Why am I being asked to apply?

Under most LTD group insurance plans, the insurance company will get a direct credit for any CPP Disability benefit that you receive. That means they are entitled to reduce your monthly LTD benefit by the exact amount you receive from CPP Disability. Thus, they want you to apply so that it reduces the amount they are required to pay you under the LTD policy.

Do I qualify?

To qualify for CPP Disability, you must have made payroll contributions to the Canada Pension Plan in 4 out of the last 6 years leading up to your date of disability (in some rare cases they will accept 3 out of the last 6 years). You must also be deemed by Service Canada to suffer from a severe and prolonged disability. “Severe” means that your disability prevents you from regularly working in any type of occupation. “Prolonged” means that your medical condition is deemed to be permanent or indefinite in duration. Usually the LTD insurance company will only ask you to apply for CPP Disability if they believe your symptoms may not improve in the near future.

Should I apply?

I always encourage my clients to apply for CPP Disability benefits regardless of their age and the nature of their disability. If you are approved, that means the Government of Canada has accepted that you are totally disabled from working in any capacity, which is strong evidence that you are disabled. Also, if your application is accepted, you will have some money to survive on in the event the insurance company unfairly cuts off your LTD benefits.

What happens if I refuse to apply?

The majority of LTD group insurance policies contain a clause which will punish you for failing to apply. The language states that if you don’t apply for CPP Disability the insurance company can estimate the amount of CPP Disability benefits that you would receive if you applied and were accepted.  They will then reduce your monthly LTD benefit by this estimated amount even though you are not actually receiving it. Thus, it is almost always in your interest to apply for CPP Disability benefits even though you are already receiving LTD benefits.

How do I apply for CPP Disability?

There are two ways to apply for CPP Disability benefits. You can print the forms from the government website and submit the paper application by mail or drop it off at a local Service Canada office. If you don’t have a printer, you may be able to pick up an application form from a Service Canada office.

The second way to apply for CPP Disability benefits is online through the Service Canada web portal.

Further information on applying for CPP Disability benefits can be found at the Service Canada website:

https://www.canada.ca/en/services/benefits/publicpensions/cpp/cpp-disability-benefit/apply.html#Submit_paper

The insurance company is asking me to sign additional forms. Should I comply?

If the LTD insurance company is asking you to sign any additional forms regarding CPP disability benefits, it is very important that you consult with a long-term disability lawyer to make sure that you know your rights.  The forms may be wholly inappropriate and place additional obligations on you that do not exist under the terms of the insurance policy.

Disability Lawyer Mark Yazdani

If you have any questions about applying for CPP Disability benefits, or if the insurance company is asking you to sign additional forms, contact my office for a confidential, no-charge consultation about your rights.

Likewise, if your CPP application has been rejected for any reason, contact me to discuss your options in filing an appeal or being represented by a lawyer at the Social Benefits Tribunal.

Mark Yazdani
Disability Lawyer
416-630-8880
1-877-311-8880
info@disabledlaw.ca

The post My LTD Insurance Company is asking me to apply for CPP Disability Benefits – What should I do? appeared first on Yazdani Law Office.

Your family doctor plays a critical role when it comes to short-term and long-term disability claims. When you first apply for disability benefits, it is the family doctor that most commonly completes the initial medical form (often called the Attending Physician’s Statement).  In this form they provide information about your medical condition, including symptoms and treatment.  Your doctor may also be asked to comment on whether your condition prevents you from working in your occupation.

If your doctor does not do a thorough job in completing the initial claim form, then often the insurance company will deny your claim on the grounds that there is “insufficient information” to establish that you are disabled.

Your family doctor also plays an important role in the event your claim is denied. I usually recommend that my clients ask their family doctor to write a letter of support for an appeal.  The letter should include detailed information about why the doctor believes you are not capable of reliably and consistently performing your specific job tasks. If your doctor is unwilling to do so, the likelihood of your appeal being successful is low.

