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Long-term Disability Lawyers in Newfoundland and Labrador

Injured and unable to work? Get the compensation you deserve with NL’s largest and most experienced personal injury law firm.

For over 40 years, Roebothan McKay Marshall has been fighting on behalf of people across Newfoundland and Labrador whose long-term disability (LTD) insurance has been denied or terminated.

As Newfoundland and Labrador’s largest and most experienced personal injury law firm, we’ve won thousands of cases – totalling over $500M in compensation for families across the province.

Our legal team is here to guide you through the entire process. They will explain how LTD insurance works in our province, explore what types of insurance benefits are available, and support you every step of the way. Our LTD lawyers will negotiate with the insurance company on your behalf to ensure you receive the full financial compensation you deserve.

Give us a call today; it costs nothing to talk.

What are long-term disability (LTD) benefits?

Long-term Disability (LTD) benefits are monthly payments you receive from an insurance company if you’re unable to work for medical reasons.

You may have group insurance through your employer or union. Individual LTD policies are also available. An LTD insurance policy protects you against long-term income loss from an accident, disease, mental health issue, or other form of disability.

In order to receive LTD benefits, you must first exhaust other forms of income replacement – Employment Insurance benefits (17 weeks) and Short-term Disability benefits (1-2 years). If you’ve exhausted your STD benefits and are still unable to work, LTD benefits may be available.

Too often, disability insurers deny or minimize legitimate benefit claims. If you’re medically unable to work and your LTD benefits have been denied or terminated, contact the experienced LTD lawyers at Roebothan McKay Marshall — it costs nothing to talk.

What types of compensation are available for LTD claims?

Damages, or monetary compensation that’s intended to compensate claimants for their losses, fall into several categories called heads of damages. LTD lawyers assess each head of damages to determine if it applies to your case.

The following heads of damages may be applicable as part of your long-term disability settlement:

  • Aggravated damages, as well as damages for mental distress, are intended to compensate you for the harm you’ve suffered due to being denied benefits. If you can prove that you’ve suffered significant financial and mental distress due to the denial or termination of your LTD insurance, aggravated damages may be awarded.
  • Punitive damages serve as a punishment for egregious, malicious, or negligent conduct in the handling or denial of your insurance claim.

The best way to ensure you’re fairly compensated for any damages is to contact an experienced personal injury lawyer.

Our lawyers at Roebothan McKay Marshall are highly experienced in Newfoundland and Labrador legislation. We’ll review and research the facts of your case, gather all necessary evidence, and assess the long-term impacts of your disability to comprehensively understand your claim and seek a fair compensation amount. It costs nothing to talk – make the call today.

What are my legal options if my LTD benefits have been denied/terminated?

If you’re disabled and unable to work yet your LTD benefits have been denied or terminated, you have two options:

  1. You can appeal the decision internally by writing to the LTD insurer and going through their internal appeals process.
  2. You can open a claim against your LTD insurer for breach of contract.

In terms of when you can appeal or file a claim, there are different time limits for each option:

  1. For internal appeals, deadlines will be laid out in your denial letter that dictate how long you have to submit documents in support of an appeal.
  2. If pursuing a lawsuit against your insurer, you typically have two years to file a claim.

The advantages and disadvantages to appealing internally versus filing a claim against your insurer are specific to your individual circumstances. As well, while two years is the general limitation period in Newfoundland and Labrador, there may be exceptions. It’s important to consult with an experienced LTD lawyer to ensure your right to pursue fair compensation is protected.

How can a personal injury lawyer help with my LTD claim?

Roebothan McKay Marshall will guide you through the legal process, answer all your questions, and keep you informed the entire time.

  • Protect your right to obtain compensation
  • Guide you through court procedures
  • Research supporting case law
    • Request medical reports documenting your recovery
    • Ensure medical costs are covered
    • Negotiate a fair settlement

How are LTD settlements paid out?

LTD settlements are paid out in one of two ways: as a lump sum, or as a reinstatement of benefits.

Lump sum settlements

A lump sum settlement is a one-time payment made to you that represents the total of your insurance policy (including your back benefits and the value of future disability payments). In return, you must agree that the lump sum is all you’re entitled to under the policy, thus giving up your rights to future benefits.

The benefits of lump sum settlements vary from person to person, but may include:

  1. Closure —With reinstatement, there’s always the risk that your benefits could be terminated again in the future. A lump sum settlement eliminates the uncertainty of future benefits.
  2. Tax Advantages — The Supreme Court of Canada has ruled that only the arrears portion of a lump sum settlement is taxable. The amount allocated for future benefits is not taxable, which could result in significant tax savings for your claim.
  3. Freedom to Return to Work — If your health improves and you’re able to return to work, a lump sum settlement allows you to do so without having to report to an insurance company.
  4. Security for Your Loved Ones — In the event that the disability requires end-of-life support, a lump sum payment ensures that a set amount of money is available to your family right away.

Reinstatement of benefits

Reinstatement refers to the resumption of your regular LTD benefit payments after they’ve been terminated.

The court can’t force an LTD insurer to provide your compensation as a lump sum. The judge can award legal costs, aggravated damages, back payments, and order reinstatement going forward, but cannot award a lump sum amount.

If you accept a lump sum payment, you must give up any further claims you might have under the policy or in court — whereas a reinstatement of benefits offers a return to regular LTD payments, in accordance with your policy.

Which type of long-term disability settlement should I choose?

