Having a long-term disability that prevents you from working is frustrating not only because of the physical or mental limitations that it puts on you, but also because of the financial constraints that come along with not being able to earn a paycheck. Fortunately, if you have disability coverage, your insurance can offset the financial challenges of having a long-term disability.
Here is what you need to do when making a claim:
1. Get a claim form
If you have disability coverage through your work, you should be able to get a claim form through your employer. If you have your own coverage, you should contact your insurance company to get a form. If you are not covered either by your employer or with your private insurance, you may still be covered under WSIB and may be able to apply for benefits.
2. Obtain support from your doctor
In order to be approved for benefits, you must first get supporting medical documents to show that you have a disability that prevents you from working. You may obtain this information from a healthcare provider such as your family doctor, psychiatrist, other treating specialist, etc.
Your healthcare provider will have to provide a medical certificate that supports your claim, and they may also make recommendations that will allow you to improve your condition to help you return to work.
3. Complete the application
Long-term disability claims tend to be complex and will require a lot of supporting information. While each insurance policy may have its own unique requirements, your application will generally require a number of forms, including:
- Plan member statement, which outlines the details of your claim. This will include specific questions about your symptoms and what caused them.
- Attending physician’s statement, which will include relevant medical documentation to support your claim.
- Plan sponsor statement (if applying through your work coverage) – this is signed and sent by your employer.
- Job description – describes the primary responsibilities and physical requirements of your job.
4. Submit the application
Once you have the necessary information compiled, you may submit the claim to your insurer. It is important to note that there are usually time limitations for submitting a claim, so you shouldn’t wait too long after the injury or illness occurs to get started on the process of submitting your claim.
5. Assessment of your claim
Once you have submitted your application, a case manager from the insurance company will review your claim and determine your eligibility for benefits. Often during your assessment, this case manager will conduct an interview with you in person or over the phone to evaluate the following information:
- The medical information that you provided
- How your disability affects your ability to work
- The demands of your specific job
- Your ability to perform tasks of daily living
Your case manager may also wish to speak to your doctor, your employer or ask you to take additional independent medical exams. Following the assessment, your claim can take anywhere between seven and thirty days to be approved or denied.
Why legal advice is important
The process for filing a long-term disability claim is lengthy and complicated, and one small error or omission could cause your benefits to be delayed or even denied. An experienced disability lawyer can help ensure your claim is accurate and complete in order to help you get the maximum benefits that you are entitled to.
Furthermore, if your claim is denied, your lawyer can help you through the appeal process.
Contact Hoffman Law today If you are filing a long-term disability claim, or you feel that you have been unfairly denied a claim, we are here to help. We offer free consultations and no upfront fees, so you have nothing to lose. Contact us today to speak to a disability lawyer.