Even if your LTD or STD claim is initially approved, your family doctor can play an important role in making sure your benefits will continue. Your disability case manager will often contact your family doctor to request clinical notes and medical chart entries. These are the records that your doctor writes down during or following your appointments. Also, if the LTD insurance company wants to force you to participate in a rehabilitation plan, your case manager may contact your family doctor to ask for a comment on whether you are able to participate.

If your doctor’s office delays in responding to the insurance company, or delays in sending them medical records, then the insurance company might use that as an excuse to suspend or even terminate your disability benefits.

Why won’t my family doctor help me?

Many family doctors have extremely busy medical practices. They often simply don’t have the time to dedicate to thoroughly filling out insurance company paperwork or responding to questionnaires. Also, OHIP unfortunately does not properly compensate family doctors for writing appeal support letters, completing questionnaires, or filling out paperwork. As this CBC article shows, many doctors are dealing with rising overhead while their compensation remains stagnant. Of course none of this is your fault, which only adds to the frustration.

Some family doctors also have a negative attitude toward disability claims and believe that discontinuing work and collecting disability benefits is counter-productive. Some believe that best efforts must be made to continue working as long as possible even if you are suffering with severe pain or a serious psychiatric illness.

What can I do? Should I change doctors?

I usually advise my clients that changing doctors should be a last resort. Firstly, there is a family doctor shortage in Ontario and it may take a very long time to find another doctor willing to accept new patients. Secondly, even if you can find a new family doctor it will take them some time to become familiar with your medical history and they may be unwilling to immediately fill out questionnaires or write appeal support letters on your behalf.

Your best course of action is to try and break through to your doctor, appeal to their compassion, and try and communicate just how important their assistance is to your life. The following tips will hopefully be helpful to you in achieving this outcome:

1.When requesting forms to be completed or requesting an appeal support letter, always try to meet your family doctor in person. It will be easier for you to appeal to your doctor’s compassion in person as opposed to by telephone or video. You can emphasize how critical disability benefits are to your life and how much you need them to pay your rent or mortgage and put food on the table for your family.

2.Make your doctor’s job easier by giving them the information they need to fill out a disability form or to write a support letter. You can describe the severity and frequency of your symptoms and you can explain to your doctor the specific job tasks that you are not able to perform (always provide 2-3 examples of job duties that you have). If your doctor doesn’t have time for a comprehensive discussion, consider providing the above information to your doctor in bullet form (note it is important that your doctor use his/her own words).

3.If you are able, offer to pay the doctor for their time – especially if you are asking for an appeal support letter.

If none of these tips work, consider whether another doctor that you have seen, such as a specialist, might be willing to assist you. Insurance companies will usually give higher credence to a specialist’s opinion to that of a family doctor.

You may also consider asking a non-physician medical professional such as a psychologist, counsellor, physiotherapist or chiropractor to write an appeal support letter. You can then ask your family doctor to review the letter and ask them to simply write on the letter “I agree with this assessessment”.

Disability Lawyer Mark Yazdani

If you are having difficulty with your doctor and it is affecting your STD or LTD claim, please call me for a confidential, no-charge consultation to discuss your options.

Likewise, if your disability claim has been rejected or terminated for any reason, contact me to discuss preparing an appeal or if necessary, starting a court case against the insurance company.

Mark Yazdani
Disability Lawyer
416-630-8880
1-877-311-8880
info@disabledlaw.ca

The post My family doctor is not supporting my disability claim. Is there anything I can do? appeared first on Yazdani Law Office.

Please visit my new website at wontclose.com for further information. I also have a real estate blog where I provide court case summaries of recently failed property closings and the lessons that can be learned.
Mark Yazdani
416-630-8880

The post Real Estate Litigation – Failed Closings appeared first on Yazdani Law Office.

I have also had disability insurance companies try and use surveillance to justify denying a disability claim or during the course of a lawsuit to “prove” that my client is not truly disabled.

