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What to do if your long term disability is running out and your employer is forcing you to go back to work

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An insurers rights of assessment while your on disability benefits

Whether you have been on long-term disability benefits for many years or only a short while your insurer has rights under your policy to investigate and assess your ongoing long-term disability claim from time to time.  These assessments may require you to produce additional documentation or submit to certain medical examinations. However, these examinations must be reasonable and relevant to your disability and treatment regime as well as not be in disagreement with your own medical professional’s views of what you are able to tolerate. 

Often disagreements arise as to what is relevant and reasonable.  A refusal by a disabled insured to comply with a recommended treatment plan or request for assessment or documentation will often cause an insurer to deny benefits on the grounds of failing to cooperate with the terms of the policy.  Sometimes these denials can be legally upheld and sometimes they can not.  A disability insurance lawyer can help you discover the difference.

You’ve been asked to participate in a return to work program

If a disabled insured has been on disability benefits and receiving disability income for over two years an insurer will arrange a return to work or work hardening program with the express purpose of attempting to rehabilitate the insured and return them to work.  These programs can be effective but can also be used by the insurer to gather evidence of the disabled persons functioning. These programs can also possibly be used to terminate a benefit if the insurer feels the disabled person has demonstrated they are fit for some work.  

A disability insurance lawyer can assist you in determining whether a work-hardening program is reasonable to comply with, as well as fighting back if the results of such a program is used to terminate your long-term benefit claim.   

You must comply with reasonable attempts by an insurance company to rehabilitate you and return you to work but only if these attempts don’t run contrary to your own medical professional’s advice and only if the attempts match your disability and employment.

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Your insurers transferable skills analysis has found alternative jobs they feel you can do

As above an insurer has the right while you are receiving their disability benefits to periodically assess and investigate your ongoing disability.  This requires examining the exact medical nature and extent of your disability. These investigations also compare your disability to the insurance policy’s exact test for disability (which varies from policy to policy) and compare it to the types of work you are qualified to do with your education and employment skills background. 

Often an insurer will take a two-pronged approach.  Firstly, they will demand that you undergo a functional abilities evaluation to see what skills and functioning you have left with the exact disability you suffer from. Secondly, then figure out what “transferable skills” you have in order to discover what other types of occupations you would qualify for, if they accept you will never be able to return to your former occupation. 

These alternative occupations may not necessarily exactly match your skillset.  They may also be unrealistic in terms of providing income that matches your former income, or they may simply be overly optimistic in terms of what you are able to do, on a full-time basis, with your level of residual disability.  In any case, a disability insurance lawyer can help you assess whether the insurer’s transferable skills analysis and list of alternate occupations is fair and accurate and help you fight back if the insurer uses this analysis as a reason to deny you the benefits. 

If you would like to discuss a potential long-term disability claim or denial, our team of experienced disability lawyers can help. Contact us online for a free legal consultation or call 1-800-563-6348 to speak directly with one of our lawyers.

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