At the company summer picnic, Lily, an administrative assistant with a small Ontario manufacturer, got a surprise. Her tenth anniversary with the company was announced and applauded. Everybody knew that Lily loved macaroni salad, so she was presented with a platter of her favourite picnic food. Obese and diabetic, she enjoyed it anyway, happily sharing in the celebration. That’s when it all started.
Feeling a little nervous from all of the attention, plus a touch of heat stroke, Lily cut her right hand. Fortunately, she managed to keep that secret at the picnic. Unfortunately, the cut did not heal properly. Within a few days, her hand, cool and numb, had developed gangrene.
On a visit to her doctor a few weeks later, Lily learned that gangrene is treatable when diagnosed early enough, before flesh begins to die. After flesh dies, amputation is the standard treatment. Before the gangrene spread too far, Lily’s forearm would be amputated.
While recovering in hospital from the amputation, Lily had the kind help of a co-worker to fi ll out the papers for her disability insurance claim. The hospital staff helped, also, and the claim was accepted. Clearly unable to work at her own occupation, Lily soon began to receive disability insurance benefits of $3,600 per month.
About two years after the payments began, still unemployed and having psychological troubles, Lily received a letter from her insurance company. It stated that she had been receiving benefits because her disability kept her from working at her own job. This did not mean that she could not work at any job. Without proof that she could not work at all, a change of definition would result in her benefits being terminated.
Lily’s family doctor referred her to Share Lawyers. Share Lawyers accepted her case.
After review and investigation, Share Lawyers argued that, while Lily could possibly earn some income – despite her missing right forearm, diabetes, and psychological troubles – she would not be able to find work equivalent in pay, equivalent to her level of experience, or equivalent to her overall needs for a livelihood. The insurer resisted this argument right up to the courtroom steps. However, after pre-trial discussions, they relented and agreed to reinstate Lily’s benefi ts. This allowed her to continue receiving the money she would need to maintain a decent life.
*Names have been fictionalized to protect the privacy of our clients.