Long Term Disability and MS – have you been denied your disability benefits?

MS is a progressive disease that normally happens when a person’s own immune system attacks it’s cells, called myelin, that wraps and protect neurons. Without myelin, your nerve cells can become damaged and scar tissue can form.  As people lose myelin that wrap their nerves cells, they start to feel weak, have trouble walking and eventually, vision, your brain and spinal cord spinal cord all become negatively affected. Many people develop more severe symptoms such as paralysis, as the disease progressive.

Workers that are diagnosed and that suffer from MS expect that their group or private long-term disability benefits will protect them when they determine that they are unable to work. The essence of long-term disability insurance is to help replace some of the income that a sick or injured person is no longer able to earn. Disability benefits can be a very significant economic safeguard for people with MS, their families and their loved ones. However, as we have found, many claimants at times have found the process of securing long term disability benefits somewhat more challenging than anticipated as they often face unexpected delay, denials and termination.

If you suffer from Multiple Sclerosis and are dealing with a disability insurance company that denied or cut-off your long-term disability benefits, it is important that you contact a Hamilton disability lawyer that is experienced in representing claimants whose benefits have been wrongfully denied or terminated by their insurance company.

Long-Term Disability Benefits and Multiple Sclerosis

The misapprehension between short and long-term disability benefits is quite common and understandable. Remember, there is a very important distinction between short-term and long-term disability insurance benefits. Short-term disability insurance provides partial income replacement during what is called the “elimination period” which is normally about 90 to 120 days after the discovered “date of disability”. If, after the expiry of the elimination period, a person is not in a position to return to work because of a multiple sclerosis relapse or the ongoing suffering of symptoms, then he or she is eligible to apply for long-term disability benefits.

The decision to stop working because of Multiple Sclerosis can be a difficult one for many workers, whether they are the family bread-winners or not. Going on long-term disability is a decision that you should cautiously consider with your doctors, your family and your employer.  Our Hamilton disability lawyers can also assist with the application process.

Do I qualify for long-term disability benefits?

In order to qualify for long-term disability benefits you must, more likely than not, suffer a total disability that prevents you from engaging in the substantial duties of your job. If you are unable to continue with the obligations and responsibilities of your job because of interfering MS symptoms and you have thoroughly considered, discussed and attempted all reasonable accommodations at work, then perhaps it may be time to apply for disability benefits.

Has your progression not yet developed or slowed? Has your insurance company told you that you can work? What happens if I am cut-off or denied long-term disability benefits?

Often times, insurance companies will dispute the fact that your MS symptoms may be yet interfering with the abilities to perform the substantial duties of your work. Your case manager or adjuster may decide that because you can still carry equipment, your organizational skills are still intact, your memory is still sharp or your physical symptoms are manageable that you do not suffer a total disability.

If you have been denied long-term disability or your benefits have been terminated, it is important that you contact a Hamilton disability lawyer who specializes in disability insurance to help seek the Court’s declaration that you are in fact disabled as per policy definition and that you are entitled to payment of past and ongoing disability benefits.

Remember, the prerequisite to receiving long-term disability benefits is that (in most policies) you must suffer a “total disability.” Although defined differently in many policies, total disability depends on your inability to perform the substantial duties of one’s “own occupation” or “any occupation” in light of your education, training or experience.

MS is a unfortunately a very complicated disease for insurance companies to figure out because symptoms will no doubt appear and then fade for a while – hence MS claims are often thought to be either be either remitting or relapsing. At times individuals with MS may suffer from a flare up and can’t work for some time – either days, weeks or months.  At other times, they are certainly able to work for long periods.  There may also be some serious depression and psychological factors to consider.  There is no doubt certain variability of physical and cognitive impairment which characterizes MS that can complicate the adjusting process, no matter if a person is suffering from:

  • Relapse-remitting MS – when MS worsens progressively with no precise or well-defined. the disease gradually gets worse over time. You may suffer a succession of relapses when your MS conditions – when seem to worsen, lessen or disappear. Many people will call the relapse period a time filled with flare-ups.
  • Primary Progressive MS – when MS causes a steady decline in terms or a person’s symptoms.
  • Secondary Progressive MS – Remission stages have worn away leaving only a steady deterioration of symptoms without the occurrence of relapse or remission.
  • Progressive-Relapse MS – this is a rare form of MS which is seen as rare and the worst kind of MS. The disease progresses steadily from the beginning, with acute relapses. There are no remission phases in the progressive-relapse category. While medications may ease the pain of the symptoms, they no longer help your body into the remission phase.

It can be very difficult for adjusters to make a certain objective assessment of a claimants with MS based on their type of MS and progressive level of disability. Your LTD insurance company will need to evaluate your ability to perform your substantial work activities. In doing so, your insurance company will try to determine your functional capacity in correlation with the substantial duties of your job and determine whether or not to provide, not-provide or cut you off our long-term disability benefits.  We understand that if you have MS you may be suffering from the onset of symptoms which may prevent you from working, such as:

  • Mobility issues
  • Impaired hand function
  • Fatigue
  • Difficulty concentrating, with focus or problem solving
  • Bladder or bowel control issues
  • Spasticity
  • Sexual dysfunction
  • Tremors or loss of coordination
  • Blurred or double vision
  • Anxiety
  • Depression
  • Uhthoff’s Syndrome
  • Overall weakness
  • Vertigo and/or dizziness

 

Have you been denied of cut-off long-term disability benefits?  Has your progression slowed but you feel you can’t work?

Any or all of the above symptoms may which case you may be unable to work or perform the regular duties of your job. If your adjuster has unreasonably assessed your condition and you have been denied long-term disability benefits, or you are experiencing problems with getting your benefits paid, speak with an experienced long term disability insurance policy lawyer who has successfully represented MS claimants against all Canadian insurance companies. Call us at 905-333-8888 or chat with our live operator 24/7 to schedule a free no obligation consultation to discuss your situation.

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