Because of the particularity of each Long-Term Disability (LTD) claim, it is important to have a lawyer review your policy before giving you a legal opinion about your options.
Long Term Disability (LTD) claims are contractual in nature. Your particular policy will define:
- What disabilities are entitled to benefits;
- How much the benefits will be;
- If they are taxable;
- What other income may be deducted from them;
- What if any rehabilitation expenses are covered;
- Any exclusions (for example, that impairments arising from work accidents are not covered);
- What your obligations as a claimant are.
Many LTD policies have more than one standard of disability, which apply at different times. For example, a policy may state that for the first two years of your claim, you are entitled to benefits if you are disabled from returning to your own occupation, but after the two years you must be disabled from any and all employment in order to qualify.
If you dispute the insurance company’s decision about your entitlement to benefits, most LTD policies require a lawsuit to be filed within one year of a clear denial of benefits. If the policy is silent on the issue, the Limitations Act allows you two years. If you do not file a lawsuit by that time, you may still be able to sue the insurer, but the amount of your claim will be limited.
The evidence required to prove an LTD claim is similar to that required for other personal injury cases, and consists mostly of medical reports and documents establishing your impairments, and information about the requirements of your occupation and your education, training, and vocational aptitudes.
Once a lawsuit is filed, the procedure for LTD claims is similar to other personal injury claims. There may be a mediation to try to resolve the dispute, and there will be an examination for discovery and a pre-trial conference before any trial.
This website is meant as a general reference for injured persons and their families. The medical and legal information contained in this manual is not intended to offer legal or medical advice. The content of this website is for informational and educational purposes only and is not intended as a substitute for the professional judgment of a legal and/or healthcare professional, and you should not rely upon any material or statements made on this website for legal or medical advice. It is not intended to create a solicitor-client relationship.
It is recommended that you review any medical information carefully with your doctor or healthcare professional before making any decisions regarding your health or recommended medical treatment. While reasonable attempts have been made to ensure the accuracy of the information on this website, our firm cannot make express or implied representations or warranties about the accuracy or completeness of the information. Each person's legal needs are unique, and these materials may not be applicable to your legal situation. Please contact an Ontario Personal Injury lawyer for a consultation on your particular personal injury matter.