Surveillance is a serious invasion of your privacy. A private investigator is hired to secretly videotape you as you exit your home. They will start recording if they see you sitting on your porch, taking the garbage to the curb, chatting with a neighbour or walking the dog. If you drive to a store to go shopping or drive to a medical appointment they will follow you and make detailed notes of everything they observe including how you carry a purse, how you get into and out of your car, how many shopping bags you are holding and how long you stopped for a coffee at Tim Hortons. Surveillance can also consist of conducting online spying on your social media accounts or searching public records databases.

You may be wondering – is this legal? Unfortunately, the answer is yes – LTD insurance companies are permitted to hire investigators to observe you outside your home. In fact, one court even ruled that a private investigator hired by Manulife had not breached a woman’s privacy when he photographed her while she was inside her home but standing by the window with the blinds drawn and light on.

Should you be worried? Fortunately, most times the answer is no.

Firstly, surveillance is very expensive. Just three days of surveillance can cost and insurance company thousands of dollars and thus it doesn’t make economic sense to park a private investigator outside your home for weeks or months. Usually they will be strategic and try surveillance during periods of good weather and on the weekend.

Most importantly, the vast majority of surveillance reports I have seen throughout my career have had little to no impact on the strength of my client’s case. There is no requirement that you must be shut in your home and unable to leave in order to satisfy the definition of disability under the LTD policy. Taking your children to soccer practice, going for a short walk, running some errands at the store or stopping for a coffee does not mean you are capable of reliably and consistently working in your job on a full-time basis.

Also, given that the surveillance is usually conducted for a limited time, it is not representative of what a disabled person’s regular activity level is like. Most individuals suffering from conditions such as chronic pain, fibromyalgia, and chronic fatigue syndrome will have good days and bad days. If the surveillance catches them on a good day where they have more energy to be active, it does not mean they are consistently that active all the time.

Surveillance can be detrimental to a disabled person’s legal case if the footage contradicts what the person has said they are capable of. For example, if you tell your case manager that you cannot drive and the surveillance shows otherwise, then your credibility may be called into question. If your case goes to trial the insurance company will try and convince the court that your evidence about your pain, fatigue and depression should not be accepted because you are not a credible person. Credibility is a critical factor in disability cases and that is why I always recommend that my clients not speak in absolutes (such as “I never drive” or “I always walk with a cane”) unless it is absolutely true. Likewise exaggerating the extent of your limitations may reflect poorly on you if contradicted by video footage.

If your disability claim has been denied or your benefits terminated because of surveillance, call me for a free confidential consultation about your case.

Mark Yazdani
Disability Lawyer
info@disabledlaw.ca
416-630-8880
1-877-311-8880

The post Surveillance – Should I be Worried? appeared first on Yazdani Law Office.

Counselling Sessions/Psychotherapy

Disability rehabilitation programs can take a number of different forms. If you suffer from a psychiatric illness such as depression or anxiety, it will often take the form of counselling or psychotherapy sessions with a psychologist chosen by the insurance company. This psychologist is paid by the insurance company and provides regular updates to your disability case manager as to your progress.

You should be highly skeptical that the psychologist chosen by the insurance company is on your side. The psychologist may heavily rely on the insurance company for referrals and have every financial incentive to keep the insurance company happy by declaring that you are now improved and ready to return to work – even if that is not true.

I always recommend that you only attend psychological counselling sessions with a medical provider of your own choice and one that has been recommended by your family doctor. This way you can be assured that the psychologist or counsellor will only be loyal to you – not the insurance company. Remember, the LTD policy does NOT give the insurance company the right to dictate who provides you with medical treatment and advice.

Work Hardening Program/PGAP

If you suffer from chronic pain, fibromyalgia or chronic fatigue syndrome, a rehabilitation program will sometimes take the form of a “work-hardening program” or a Progressive Goal Attainment Program (PGAP). Most of the time the disability insurance company will outsource this program to a third party vendor. These rehabilitation companies are paid by the LTD company and provide your case manager with regular updates about your progress.

