Hi,
I have been on disability for over 3 years. First on STD then LTD. The 2 year mark of my LTD passed a few months ago and the insurance company says that I can either return to work or try an other occupation because we are in the “any occupation stage”. My disability started following a MVA accident where I sustained a concussion and as a result of that I not have permanent cognitive issues mainly with concentration, memory and fatigue. I also have frequent headaches, dizziness and I suffer from anxiety and depression and panic attacks. I also since developed fibromyalgia and nerve pain and I also have TMJ that flares up every once in a while. There is something else but I’m not sure that the insurance really cares about that and if that factors in. I have 2 children, both are autistic. My son is mildly affected but my daughter is severely autistic and has daily therapy in a center. Having to take care of 2 special needs children is a lot of work for any parent but in my case I can barely get through the day while I am not working and if I return to work it will be a disaster for my health both mentally and physically. I had 2 failed attempts to return to work, both of them caused a major relaps and increase in symptoms. What I am wondering at this point is what should I do? Should I take legal action against the insurance company or just apply for Ontario disability? My doctor does not agree that I should return to work, he really thinks it would be in my best interest not to return because it will just cause a relaps and make my current symptoms worst and it will not just impact me but my whole family. What would you suggest?
Legal action seems to be the most appropriate thing to do at this point. Unless you think you can just appeal their decision. At the same time you can apply for disability. Why are you hesitant to do those things?
CPP would not really benefit me I was told, because I am only 31 years old and I have not contributed enough in the few years I have had in the workforce. I was ODSP would be a better option for me. The insurance is cutting me off unless I appeal the decision and they decide to keep giving me benifits but somehow I don’t think they will since nothing has changed. Would ODSP approve me if the insurance denied me?
I realize they might think that or they may try to make it seem like that’s what I am doing but my children have always had this condition and I was able to handle working and caring for them at the same time before my disability but now I can’t. That is the bottom line. The reason why I mention that is because this is just an added stressor they have to factor in and maybe a reason as to why I have not yet recovered and sometimes I just get worst with time in some ways with some of the symptoms.
Please go for a free consult. ODSP -you can apply for and if still appeal your LTD claim. Appealing is often just a way for Insurers to stack a claim file against you–and make it look more reasonable on them. Please speak to a lawyer-you are young-don’t give up good benefits this early
This is a very common scenario and you should absolutely take legal action. Many insurers vastly overstate what is required to qualify for disability benefits on the “any occupation” standard. This does not mean if you can rip tickets at the cineplex then you don’t qualify. There is a very nuanced assessment that takes place that takes into account your age, work experience, etc. In many cases there is no practical difference between the own occupation and any occupation standards. Don’t give up and seek advice from a lawyer experienced in disability insurance claims. We would be happy to discuss with you in private.
David Brannen
Disability Lawyer with Resolute Legal
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Appeal…they need medical documentation that you are able to return to work. They do this to everyone at the 2yr mark hoping they wont appeal. Ask them to provide you with medical documentaion that states you can return to work. I bet they wont have anything and you will win your appeal. If your doctor says you cant return to work…then you can’t! Did they do am IME (independent medical assessment) usually their own doctor and paid by insursnce. If so im sure that doctor would have said you could not return to meaningful work.