Ask A Lawyer: Crohn’s and Colitis

Ask A Lawyer: Crohn’s and Colitis

Crohn’s and ulcerative colitis can present in different symptoms depending on the individual. Usually those affected are diagnosed between the ages of 15-30, but flare ups and variance in symptoms are very common. When your Crohn’s disease and colitis are making it too difficult to work, and you are applying for short or long term benefits so you can take the time to focus and be well, it can be challenging when you face a denied claim from your insurance provider.

Share Lawyers is here with some answers when it comes to some questions you might have when dealing with your insurance provider when it comes to handling your Crohn’s or colitis related claim.

Ask A Lawyer: Crohn’s and Colitis

I’m working with my GP and a naturopath to approach my care and manage my symptoms of Crohn’s disease. I spend more time with the naturopath with appointments every week. Can a naturopath complete my short-term or long-term disability claim forms?

While there is no reason why a naturopathic physician cannot complete the attending physician’s statement required for completion of a short or long-term disability claim, it may not be accepted by the insurance company and may result in them requesting that it be completed by a family doctor, psychiatrist or specialist.

I’m worried that after going back to work after receiving long term benefits after feeling my symptoms from ulcerative colitis have subsided that I may experience a flare up and still not be able to work.

What is a recurrent disability provision? And how can it help if I am unable to go back full time?

When an employee on long-term disability insurance benefits tries to return to work but fails due to the same or a related disability, they may go back on-claim without having to satisfy another waiting or “elimination” period. This is called the recurrent disability provision, and its purpose is to protect employees who wish to return to work on a trial basis without having to worry about losing their benefits.

Recurrent disability provisions have time limits, and these time limits vary from policy to policy. If the disability recurs after the time limit, the claimant must file a new claim and will once again be subject to a waiting period.

My insurance company has dismissed my claim for long-term disability benefits because they believe that my Crohn’s disease is manageable because I working for 10 years before my symptoms became so bad I had to stop working . How can I prove to them that the symptoms prevent me from doing my job?

Although the recurrent disability provision is designed to have benefits start immediately in the event of a disability relapse, it is not uncommon for insurance companies to refuse to restart benefits, even if a claimant is well within the recurrent disability time limit.

They often argue that if the claimant was able to return to work temporarily, they are not totally disabled; or they may argue that the recurrent disability is related to the previous condition. In summary, although the recurrent disability provision is meant to safeguard claimants’ benefits; insurance companies, in their signature underhanded style, may use the temporary return-to-work as an excuse to terminate benefits.

 

Have more questions? Check out the Ask A Lawyer feature at the Share Lawyers website.

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