If you have been paid long-term disability benefits for the past two years you are approaching what is called the “change of definition”.
In order to qualify for long-term disability benefits under most individual or employee long-term disability policies, the onus is on you as the disability claimant to establish you suffer a total disability during the “qualifying period” and during the first 24 months or 2 years of long-term disability. “Total disability” is normally defined as the condition of claimant being continuously disabled by a chronic illness or accidental bodily injury which prevents you from performing the substantial duties of your normal own occupation.
As is customary in long-term disability benefit plans, there is a change of definition of “total disability” at the 2 year mark, which often is not properly explained by disability companies.
What occurs is that the total disability test changes to a more difficult definition which requires the individual to be disabled from performing any occupation for which he is reasonably suited (language like “qualified, or could become qualified for, by reason of education, training or experience”). This is known the “any occupation” (any occ) period. It is at this point where termination of coverage often occurs. Before the “own occupation” period expires, your disability insurance company may have sent you to one or more independent medical examinations (IMEs) with a view to obtaining medical evidence to use to support terminating the claim. Your insurance company may also conduct surveillance, which was found to be a detriment to your claim of total disability. The insurer could argue that there is a lack of objective evidence, inadequate medical evidence, you are not following a treatment plan or your social media tells a different story than what you are telling your doctors.
If Manulife has cut off or stopped your long-term disability benefits after two years and you and your doctor are of the opinion that you still cannot work, call our Hamilton long-term disability lawyers at 905-333-8888 or fill in a contact form today. We are disability lawyers in Hamilton that serve claimants all over Ontario, from Sudbury to Niaraga.
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