Minimum work for insurance to deny LTD


#1

I read (can’t find the thread) that an insurer wanted to deny LTD because a person was videoed going for coffee every day and could therefore have a job as a courier.
It got me thinking.
This person can do a courier job for say 1 hour a day for 5 days.
Is there a legal standard number of hours a person needs to be able to work to not get LTD?
$4000/year seems pretty unreasonable to cut someone off LTD for being able to make.


#2

The definition of disability for any occupation is set out in the policy. For my husbands he needs to be able to earn 50% of his earnings from his previous employment. Other polices are much better at 70-80%


#3

How do we know what percentage of earnings they work off? Do they always work off this percentage? Gosh they make it all so confusing and stressful!! Where would a person go for income if we get cut off at end of 2 years, we can’t work and get denied CPP?


#4

Mmmm,
I didn’t see this in my benefit booklet.

My benefits booklet just says:

For the purpose of this provision, an employee is totally disabled if
prevented by illness from performing any occupation the employee is
or may become reasonably qualified for by education, training or
experience


#5

It is not such much the earnings, rather whether the earnings would amount to gainful employment. Gainful employment is considered on a case by case basis. The starting point is always the wording of the policy and in particular the defintion of disability from any occupation. Sometimes it will set out a formula for defining gainful income. There are some general rules that are applied but this is something you need to get a custom legal opinion on. Very hard to give general advice here.


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 reliabile 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.


#6

Thanks David,
I won’t worry about about it before it happens (hopefully if not when it happens).


#7

Sometimes the gainful income threshold can be very high. As much as 60-66% of your pre-accident income, so it creates a situation where in theory you can work to full capacity and if its less than that income threshold you can get both LTD payments and income. There are formulas that take into account your income from employment and some of it can be offset by the insurer at a certain point. I say in theory you can work and have LTD because most insurers will never pay benefits in that situation (at least not for long) so you are stuck with doing lawsuits against them. We see this all the time.

Many people think you need to be bedridden to qualify for “any occupation” disability benefits, but that is never the case. These always needed to be determined on a case by case basis as there are lots of exceptions.


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 reliabile 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.