Work hardening and PGAP rehabilitation programs vary between companies. Typically, the program involves regular meetings with rehabilitation professionals, including career counsellors, kinesiologists, physiotherapists and vocational retraining personnel. These meetings normally take place in a facility where you will be required to perform various activities such as stretching, exercises, talk-therapy, and retraining activities such as working with a computer. Their goal is to push you to gradually increase your activities and improve your pain or fatigue tolerance every week so that by the end of program you can return to work. In between sessions they will often demand that you do “homework” such as performing household chores, going for walks, or otherwise increasing your activity levels.

Given these companies often rely upon insurance companies for referrals, they are under tremendous pressure to successfully return you to work. Unfortunately, that often means they will try and bully you into doing more than you are capable of which can result in a setback to your recovery. If you protest and push back due to extreme fatigue or pain they may accuse you of “not trying hard enough”. Then your disability insurance company may declare that you are refusing to comply with the rehabilitation plan and use that as an excuse to terminate your disability benefits.

Once you have completed the program, the third party rehabilitation companies are highly incentivized to report that you are fully recovered and ready to return to work – even if that declaration is untrue. The LTD insurance company will congratulate you on the successful completion of the program and advise that your disability benefits are now being terminated as you are no longer disabled.

Know Your Rights

Before you agree to any rehabilitation program, it is essential that you first have a discussion with your own medical providers. Ask your LTD case manager for a full written description of what the program involves and what is expected of you. Then, have a detailed discussion with your doctor about whether they believe it would be appropriate for you to participate and if you are capable of doing so. If your doctor disagrees with the rehabilitation program, ask for a letter to that effect and provide it to the insurance company as a reasonable basis to refuse.

Even if your doctor approves of your participation, it is very important to make sure they know about any struggles that you experience during the program or any complaints that you have. Doing so creates a paper trail of your difficulties which can counter any false narrative by the rehabilitation provider that you are now fully healed and ready to return to work.

If you do participate in the rehabilitation program, do not let them bully you into doing more than you are capable of. Only you know how much pain, fatigue, and anxiety that you are experiencing and what your limits are. Make sure you document any bullying or harassment so that there is a record of such behavior.

If you are being unfairly pressured or harassed by a rehabilitation company or if the insurance company is threatening to cut off your benefits, give me a call to get legal advice about your rights.

Likewise, if the insurance company wrongly terminates your long-term disability benefits following your participation in a rehabilitation plan, or because you have reasonably refused to participate, call me for a free confidential discussion. We will discuss your legal options, including filing an appeal or commencing a lawsuit to get your benefits restored.

Mark Yazdani
Disability Lawyer
416-630-8880
1-877-311-8880
info@disabledlaw.ca

The post What You Should Know Before Agreeing To A Rehabilitation Program appeared first on Yazdani Law Office.

Can photographs and video of a disabled claimant be relevant to a disability claim? The answer is yes. For example, if a disability claimant makes a claim for severe depression and tells their case manager that they never socialize and rarely leave their home, photographs of the claimant attending numerous social gatherings during the time she claims to be disabled would most likely be deemed relevant. While the photographs may not prove that the claimant is capable of working, they would potentially speak to the credibility and truthfulness of the claimant – both important factors in disability claims.

While photographs and video can be relevant to the issue of credibility, they have limited impact upon the issue of disability itself. A photograph is only a snapshot of a particular moment of time – you cannot reliably extrapolate functional abilities from them. For example, a photograph may show a disabled claimant suffering from fibromyalgia and chronic fatigue syndrome posing by a famous landmark while on vacation. The only reliable evidence obtained by that photograph is that the claimant at some point visited a landmark on a particular day and time. It does not prove she can perform her job duties on a full-time basis. Likewise, video clips are for short durations and are not representative of a person’s regular activity level.

However, photographs and video can have prejudicial impact even if they are not relevant to the issue of disability. The real danger exists that a court will make improper assumptions and draw inaccurate conclusions from a photograph.

Courts in Ontario have held that photographs and other information posted on an online social media profile can be produced in court proceedings and used as evidence. To avoid an insurance company potentially misconstruing photographs or other information posted online, and subsequently using that information to wrongly deny or terminate a claim, it would be advisable for disability claimants to avoid opening social media accounts such Instagram, Facebook, Twitter, etc.

