LTD Payments Terminated after 5yrs - Help Requested & Offered :)

Help Requested

Hi All,

I’ve been on LTD since 2015. The Insurance Company sent me for an IME a year ago and are now claiming that I’m fit to go through their Rehab program and return to work to work. My GP is supporting me fully and feels that it would be detrimental to my health… However, they simply ignored everything I said and everything my GP said and have told me that her opinion is subjective. I have refused to budge and so they have terminated my payments, which wasn’t totally unexpected, but obviously leaves me in a precarious position yet again as I have absolutely no income.They have told me outright that they are basing this push for me to go back to work, solely on this IME Report. I’ve gone through the IME Report myself and as expected, it is unfair, biased. insulting and has several outright lies in it, ones that I can actually prove as well as unfounded theories that my own medical files and life will disprove, if given a chance.

I know I can appeal the Insurance companies’ decision and try and get them to reinstate my payments but that just puts me right back under their thumb and I know they’ll never leave me alone. I’m not sure I can take living like this too much longer., dealing with them on top of the health issues has been a nightmare and to be honest the only reason I’ve stuck it out this far is because I know I’m genuine and I’m also stubborn and it’s just myself so I’m not having to worry about ending up homeless with kids etc. Anyway, I’m at the point at which I think I would prefer to just take a chance and straight out sue them and try to free myself from them once and for all. I know I have the ethical and moral high ground (all of us do) but I obviously don’t have the legal expertise needed to know for sure that I even have a case?

I’m just wondering if anyone is in or has been in a similar position and has any advice to offer? @David_Brannen David, any input at all would be greatly appreciated, I just really need to know that I’m not way off base here and obviously either way, I’ll require a lawyer, thanks.

Help Offered

Also, I have to say, I find what the Insurance Company do to people and the fact that they get away with it absolutely reprehensible. I was so sick and clueless the first couple of years that I had no idea what was going on and at times I thought I was losing my mind. I know there are many more people like me fighting this fight. To that end, if you are just starting down this path or just realising what’s involved, please feel free to contact me. There are things you can do from the start that will help you throughout all of this and I’m happy to share “lessons learned” so to speak because you will have to learn to advocate for yourself throughout all of this.

Thanks All & Stay Safe🙂

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Hi, this is a very common situation but needs to be handled differently depending on the specific facts of the situation. I would encourage you to reach out to us for a free consultation because you will need customized advice and approach in this situation. If you have been denied for refusal to participate in treatment you have very limited options for how to overturn the decision.


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.

Thanks a million David, I’ve set up an In-take call for tomorrow so hopefully that will help clear some things up for me. I appreciate you taking the time to respond.

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You are not alone. I have had very similar situation. Giving them several specialist reports but saying they are not good enough. Then they only want to accept reports from my family dr and not the specialists. I feel the same way… I would love to get rid of them and get them off my back. It isn’t helping my health or helping me improve and get back to work. I do not know how they get away with this.

Hi @glog88 , thanks for replying and I’m sorry to hear you’re going through something similar, I know the feeling, It really is hard to navigate it all while trying to protect yourself. I found nearly every single interaction with them had a negative impact on my health and made everything so much worse so I’m not surprised you feel the same. I actually had a free consultation with @David_Brannen and found it incredibly helpful. I would suggest that you do the same as he can give you some advice and at least point you in the right direction. It definitely gave me some peace of mind. Also, please feel free to pm me anytime, I understand what you’re going through and I’m happy to act as a sound board if needed :slight_smile:

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My IME was very biased as well.

Have you seen other doctors besides your GP?
Insurance companies seem to like corroborating reports/ diagnosis from other doctors particularly specialists.

I was just curious if you had been approved for CPPD since your LTD was approved. Also, who is your insurance company?

I think if you get approved for CPPD that you’ll be approved for LTD.
I would (and did) apply for CPPD on your own (before the insurance company asks).
It seems likely for the insurance company to “estimate&deduct” as soon as they ask.
It varies by your company, situation, employer.

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Thank you! I might take you up on that!

My insurance company estimated&deducted as soon as they asked.
It turned out to only be a month before I got approved for CPPD but if I wasn’t proactive I would have been screwed.
Some insurance companies apparently keep paying the full LTD while you apply for CPPD but mine didn’t.
I was fortunate to inadvertently apply early on my own.

Most are now deducting as soon as they can.

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I’d be proactive because it takes so long, apply for CPPD as soon as you think you’ll need it.