Denied STD or LTD Benefits in Ontario? Why You Need an Experienced Toronto Disability Lawyer

Many Canadian employees feel the security and comfort of having disability income protection included as part of their employment benefits package. Unfortunately, new hires are so enamored with the initial contract, usually described in a glossy benefits booklet that they do not bother to read the fine print.

In so many cases, if tragedy strikes and they must submit an income loss claim, always, they face the rude awakening of having their disability benefits claim frustrated, delayed, or denied.

As an employment and disability lawyer in Toronto with over 40+ years of experience, I have seen the good, the bad, and the ugly side of this employment nightmare. While some employers truly care about their employees’ welfare, alarmingly, the story of the bad employer who hinders the short-term disability (“STD”) and/or long-term disability (“LTD”) claim process is becoming increasingly prevalent.

This is a rare circumstance in which the Canadian legal system does not afford a vulnerable employee the ability to bring these types of disputes to a rapid conclusion. If you get into a car accident, the insurance company is obliged to bring the dispute to speedy Arbitration. However, an employer-sponsored LTD insurance claim can take years to come to a resolution and, if not handled correctly by a legal professional specialized in this area of law, will jeopardize your employment. In the meantime, the employer and their group insurance provider treat you like a rotten hot potato. Essentially, the money that you thought would be there to pay your bills, while you are recovering from illness or injury, fails to materialize.

Moreover, when a previously well-regarded employee attempts to return after an extended illness they may not be coming back to open arms. Many workplaces, deliberately engage in discriminatory practices to discourage employees from returning simply because they have replaced the position. These employees who are regarded as “damaged goods” (a particularly odious HR term) are sloughed off to the reluctant care of the insurance company. With that, the despairing employee enters a process akin to manoeuvring through a labyrinth with a blindfold.

It is in the insurance companies’ and employer’s best interest to deny disability claims for as long as possible. With the advent of the internet and social media, they have become increasingly efficient at managing employees through the group insurance assembly line. There are many sick and disabled employees who will have their group insurance claim denied over technicalities and eligibility requirements related to the timing of the application, or an ostensible pre-existing illness. In other instances, employees must deal with wool-eared insurance adjusters who make incessant demands for more and current medical information that is paradoxically necessitated by the ridiculously extended periods it takes to make a decision. Claimants with back injuries, anxiety and depression are particularly targeted in this process. Appealing to the employer’s HR apparatus is to no avail, as they will simply and conveniently defer all medical-related matters back to the insurance company.

Without a knowledgeable disability claims lawyer by their side to assert their case, it does not take long to realize that it is all a big game designed to get an employee to withdraw the claim and prematurely return to work — never a good idea from both a medical and legal perspective.

I have realized that many competent personal injury lawyers are, not surprisingly, ill-equipped to help these particularly vulnerable employees who, through no fault of their own, have fallen into a grey phantom zone of hidden legal entitlements and competing interests designed to frustrate their insurance claims and end their employment.

Most of the clients that I see are mid-level and senior managers who have worked for over 10-15 years for the same employer. They are all commonly dealing with staggering levels of workplace stress, illness, and alienation, all endemic to the modern work experience. It is no surprise that an unexpected loss of income due to illness, along with the shock and disappointment of being denied disability benefits, can leave these employees financially insecure and, in turn, make their symptoms worse.

Yet, there is light at the end of the tunnel. It starts with being well-armed with knowledge of your rights about the real medical eligibility threshold for “own occupation” disability benefits, medical privacy, availability of interim government financial assistance programs, and the employer’s obligation to take you back from an approved illness leave with accommodation. It continues with someone being able to push back on your behalf with the ability to take on the largest insurance companies and the biggest employers.

This is an ever-changing area of law. It requires a lawyer who understands the law of employment and is well-versed in the protocols and peculiar regimens that insurance adjusters use to play their game.

If you have had short-term or long-term disability benefits denied and need assistance, call us at 416-223-5391. Our team of experienced Toronto Disability Claim Lawyers can help.