If you already have an online profile, it would be advisable to cease updating it or adding photographs and video to it. It would also be advisable to restrict the account such that it is only accessible by your close friends and family and not accessible by members of the public. Also, be wary of accepting friend requests by accounts that you do not personally know as it possibly could be a private investigator trying to access your account.

If you already have an online social media account, are you permitted to delete it? The answer: it depends. Certainly if you are involved in litigation against the insurance company you are not permitted to destroy evidence relevant to the issues in the lawsuit. Deleting or destroying relevant photographs or deleting an online profile with relevant information could possibly be held against a claimant in court. However, there is no legal prohibition against closing a Facebook account for reasons other than to destroy evidence. In the Ontario court  decision of Schuster v. Royal & Sun Alliance, Justice Price stated, “There are many good reasons unrelated to litigation that people may have to withdraw documents from their friends’ view. Their right to do so should not be lightly interfered with.” Thus, a disability claimant has the right to close his or her Facebook account simply because they are no longer interested in participating or because they no longer wish to share information or photographs with friends and family.

If your disability claim has been denied or your disability benefits have been terminated, contact me for a free consultation regarding your legal rights.

Mark Yazdani
Disability Lawyer
416-630-8880
1-877-311-8880

The post Tips for Disability Claimants #2 – Avoid Opening a Facebook Account appeared first on Yazdani Law Office.

Undergoing regular treatment and visits to your doctor help to demonstrate to the insurance company that you are suffering from a valid disability and are therefore unable to work. Also, many short-term and long-term disability policies contain clauses that require claimants to be under the regular care of a qualified physician in order to qualify for disability benefits.

It is important to continue getting medical treatment even if your disability claim has been denied. A court or tribunal is much more likely to find a disability claimant as being credible if there is evidence that he or she has been regularly seeking treatment for their sickness or injury.

Family physicians are critical as the first-line of treatment for a disability. However, it is also important to seek the care of a specialist when appropriate. For example, while a family doctor is trained to treat a patient suffering from depression, a disability insurance company will likely expect that a disability claimant with severe depression receive treatment from a psychologist or psychiatrist.

Of course, the largest and primary benefit to maintaining regular treatment is (hopefully) an improvement in health and function such that you can resume your life and career.

The post Tips for Disability Claimants #1 – Maintain Regular Treatment appeared first on Yazdani Law Office.

In most circumstances, an insurance company will offer a lump sum settlement if they believe it is unlikely that the claimant’s health situation will ever improve. Thus, rather than pay monthly benefits until the claimant reaches age 65, the company will look to reduce their liability by offering a one-time lump sum payment which is discounted.

There are pros and cons to accepting a lump sum offer. The largest disadvantage is that no matter how large the sum, a claimant will receive less (often significantly less) than if they remained on claim and received a monthly benefit to age 65.  Further, once the lump sum has been spent, the claimant is not eligible to receive any further disability benefits under the policy. Thus, unless the claimant returns to the workforce, their only source of income may be CPP disability benefits, social assistance, or other government disability benefits.  Another disadvantage may be that the claimant loses other benefits contained in the group policy – for example, group life insurance coverage.

However, some claimants prefer to receive a lump sum as opposed to monthly benefits so that they can use the money to purchase a home or pay off a mortgage. Some claimants also prefer a lump sum because they will no longer have to deal with the insurance company and the continuous requests for updated medical information. Once a lump sum agreement is reached, there are no further dealings with the insurance company. Further, if after taking a lump-sum benefit a claimant’s health improves such that they can return to the workforce, they will not be required to return any of the money to the insurance company. Finally, for claimants who are taxed on their monthly disability benefit, the entire lump sum amount received would be non-taxable. For these reasons, some claimants will themselves approach an insurance company and inquire about the possibility of a lump sum settlement.

