What to do if you are experiencing long-term disability?

When you’ve suffered an injury and have been approved for coverage it is important to remember that your insurer will remain in contact with you and you will have frequent obligations to update them on your condition. For this reason, if you suffer from a long-term disability there are a number of things you must keep in mind. If you make a claim, insurance companies have the right to request a variety of types of records, which may include your medical, hospital, and prescription records, and employment and income records, in addition to others. They also have the right to conduct surveillance of you. With that in mind, the following are tips for long term disability litigation:

1. Be mindful of what you say or present on social media

Believe it or not, social media can influence your long-term disability claims. Social media (Facebook, Instagram, Twitter, etc.) are among the most popular means of communication in Canada today, with more than 75% of internet users having some form of social media account. Social media is an amazing tool to stay in touch with friends and family but there are downsides to posting and updating on a regular basis. One of the downsides is an increasing number of denials due to social media posts and insurance companies admit that they will fully investigate every injury claim to the fullest extent possible. Several infamous cases include people making an injury claim but have pictures posted of them dancing or playing sports after the accident. It is now standard practice for insurers to search the digital universe for information that could be used against you in determining your entitlement to benefits. Court decisions have found that information from social media sites like Facebook and Twitter will, in some circumstances, are relevant to making a decision about your entitlement to compensation. With this in mind, it is important to keep in mind that what is posted on the internet is forever. As such, it is recommended that you change your privacy settings on social media sites to limit access to your information. Even with these precautions, the information may be considered relevant to your claim, and you should never post details about the accident, your injuries, your health or your treatment to any website.

2. Understand your insurance policy

Insurance policies can be long and complicated documents, often using language the general public is not familiar with. Despite this, having a basic understanding of your policy is critical when dealing with a long-term disability claim. This means understanding your rights (and obligations) under the policy. It is good practice to keep any notes or documentation you have received from your insurer related to your policy and to your claim. This includes any communication from your insurer and keeping detailed notes about any phone calls, including the dates and times. These practices will not only keep you informed about the status of your claim, but ensure you are able to point to what your insurer has said to you and when they said it, as the timing of notice or the relaying of information from your insurer can be highly relevant in a litigation context.

3. Medical Examinations

When making a long-term disability claim, it is very likely that you will have to undergo one or more independent medical examinations to ensure your injuries are consistent with initial findings of your primary physician. These examinations will be by a medical professional who will examine your condition with the intention of verifying the nature of your claimed disability. These types of examinations are common in long-term disability claims as part of the insurer’s investigation. Additionally, it is likely that your medical (as well as employment and financial) records will also be requested and reviewed if you have made a claim. Once again this is the adjustor’s way to ensure you are not trying to manipulate the system. While these examinations are at the request of the insurer, it is important to be forthcoming with your condition during any independent medical examinations.

4. Disclosure of Documents

Your insurer will require you to submit documentation verifying the facts about and the medical evidence supporting your claimed disability. It is important to know that they are entitled to make these requests, and claimants have an ongoing duty to disclose any new developments or changes to the claimants condition/circumstances. However, in order to protect yourself, you should consult with a lawyer when these changes arise and/or when such requests are made. It is possible that the insurer may not be entitled to all documentation being requested, or that certain documentation may include sensitive information you may not wish to divulge, either way, a lawyer can guide you through what your disclosure obligations are in such situations.

5. Disclosure with Doctors

 

A long-term disability claim can be a highly personal matter given the way disabilities can impact one’s lifestyle, ability to work, and need for long-term medical treatments. For this reason, you should be upfront and honest with your treating physicians with respect to any symptoms or pain being experienced as they relate to your underlying injury. Being upfront with your treating physicians is important in long-term disability claims as your doctor’s records and opinions can be utilized to support the validity of your claim. Further, some physicians are retained to offer their opinions on your condition and future prognosis. In these situations, these doctors may be called upon as expert witnesses should your claim be litigated all the way to a trial.

6. Should you settle?

Long-term disability claims litigation can be a protracted affair. For a number of reasons parties often seek to settle the claim before a trial, but offers to settle are not guaranteed, nor are they always reasonable given the claimants condition. Any offer to settle is something that a claimant should not accept without careful consideration, as most settlement offers include a final release, meaning a claimant cannot reignite a claim once they have signed off on settlement.  While there are plenty of chances for a claim to settle before trial, and an experienced disability lawyer can explain the pros and cons of settling a claim, the decision to settle a claim is one that can only be made by the disabled person themselves based on their needs.

Taking action

If you feel you have a valid long or short-term disability claim and you have questions or need assistance at any stage remember to contact the Disability Lawyers at FDT Law at 1-800-563-6348 to get a consultation.