Client's Disability Benefits Terminated; Insurer Alleges Non-Compliance with Treatment
Anthony's earliest memories involved spending time in his family's barbershop. As a young man, he learned how to cut and shave hair from his father and began to work as a full-time barber after graduating from secondary school. When his father retired, Anthony inherited the shop, and it became his pride and joy. He embarked on what would become a forty-year career as a barber.
Repetitive Tasks Cause Disability
Anthony was in good health until his early fifties, when he began to experience concerning physical symptoms. It started out as tingling in his fingers and then, numbness in his hands and wrists. Finally, the problem progressed into constant shooting pain (progressive chronic pain) and loss of strength in both of Anthony's hands.
An MRI revealed carpal tunnel syndrome, a progressive condition caused by compression of the median nerve in the wrist. Years and years of repetitive arm and hand movements that were a part of his job were now preventing Anthony from working. Anthony's doctor suggested rehabilitation and if there were no improvements, surgery. One thing he was clear about was that Anthony should take a break from the barbershop or his condition could worsen.
Progressive Chronic Pain Disability Claim Approved
Anthony submitted a claim for disability that was part of his life insurance policy. They approved the claim, allowing Anthony to focus on rehabilitation. He closed the shop indefinitely and visited his physical therapist twice a week.
Insurance Company Alleges Non-Compliance with Treatment
Six weeks after Anthony was first approved for disability benefits, his case manager called and asked when he was scheduled for surgery. Anthony informed her that he was currently seeing a physical therapist and was not sure if he was going to have the surgery he and his doctor had discussed. A week after this telephone conversation, Anthony received a letter stating that his benefits had been terminated. The reason cited in the letter was "non-compliance" with recommended treatment.
Benefits Terminated and Appeals Denied
Anthony and his doctor were taken aback by this; they assumed that the insurance company had misconstrued his clinical notes and records. Together, they submitted an appeal. When that was also denied, Anthony knew he was in trouble. Anthony's neighbours, who had had their own troubles with their insurance company in the past, recommended he contact Share Lawyers for a free consultation.
Legal Action Taken
Anthony met with Share Lawyers and was assured that it wasn't the end of the road for his claim. After a thorough assessment, he was provided with a clear explanation of what to expect after suing the insurance company for benefits. It was a great relief to know that, while legal action was not an overnight resolution; the firm would handle every step of the process so that he no longer had to battle with the insurance company. He could finally focus on getting better from his progressive chronic pain while his lawyers focused on winning him the maximum settlement possible.
Working toward a Settlement
After reviewing Anthony's policy and medical history with a fine-tooth comb, Share Lawyers prepared their case against the insurance company. In mediation, Share Lawyers used expert medical evidence to identify that Anthony had fully complied with all recommended treatments at different points in his disability. The insurance company argued that Anthony should have opted for surgery as soon as he could not continue working; however, Share Lawyers demonstrated that in Anthony's case, surgery was recommended as a last resort, and that he was pursuing other less invasive options when he was terminated from his benefits. The case was settled after many hours of aggressive negotiations between Share Lawyers and the insurance company's legal counsel. Anthony was finally awarded a sizeable lump-sum to cover disability benefits owed, a portion of benefits he would have received in the future, as well as a portion of his legal expenses.
After the Settlement
Anthony was pleased with the outcome of his case because it afforded him the time to make the best choice for his health. Ultimately, he did require carpal tunnel release surgery, and he was able to return to work a few months later on a modified basis.
*Names and identifying details have been changed to protect the confidentiality of all involved.
If you have had your claim for long term disability denied,contactthe long term disability insurance lawyers at Share Lawyers. Our 35+ years of experience in long term disability (LTD) law can help you win your case against Canada Life, Desjardins, Manulife, RBC Insurance, Sun Life, and other insurance companies. We offer free consultations and there are no fees unless you win your case. Join us on Facebook and become a Top Fan for a chance to win each month.
Denied your long term disability claim?
Contact Share Lawyers today and put our experience to work for you. Our 35+ years of experience can help you win your case against Canada Life, Desjardins, Manulife, RBC Insurance, Sun Life, and other insurance companies. We offer free consultations and there are no fees unless you win your case. Join us on Facebook and become a Top Fan for a chance to win each month.
A note from our long term disability lawyers
Taking a medical leave from work is not an easy decision to make. Concerns about providing for yourself and your family and keeping your job may cause you to want to push through your pain, but this won’t make your problems go away. Stopping work is often the smartest decision for your long term health and well-being, and your disability benefits are there to provide you with financial support until you can return to work.
If you have made the tough decision to stop working and apply for your short term disability or long term disability benefits, you may feel overwhelmed by the process and have questions that your employer and your insurance company are not able or willing to answer. Share is There to see you through and answer your questions.
Our Disability law firm knows what you have been going through
We understand that things have not been easy for you over the last little while. Your health has been suffering, you are unable to work, and now your insurance company, who was supposed to be there in your time of need, has decided they will not pay your disability benefits or respect your disability claim. These benefits exist to provide you with the financial support you need so that you can focus on your health and rebuilding your life. It is unfortunate that your insurance company has not lived up to its promise. If your disability claim has been denied, we will fight to get you the benefits you are entitled to. Our disability lawyers have helped thousands of Canadians get their long term disability benefits over the past 35 years, and we can help you too.
Our experienced disability lawyers can fight back on your behalf
Share Lawyers believes that every client who is dealing with a disability claim deserves superior personal service. To achieve that goal, we have developed our team of experienced, compassionate, and caring long term disability lawyers, law clerks, and administrative staff to meet all of your needs. Our team of experienced long term disability, life insurance, employment, and critical illness insurance lawyers have made successful claims against many insurance companies, third-party administrators and employers.
If you are unable to work, your disability benefits should be there to provide you with the financial support you need. While your insurance company may be focused on finding ways to avoid paying your claim, our focus is on what is in your best interest. When Share Lawyers gets involved, you have an entire team of lawyers that are there to support you and to fight for what is yours.
Our disability claim lawyers fight for your disability insurance claim by relying on our many years of experience to apply the best strategic planning and approach in each case, using the latest technology available. Experience matters, and with Share Lawyers, you are in the best hands with 35 years of success on your side.
In this video, we explain the role of a long term disability lawyer and how we can support you when you have been denied your long term disability benefits.