Casestudy - Long Term Disability Benefits Claim

*Names have been fictionalized to protect the privacy of our clients.

Nelson Alvarez - Disability Claim Denied

Faced with stress at work and numerous personal problems, Nelson was having trouble coping. Initially his employer had been understanding and under the Group Disability benefits he had at work, he applied for short-term disability on the recommendations of his family doctor and psychiatrist, who felt some time away from his daily stress would help him find a way to cope again.

The whirlwind of difficulties in Nelson's life did not disappear while he was away from work, and in fact, matters became worse. Nelson's anxiety and depression deepened. With this came more frequent visits to his doctors and higher levels of medication. At the conclusion of his short term disability coverage, he applied for long-term disability benefits, and after several months, without payments coming in, his claim was denied. The insurer said they would review his case if further and new medical evidence could be provided, but they were not satisfied that his condition was sufficient reason for him to be absent from his job as a social worker in a large government institution.

Submission of further medical evidence was met with similar denials and requests for additional information. Nelson was at the end of his rope when he decided to contact David Share Associates.

After gathering medical records, policy information and other relevant data, a lawsuit was commenced on Nelson's behalf. It was explained to Nelson that pursuing the matter would take time and would be difficult. Within a year of retaining David Share Associates, a private mediation had been arranged, and during an all-day session a settlement of $125,000.00 was negotiated. This enabled Nelson to pay off his debts and provided him with some security while he sorted out his personal and work-related problems. He now had some hope that he could put the pieces of his life back together.

Fibromyalgia Long Term Disability Casestudy

*Names have been fictionalized to protect the privacy of our clients

Lynda Morton- Fibromyalgia Claim Denied
At age 48, Lynda Morton thought that life was unfolding as it should. She had a happy marriage and two grown children. Her work as an assistant manager in a retail store was rewarding enough that she had stayed withthe company for fifteen years. In a few years, she could look forward to retirement. Then illness overtook her.Fibromyalgia Lynda knew what it was like to work with the pain. Years earlier, she had begun to develop irritable bowel syndrome, neck and lower back pain, and incontinence. These symptoms combined with sleep disorder,chronic myofascial pain, chronic headaches and migraines, asthma, and episodic vertigo; Lynda was diagnosed with fibromyalgia in 1992. Despite these conditions, she soldiered on for another eleven years.

Claim Denied
In 2003, despite medication and various therapies, Lynda’s symptoms got much worse. She could not continue working. She made a claim for Long Term Disability benefits from Great West Life under her group disability plan from work. Her claim was denied on insufficient medicalevidence. Great West Life argued that Lynda had worked for many years, but with no explanation from the doctors who had been treating her, as to why she could no longer work. The doctors agreed that there had been a severe worsening in her symptoms, but they could not pinpoint a cause.

Help At Last
With no income but debts accumulating, Lynda felt desperate. She was running out of options. Then she called David Share Associates. When she learned that there would be no charge unless we were successful, she was happy to find someone who could help without putting her further into debt.

Early Mediation
On Lynda’s behalf, we sued Great West Life for all benefits owing andfor future benefits. Rather than take the case to court, they agreed to anearly mediation. Meanwhile, they had Lynda go to their doctors for psychiatric and physical assessment.

Honest and Credible
Lynda didn’t want to go to their doctors. She felt that it was pointless, except perhaps to make her feel like a criminal. Still, she attended the assessments. Though the results were in favour of the insurance company, the specialists noted that Lynda was honest and forthright. This credibility helped in mediation.

Payment and Validation
When her case was heard at mediation, a lump-sum settlement was negotiated in Lynda’s favour: $120,000. Lynda was very happy with the amount. She felt that it validated her claim and strengthened herability to get on with her life.

Moving Forward
Her priorities now are to control her symptoms, pay her debts, and possibly to work part-time from home when feeling well enough.

David Share Associates - Our Fees

At David Share Associates, all initial consultations with our lawyers are free. There are no fees until we settle your claim.

We understand that our clients have suffered serious injuries or illnesses and are usually under great financial stress. For these reasons, we do not ask our clients to provide any financial contribution at the beginning of the case. We only get paid if we recover money for you.

Our fees are calculated as a percentage of the total amounts recovered. The percentage that is applicable to each client's case is discussed fully before we start and is set out in writing in our retainer agreement, which includes an example of how the fee is calculated, so that there are no surprises when we conclude the case.

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About David Share Associates

David Share Associates Lawyers is a leading Toronto disability claim and personal injury law firm concentrating its work in serious injuries, death claims, insurance disputes and medical and disability coverage disputes in Ontario. If you have suffered a personal injury or are disabled, you need excellent legal representation. Our team of dedicated lawyers, law clerks and legal assistants provide our clients with caring, comprehensive professional legal services. We offer home and hospital appointments if required. We believe that the client is the most important person who will ever be in our office. Finding the right personal injury and disability lawyer for your case is critical to your success. Click here to find out why David Share Associates is the right personal injury or disability claim law firm for you.

Our team of disability lawyers have made successful disability claims against: AIG Insurance, Canada Life, Clarica, Co-operators Life, Empire Life, Equitable Life, Great West Life, Liberty Health, Manulife, Maritime Life, Medcan, National Life, OTIP, Paul Revere, Provident, Prudential, RBC Insurance, Standard Life, Sun Life, and Unum Canada.

Our team of accident lawyers have made successful car accident and personal injury claims against: AIG Insurance, Allianz, Aviva, AXA Insurance, Belair Direct, CAA Insurance, Certas, CGU, Co-Operators, Echelon Insurance, Farmers Mutual, Federation, Gore Mutual, Halifax, ING Insurance, Kingsway, Liberty Mutual, Lombard Insurance, Monnex, Motors Insurance, Pilot Insurance, Primmum, RBC Insurance, Royal/Sun Alliance, Security National, State Farm Insurance, TD Insurance, The Personal Insurance, Wawanesa Mutual, Zenith Insurance, and Zurich Insurance. David Share is a member of the Ontario Bar, the New York Bar, the Association of Trial Lawyers of America, the Ontario Trial Lawyers Association, the New York State Bar Association, the Canadian Bar Association and the American Bar Association.