Disputing a Denied Disability Claim

Aug 18, 2019 | Initial Consultation, Long Term Disability Claims

Moussa Sabzehghabaei

Personal Injury Lawyer

A survey conducted by Statistics Canada in 2012 revealed that only 49% of people who suffer from a disability were employed. For persons living with disability, finding employment becomes difficult mainly due to the stigma associated with their disability as well as their inability to perform work. This survey was a clear revelation that people with disabilities face challenges trying to make ends meet.

Common Injuries in a Pedestrian Accident

Disability insurance

When disability insurance was introduced, many Canadians purchased it in order to protect themselves in case of an accident that would render them unemployed for a long time. With this policy, individuals can get compensated when they are injured and unable to work for prolonged periods.

Why some disability claims are denied

Insurance claims are often denied by providers as one of the ways of maximizing their profits by keeping the volume of pay-outs low. One common reason why your disability claim could be denied is when an individual is found to be faking or exaggerating an injury. Insurance companies refer to this as ‘malingering’. This allegation can be very frustrating to the victim and loved ones. Without proper legal representation, the claim cannot be approved. The victim may end up losing important benefits that have life-long impacts.

Why you shouldn’t exaggerate your illness

Granted, most insurance companies are in the business of maximizing profits which they do by minimizing payouts as much as possible. However, some individuals malinger or exaggerate their condition in order to benefit more than they should. These victims often assume that by exaggerating their illness, they can get more financial compensation or avoid work. This is wrong and if one is caught, he/she loses the slightest opportunity to receive any payout.

The court will review critical documents such as the victim’s medical test results and the physician’s opinion in order to ensure that the plaintiff isn’t exaggerating their symptoms. The insurance company’s lawyers may try to dissuade the court by undermining the plaintiff’s credibility. They look out for gaps in treatment or unclear medical test results in order to prove their allegation of malingering.

Proving your claim

It’s going to take extensive skill and experience to beat the evidence gathered by insurance companies to conflict your disability. That’s why it’s critical to work with an experienced long term disability lawyer. Insurance investigators will go to great lengths to conflict your claim. From getting an expert to review your medical condition to looking for video evidence that conflicts the claim, you’ll need an experienced litigator by your side to build a strong case against any charges that are brought against you in court.

The steps you take immediately after the accident or injury can help prove your case. We’ll go over the steps to take if involved in an accident that results in a disability.

Step 1: Seek medical advice

First and foremost, when you are involved in an accident, see a doctor immediately. Do not suffer in silence. In fact, failing to seek medical advice could work against you for two main reasons. First, your condition may get worse over time so you need to receive proper care as soon as possible to increase your chances of a speedy recovery. Even if you don’t feel any pain immediately, see a doctor and don’t just assume that all is well.

Keep in mind that some accidents can result in serious medical conditions that cannot be easily identified through tests like diagnostic imaging. A good example is chronic pain. Individuals who get involved in accidents that later result in chronic pain without postiive diagnostic image findings are often frustrated because insurance companies are known to undermine this condition. In such matters, expert evidence from a medical specialist is key because the court will review this to determine if chronic pain is a basis for disability.

Step 2. Keep a journal

It’s really important to keep a personal record of your condition in a journal. This journal will help you to document important details of your condition such as the level of pain you feel, the times of day when you experience the most pain, the days you go for rehabilitation among other details.

Step 3. Speak to an experienced long-term disability lawyer

If your condition has resulted in your inability to perform work, it’s really important to speak to a lawyer who specializes in disability claims. Long term disability claims are complex and should be handled by an expert who has experience in similar cases. Your lawyer will develop a strategy to refute all the allegations that could lead to your claim being denied. If you take too long to file your claim, it may eventually be denied due to the statute of limitations.

Why you need an experienced long-term disability lawyer

To begin with, disability lawyers have a network of medical specialists whom they work with closely because they understand how critical the diagnosis is to your case. When they present their case in court, they speak using the evidence obtained by these medical experts.

A long term disability lawyer will take time to understand your case and gather the necessary evidence that proves their client’s behavior, as well as daily activities, have changed since the accident. A good lawyer will go great lengths to prove your disability including speaking to those who are close to you such as your family members, coworkers or supervisors.

The disability insurance company is likely to make accusations to conflict your claim. An experienced litigator knows this and will gather all the evidence just in time to prove them wrong.

If you choose to settle outside the courtroom, the lawyer will help you to negotiate a fair settlement. It’s never recommended that you negotiate for settlement without an experienced litigator by your side. An expert lawyer will ensure that your rights are protected before the negotiations begin. He/she will also inform you of all your legal rights and answer any concerns you may have before entering the settlement negotiations.

If you or a loved one has been involved in an accident that results in disability and the insurance company is denying your claim, seek legal assistance immediately. A long term disability lawyer will help you to better understand your rights and obtain the compensation you are entitled to.