Insurance Denied for Lasting PTSD

Insurance Denied for Lasting PTSD

 

Insurance Denied for Lasting PTSD

Alicia had just turned 49 and was living alone for the first time. When her only child went away to university, Alicia moved to a small 2 bedroom house in a nice neighbourhood with high hopes for the next chapter in her life.

In the middle of the night, she awoke to the sound of noises and footsteps in her house. It took her a few seconds to realize that hearing noises within her home at night was no longer normal. Before she knew it, she was quietly moving down the stairs to the ground floor – and came face-to-face with a man and a gun.

Her home intruders tied her up and locked her in her basement furnace room while they stole many of her cherished possessions. Across the street, one of Alicia’s neighbours saw flashlights moving around in the dark house, and called the police. He watched out his window as the two intruders eventually ran into a van waiting outside.

When the police arrived 15 minutes later, they searched the house and found Alicia in the furnace room, in distress.

Alicia was taken to the hospital to be checked out. She was was obviously shaken, but had no physical injuries. After talking to the police and filing her report, an officer made an off-the-cuff remark – that some people who have gone through situations like this might want to take some time off work to recover. When Alicia saw her family physician two days later, the doctor agreed – taking some time off could be beneficial. Alicia’s doctor was specifically concerned that Alicia had been having some difficulties sleeping since the robbery, but advised her that these symptoms should eventually pass.

Alicia followed her doctor’s advice and took a short term leave, just a few weeks off work to recover. Her employer was very understanding about the time off.   

When it was time to return for work, Alicia was unable to leave the house, overcome with fear about what could happen to her and to her home. She called in to work in a panic, and her boss assured her it was okay – she could try again tomorrow. The next days saw the same fears and inability to leave the house.

Alicia’s doctor sent her to a specialist, and, after listening to the story and analyzing her behaviour, determined that this attack had caused psychological damage.  She was diagnosed with Post-Traumatic Stress Disorder (PTSD) and was recommended more time off work and talk therapy to help her deal with her condition.

Alicia was distraught but glad to be told that what she was feeling was somewhat normal. She informed her employer that she would be taking a longer term leave and gathered the necessary documents to apply for long-term disability.

Her insurance company called her – her claim had been denied. They stated that there wasn’t enough medical evidence to support her PTSD diagnosis – that she was unharmed by the robbery and should have gotten over her incident enough to go back to work. Alicia was shocked. She had consulted with a doctor and a specialist and thought she had a proper case.

Alicia got in touch with Share Lawyers because she saw a TV commercial.  The lawyers listened to her story and worked together with Alicia’s medical specialists to build a strong case against the insurance company. They were able to get her the benefits that she was entitled to and win her claim.  

Alicia was glad to have gotten in touch with Share Lawyers. Thanks to them, she could now take the time she needed off work to prioritize her therapy sessions and recovery. She is determined to learn to cope with her PTSD so that she can one day return back to her old job.

*All names and identifying details have been changed to protect the confidentiality of all involved.

Has your long-term disability claim been denied? Contact Share Lawyers and put our experience to work for you. We offer free consultations and there are no fees unless we win your case. Find out if you have a disability case.

We have recently settled cases against SSQ, Manulife, Sun Life, Great West Life, and many more. We love hearing feedback from our clients, so please share your own experience with us.