It is critical that you consult with a disability lawyer prior to entering into a lump sum agreement. A disability lawyer can provide you with a present value calculation of your monthly benefit and advise you as to the reasonableness of the insurance company’s offer. A disability lawyer can also review your policy and explain all the ramifications of surrendering your coverage and signing a Full and Final Release. A disability lawyer can also negotiate the lump sum settlement on your behalf.

At Yazdani Law Office, we have experience and expertise in negotiating and assisting clients across Canada with lump sum settlements. Contact us today for a free and confidential consultation with disability lawyer Mark Yazdani.

1-877-311-8880

416-630-8880

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Unfortunately, workplace conflicts can also have very serious mental health ramifications. For some people they can result in serious anxiety disorders, major depression, psychiatric trauma, and other psychiatric conditions. Even with medication and treatment by a specialist, these disabilities can be long-term in nature and completely prevent a person from being able to return to work.

Long-term disability insurance companies will often reject disability claims relating to workplace conflicts. Primarily, the insurance company takes the position that the employee is only away from work as a result of the workplace conflict and is not truly disabled. They argue that the employee is capable of working in a different environment or with a different employer.

From a legal standpoint, almost all LTD policies are occupation-specific, not workplace-specific. The policy provides for benefits when an employee is not able to perform the duties of their occupation – regardless of that employee’s particular workplace. For example, a teacher would not qualify for disability benefits if she is found to be fully capable of teaching at another school.

However, insurance companies often fail to grasp that a psychiatric disability caused by a workplace conflict is a legitimate disability that can completely prevent an employee from performing job duties in any work environment. Employees who suffer from major depression or a generalized anxiety disorder are not magically cured by simply working with another company or with different co-workers. They have serious mental impairments that prevent them from concentrating and functioning in any working capacity.

If your insurance company has denied your short-term or long-term disability claim on the grounds of a “workplace conflict”, do not give up. A court of law may strongly disagree with the insurance company’s position and award you disability benefits.

Contact Ontario disability lawyer Mark Yazdani today for a free consultation regarding your legal rights.

1-877-311-8880

The post Reasons Claims are Denied #4 – “Workplace Conflict” appeared first on Yazdani Law Office.

Is activity noted on surveillance sufficient to justify the denial or termination of a disability claim? Certainly the answer would depend on the type, frequency, and duration of the activity, as well as the nature of the claimant’s disability. However, surveillance often has only limited relevance to the question of whether a claimant is truly disabled.

Firstly, surveillance is usually conducted over a relatively brief period of time – most commonly 3 or 4 consecutive days. If a disabled person is shown to be active during that time, it does not necessarily mean that the person is capable of being active all the time. Many disabilities are of fluctuating severity such that people have “good days and bad days”.

Secondly, activities shown on surveillance are usually brief in nature and not indicative of whether is someone is capable of working. Surveillance showing a person walking their dog in the morning, shopping for groceries, or mowing the lawn is usually not sufficient to prove that they are capable of working 8 hours per day at a full-time job. Also, the surveillance will not show what is happening inside a claimant’s home after they return from their activity – many individuals will be completely exhausted and unable to do anything else but rest.

While surveillance is often not relevant to the issue of whether a person is disabled, it can be relevant to the issue of a claimant’s credibility. If a claimant tells their case manager that their condition is so severe such that they are always bed-ridden, surveillance showing the claimant active outside their home will be damaging to the claimant’s credibility. Likewise, if a claimant states that they are unable to drive a car, video footage proving otherwise will be damaging to the claimant’s credibility. If the insurance company can establish a claimant is not credible, it will have a negative impact upon a claimant’s chance of success at a trial.

If your short-term disability (STD) claim or long-term disability (LTD) claim has been denied on the grounds of surveillance evidence, do not lose hope. A court of law may strongly disagree with an insurance company’s interpretation of surveillance data. Also, in some cases, the investigator may have obtained footage of the incorrect person. Contact my office for a free consultation with an Ontario disability lawyer regarding your legal rights.

1-877-311-8880

The post Reasons Claims are Denied #3 – Surveillance appeared first on Yazdani Law Office.