My disability file has been closed and my benefits have been denied. What do I do now?
If your disability claim has been denied, there are several steps you should take:
Return to your specialist and request more detailed information that specifically addresses the issue of why you cannot work so that you may then submit this information to the insurance company as part of your appeal. It is appropriate and acceptable to pay physicians in Ontario to write a detailed report for you, and could be the motivating factor if your doctor is managing a heavy patient load.
Make a claim to Canada Pension Plan disability benefits. They may be available to you if you have made enough contributions to CPP. The CPP definition states that a disability has to be both "severe" and "prolonged," and must prevent you from being able to work at any job on a regular basis. Applying for CPP disability benefits may also strengthen your case against the insurance company. You can obtain the application online at http://www.sdc.gc.ca.
Apply for Ontario Disability Support Program income support. The program provides financial assistance to eligible people with disabilities. To meet the requirements, you must qualify financially and have a "substantial physical or mental impairment that is continuous or recurrent and is expected to last one year or more." More information is available on the website of the Ontario Ministry of Community and Social Services at http://www.mcss.gov.on.ca.
Hire a Lawyer. Upon notification that their insurance company has denied their disability claim, many claimants fail to take action. They may believe that their options have been exhausted; others may be tired and simply ready to concede to defeat. It is important to know your rights, what options are open to you, and what resources are available. You should be aware of and understand your policy's many provisions, such as waiting periods, pre-existing conditions, financial entitlement, time and other limitations, and the maximum policy benefit. Your policy's provisions will be lengthy and deliberately complex. The best way to ensure that you understand your rights and obligations is to seek the help of a lawyer experienced in the area of disability insurance. A lawyer can level the playing field and successfully navigate the complex policy roadblocks the insurance companies intentionally put in your way. Without a lawyer, claimants are at the mercy of their own limited knowledge.
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This searchable database contains information about disability, critical illness and life insurance claims, and what you can do if you are denied or cut
off of your benefits. It is a collection of the most common questions we receive from our clients. General answers have been provided by our lawyers.