Life is stressful when you suffer from an injury or illness that keeps you from being able to work and earn an income. You may worry about paying your rent or mortgage, making your car payments, handling loan or credit card bills, and taking care of your family’s many other expenses.
Disability insurance can replace a great amount of that income and help you to get through a trying time. However, if you don’t know what goes into filing a disability insurance claim in Vancouver, it may cause your stress to go even higher — and lead to costly mistakes.
Here, the Vancouver disability benefits lawyer explains how the disability insurance claims process works, including what information must be provided when you file a claim. We also discuss how insurance companies typically review claims, what you can expect if your claim is approved, and what you can do if it gets denied. Of course, at Warnett Hallen LLP, we believe that the most effective way to ease your stress will be to get help from an experienced and dedicated Vancouver disability claims lawyer as early as possible. Contact us today to learn how we can put our decades of combined experience to work for you.
What Do I Need to Include in a Disability Claim?
If you suffer an injury in an accident of any kind or if you are diagnosed with a serious illness, you may qualify for disability insurance benefits through an employer-provided plan or one that you purchased privately. After you have exhausted all your paid sick leave and/or federal Employment Insurance (EI) benefits, you should be ready to file a claim with your disability insurance provider. The claim will consist of these three basic parts:
- Claimant’s Statement (or Notice of Claim) – You must tell the insurer about the nature of your disability, when it began, and how it keeps you from being able to do the job you had at that time (or any other job). If you suffer from multiple medical conditions, you should list them all. Each condition may qualify as a disability, or the combination of the conditions may leave you disabled.
- Occupational Description (or Employer’s Report) – Your employer must provide information that includes how long you have worked for the company, how much you are paid (including salary, bonuses, and incentives), and what duties and level of skill your job involves.
- Attending Physician Statement (or Doctor’s Report) – The general practice physician or specialist treating your condition should complete this form. The doctor should describe the diagnosis of your condition, when it arose, how it limits your ability to work, and the likely course it will follow based on your current treatment plan. The doctor should include all necessary medical records and other documentation.
How Do Insurance Companies Analyze Disability Claims?
When you file a disability insurance claim, the insurance company will assign your case to a claims representative. The representative will review the information you provided and likely contact you with questions or requests for more information, such as medical records. In some cases, the representative may ask you to participate in an interview or undergo a medical examination. Many insurers investigate claims by going through a claimant’s social media postings or even conducting surveillance.
What Happens When a Disability Claim Gets Approved?
If your disability claim is approved, you should expect to get payments that are retroactive to the date when your disability began. An insurance company may pay those benefits in a lump-sum settlement or in monthly checks or deposits. A lawyer can work with you and your insurer to determine the best payment method for you.
With claim approval, you may receive anywhere from 65 to 85 percent of the income you earned when you became disabled. It will depend on your plan. While short-term disability benefits typically last no longer than six months, a long-term disability claim may result in benefits that last for several years.
In many disability insurance plans, long-term benefits often start as “own occupation.” In other words, you qualify for payments if your condition keeps you from working the job you had at the time. After one or two years, you may be eligible to keep receiving payments only if your condition prevents you from working at “any occupation.”
What Happens When a Disability Claim Gets Denied?
An insurance company can deny a disability claim for any number of reasons. For instance, you may have failed to provide sufficient documentation of your injury and income through medical records and employment records. An insurer may also assert that you are not disabled or that your condition allows you to work at a different type of job than what you had before.
If the insurer denies your claim, you can appeal through the company’s process. You should get a copy of your claim file as part of the appeal. While providing more information and getting a new claims representative to review your claim could lead to approval, many companies simply stick with the prior denial.
When this occurs, you need to be ready to file a lawsuit. If you don’t file a lawsuit within two years of the claim’s denial date, you could risk your claim being time-barred.
Do I Need a Lawyer to File a Disability Claim or Contest a Denied Claim?
Considering the crucial role that disability insurance can play in your life and in your recovery from a severe injury or illness, you should not take any chances. You will benefit from working with an experienced Vancouver disability benefits lawyer from the moment you are diagnosed with a disabling medical condition.
At Warnett Hallen LLP, we can help you to file your claim, including working with your doctor and employer to ensure the insurance company gets the information and documentation it needs for approval.
We can also help you to coordinate the different payments you may be eligible to receive. For example, you may be entitled to personal injury damages or workers’ compensation benefits in addition to disability insurance, or you may qualify for disability payments through the Canada Pension Plan or B.C. Pension Plan. Our Vancouver disability benefits lawyer can also communicate directly with the insurer on your behalf, work towards a full and fair settlement, and take your case to court, if necessary, to pursue the disability benefits you deserve.
Our Experienced Disability Lawyers in Vancouver Are Ready to Help You
At Warnett Hallen LLP, our Vancouver disability insurance claims lawyers will give you the close attention you deserve throughout your case. We will work tirelessly to seek all disability insurance payments you are due. To find out more about how we can serve you, call or reach us online today. Our initial consultations are free.
