LTD Benefits Denied Due to Pre-Existing Condition

LTD Benefits Denied Due to Pre-Existing Condition

Kirk still remembered the anxiety he had felt when he was first diagnosed with chronic pain at the age of 32.. While it was a relief to know why he’d been in so much pain, it was stressful to learn that there was no cure for the condition. He had spent more than a few sleepless nights worrying about how to live a normal life.

Thankfully, his fears proved to be mostly overblown. Some days were worse than others, but for the most part, he was able to deal with his pain well enough to go about his day. He was on a decidedly upward trajectory by the time he reached his 40s.

Unfortunately, everything changed when his pain started getting significantly worse, and he started to have many other symptoms including feeling tired and in a fog, shortly after he turned 41. While Kirk had flare-ups in the past, the worst of the pain tended to subside after a day or two. Now he was experiencing severe symptoms that persisted for days and even weeks at a time, to the point that it was getting increasingly difficult to concentrate at work.

At first, Kirk had tried to persevere. He had been at his new job for just under one year but he was still eager to prove himself in his position. However, he was eventually forced to acknowledge that the pain had become too much to manage. The breaking point came when he went to work after two sleepless nights of excruciating pain. That shift had been particularly miserable and prompted Kirk to file a short term disability claim to get his condition back under control.

Kirk was grateful when his claim was accepted, and he looked forward to getting back to work as quickly as possible. Sadly, his fibromyalgia was now more challenging than he’d expected. His pain was yet to subside and he still wasn’t getting enough rest, so he applied for long term benefits when his short term benefits expired.

Kirk assumed it would be a relatively straightforward process based on his successful short term claim. It came as an unexpected shock when his long term claim was rejected. The insurance company argued that his fibromyalgia was not covered because it was a pre-existing condition.  

Needless to say, Kirk was devastated. He was in far too much pain to work, and he was constantly tired and in a fog, and he didn’t know how he’d be able to keep his household together without disability benefits.

Then one of his co-workers told him about Share Lawyers, who had been able to cut through the insurance bureaucracy to help one of her parents with a disability claim. Kirk made a call, and immediately felt like he had found people who were willing to listen. Share Lawyers agreed to take the case, and they fought to get Kirk the benefits he deserved.  

Benefits are often denied based on the presence of a pre-existing condition. However, in most cases, a pre-existing condition will only matter to your disability application if the disability arises less than one year from when coverage was put into place. The policy wording must be checked very carefully to determine the specific clause in each case. This is one reason why having an experienced lawyer can be so beneficial to a case like Kirk’s. 

Share Lawyers has seen it all and won many cases similar to Kirk’s. They argued that chronic pain and fibromyalgia are 2 distinct conditions.  Thanks to Share Lawyers, Kirk was able to take the time he needed to focus on his health. 

*Please note that 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 have recently settled cases against Great-West Life, Desjardins, Manulife, RBC Insurance, Sun Life, and many more. We offer free consultations and there are no fees unless we win your case. Find out if you have a disability case.