It is important to keep in mind that all policies are different, and some will have their own occupation tests that will not change. For these reasons, you should familiarize yourself with common long-term disability contract terms in Barrie law by speaking with a lawyer from our firm.
Barrie residents who are seeking long-term disability (LTD) benefits should be aware of their privacy rights. Your medical history and background are private information that your employer may not be entitled to. Anyone pursuing long-term disability benefits should not surrender their privacy rights and should know that insurance companies are obligated to approach claims from a position of the utmost good faith.
To qualify as a long-term disability under Barrie law, you must meet the exclusion terms of your contract. You must have been offered the amount outlined in the policy, which is typically four or six months. Policies can also have time limits. A long general policy can extend to age 65, while some may only be two, five, or 10 years.
The definition of a long-term disability can vary from policy to policy. Most policies utilize the own occupation test, which states that in order to qualify for the first two years of disability coverage, for example, an individual must prove that they are unable to perform their previous work duties due to injuries or diseases. There may be a qualification saying that any occupation must pay you at least 50 or 60 percent of what you previously earned.
After those two years, the qualifications for long-term disabilities can change, and you will have to prove that you are unable to perform any occupation that you would be reasonably suited for, per your education, training, or experience. That would be what qualifies you for ongoing long-term disability.
Pre-existing conditions are typically established in the terms of each long-term disability policy. Insurance companies often review clinical notes and records from people’s doctors and hospitals for the time outlined in their policy, which may be 12 to 24 months depending on the policy. Based on the notes, records, and whether or not you have been treated for something during that time, the insurance company may think you have a pre-existing condition.
Insurance companies are supposed to review claims without prejudging them. Claims should be handled fairly and without bias by an insurance company. Otherwise, they are guilty of bad-faith conduct and violating people’s rights.
It is important to remember that entitlement in long-term disability policies is functional. Having a certain medical condition or being involved in an accident does not necessarily mean that you are disabled. To determine your entitlement to benefits, you must refer to the definition of your policy and apply the facts, medicine, clinical notes, records, and doctors’ opinions.
Your entitlement to benefits will depend on whether your medical condition functionally renders you unable to work. To learn more about common long-term disability contract terms in Barrie, reach out to our firm today and schedule a consultation. We could go over your contract’s terms to determine whether you may be entitled to LTD benefits.