Every long-term disability insurance claim is unique. Whether you should seek a lump sum settlement or reinstatement of your LTD benefits depends on a range of factors, including your financial needs, the terms of your policy, and the nature of your disability. Remember: if your case goes to trial, a judge can only order reinstatement of benefits.

To fully understand which method is right for you, make the call to the LTD lawyers at Roebothan McKay Marshall. Our expert team will work with you to decide which option is right for you and will maximize your compensation for your unique situation.

When should I contact an LTD lawyer?

You should contact a lawyer as soon as possible if you notice the insurer is raising serious but unreasonable doubts about your LTD claim.

Before filing any internal appeals with the insurer, be sure to consult with an LTD insurance lawyer that has ample experience in Newfoundland and Labrador legislation.

Pursuing an LTD insurance claim on your own can be confusing and overwhelming. Knowing the meaning of terms, understanding deadlines, and properly organizing your application and supporting materials can greatly affect the success of your claim.

Our experienced LTD lawyers at Roebothan McKay Marshall can review and provide legal counsel on your case, the application and appeals process, and, if necessary, when to take legal action.

Why do insurance companies deny and/or terminate LTD benefits?

LTD insurers sometimes deny or terminate payments. This happens when, in the insurer’s opinion, there isn’t enough evidence to support the claim that you’re unable to work. Insurers frequently refer to your claim’s ‘objective evidence’ and get opinions from their own medical team to support their decisions.

However, many disabling conditions cannot be proven through ‘objective evidence’ like scans and x-rays. Chronic pain and mental health diagnoses, for example, often rely on subjective reporting – meaning there is less objective medical evidence.

For this reason, in the event of LTD termination it’s important to speak with an experienced LTD lawyer that knows how to collect the best evidence and fight for your right to compensation.

Experienced LTD insurance lawyers know how to navigate the standard insurance denial arguments, including:

  • Medical opinion does not prove disability or provide a sufficient diagnosis to support disability
  • Incomplete medical records
  • Application is insufficient to prove “total disability,” or doesn’t fall within the definition   of “totally disabled”
  • No “objective proof” of disability; the disability is based on subjective complaints of pain
  • Claimant has excluded or pre-existing conditions
  • A medical opinion by an insurance expert states you are not totally disabled
  • Failure to follow recommended care or ordered treatment as prescribed by a doctor
  • Failure to participate in a rehabilitation program as prescribed by the insurer
  • Claimant did not receive a proper diagnosis or did not receive a diagnosis at all
  • Claimant received the proper care or therapy, but the medical personnel did not supply accurate documentation
  • Claimant is not under the regular care of a doctor
  • Claimant has not complied with certain terms of the policy
  • Other terms of the policy are interpreted by the insurer in a way that denies the claimant coverage

If you’ve been diagnosed with a mental or physical condition that prevents you from working yet your LTD claim has been denied, do not accept the insurer’s explanation for its denial – that decision is made in the best interests of the insurer, not the claimant.

Speak with an experienced LTD insurance lawyer who will consider your best interests and fight for the compensation you rightfully deserve. Our experienced LTD insurance lawyers at Roebothan McKay Marshall know how to prevent insurers from improperly hiding behind these arguments in cases where they do not apply.

What’s the difference between group and individual disability insurance?

Standard Group Insurance

Group disability insurance policies are typically obtained through your workplace. They generally cover disability only during the period in which the person is working; if you are laid off, you may not be covered.

Disability insurance applies regardless of whether the onset of the disease or injury is related to work. Most disability insurance plans are through employers’ group insurance contracts.

Long Term Disability (LTD) benefits amounts are paid monthly based on a percentage of your regular basic gross earnings at the time of the injury. The usual percentage is 66% your gross earnings up to a particular maximum amount. Payment of group disability insurance usually depends on several conditions, including exhaustion of sick leave, exhaustion of short-term disability benefits, whether the individual is approaching retirement age, and whether the individual is disabled from their “own occupation” versus “any occupation.”

Individual Disability Insurance and Income Protection

If you don’t have group insurance through your employer, there are several other sources for claiming disability benefits or income protection:

  • Individual disability insurance plans are available through insurance brokers.
  • Self-employed individuals may obtain the benefits similar to group insurance through professional insurance programs offered through professional associations.
  • The Public Service Pension Plan and certain other pension plans allow an early retirement benefit if an enrolled member is unable to continue working because of a medical reason.
  • Individuals may be entitled to employment insurance (EI) during the first 17 weeks they’re unable to work, if they have sufficient insurable hours.
  • Individuals unable to work due to a workplace injury are entitled to worker’s compensation under the Workplace Health, Safety and Compensation Act.

Frequently Asked Questions

  • You need to leave feeling comfortable personally and professionally that the person is experienced. Read More
  • Before accepting any settlement an insurance company offers, you should contact a personal injury lawyer. This step is crucial to understand your rights, assess the fairness of the compensation, and determine if it’s appropriate. Often, insurance companies offer a minimal amount when they know you’re not represented by a lawyer, hoping you’ll accept it, sign a release, and walk away. What people don’t realize is that by doing so, you can never come back again if the injury worsens; there’ll be no more compensation available. Speaking with your personal injury lawyer can help you find out if that compensation is appropriate or if, in fact, you are entitled to more. Read More
  • It will generally take a minimum of a year. Read More
  • Calling us initially, there’s no fee at all. Read More
  • If the car accident is your fault, there’s still some benefits you could be entitled to. Read More