperwork and sent in the LTD forms equitable life contacted me saying they need more information I’m also now seeing a counsellor and a physiatrist which I wasn’t before the paper work for Ltd was sent in as I was awaiting appointments , I’m not able to function in any job at moment . My ? Is if I’m denied should I appeal with equitable life or go through a lawyer right away , I’ve heard of you appeal through the insurance they just keep putting it off ? I’ve got all the right paper work am on meds seeing a counsellor and physiatrist , this has just been causing me more and more anxiety as it seems the insurance company is just playing games asking for more info etc .
Does the insurance company know you are seeing a counsellor and psychiatrist now? If not, you should probably let them know.
It’s very common for insurance companies to ask for more information. If the psychiatrist could provide the insurance additional information that supports your claim it may carry more weight than what your regular doctor provided.
Yes they called me saying they need additional info because my claim doesn’t support me not being able “to do “any” job” with the info they have at the current time and they need more info from the counsellor and psychiatrist so I gave them they’re contact info and I guess they are going to provide statements my psychiatrist says I need to be focusing on counselling and my anxiety not working , I was told if you have a counsellor and psychiatrist and you’re MD backing you and they deny my claim to take it to a lawyer ?? This has also been causing me more anxiety waiting , guess I’m gonna have to worry and wait until they get statements from the counsellor and psychiatrist.
Are you sure the policy says “any” job?
A lot of policies say “your own job” for the first 2 years and then they reassess for “any job” after 2 years.
Are you unionized?
You may have to do the internal appeal first.
I would ask a lawyer IF you get denied:
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They told me not being able to do “any” job is what qualifies for LTD they also told me this over the phone and not in writing , and no I’m not unionized … my anxiety is severe at the moment which prevents from working around people for a extended period of time I’m sure my counsellor and psychiatrist are providing this info this week , and yes if I get denied I’m going to consult with a lawyer.
Can you get an online copy of your benefit booklwt?
Mine is a summary of the insurance policy.
If you have one it may clarify some definitions/obligations, etc.
I think I got it it from the insurance company website but I might have got it from my employer.
I’m going to look into that this week.
My general recommendation is that people should always do 1-2 internal appeals before resorting to a legal appeal (i.e., lawsuit) against the insurance company.
You should always to an internal appeal if there is a chance the insurance company will review your appeal in good faith and approve the claim. Whether they will do this depends on the context and circumstances of your appeal.
I wrote an article that sets out when you should do an internal appeal (on your own) vs. when it makes sense to stop doing internal appeals and move to the legal appeal: https://www.resolutelegal.ca/blog/4-reasons-avoid-disability-claim-internal-appeals
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