My 24 months on short term disability will be on December 1st. I expected to have my case reviewed to determine if I qualify for LTD however I found out today that my benefits were extended until the end of December. I'm curious for those who have been on LTD, was the change in definition (your occupation to any occupation) done on or before your 24 month period or was it extended for a certain period of time. I just want to know my future although I was approved for CPPD I would like to know what my private insurance will do.
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Hello MacDuffy. Each LTD plan is different. Most after the 2 yrs go to the any occupation clause. The insurance company can get really sticky after that point (depending on the company). I can only guess here, but they may have extended your benefits for a mth because of what your medical report has said. Once again, I'm guessing, but I would imagine that between now and then they may ask you for further info.
If you haven't heard from them in a while I would send them an email, call or letter, etc to find out what your status will be as of Dec 31st. More importantly will they be requiring extra info by Dec 31st.
The MDAO has a pretty good guide to understanding your rights under the "your occupation to any occupation" . http://www.mooddisorders.ca/guide/gu...erm-disability
In it you will find the following
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Accordingly, they will often arrange insurer's medical examinations (IMEs) to take place a month or two before the "any occ" definition takes effect in the hope of obtaining medical evidence upon which they can rely in terminating the claim at the end of the "own occ" period. They may also conduct surveillance. If you are unable to work in any reasonable capacity, you should anticipate that the insurance company will want to see proof, in the form of medical forms or reports, from your treating physicians confirming that you meet the "any occ" test. This evidence should be provided to the company at least a month or two before the "any occ" period begins to avoid any delay in receipt of your benefits. Again, to avoid any disruption in your payments, you should speak with a lawyer as soon as possible after you receive notice that your benefits may be terminated.
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The courts have made some important distinctions as to what constitutes any occupation. Also the guide has some hints on how to appeal the any occupation clause should it be applied to you. Take Care. paul m"Alone we can do so little;
Together we can do so much"
Helen Keller -
Thanks for the link! I emailed my case worker now that I had a bit more understanding of the situation. Hope I'll get some answers
Originally posted by paul m View PostComment
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I don't think all private insurers have the same policies, so it's hard to say. Where I worked, the 2-year rule was followed pretty much to the letter, without extensions. That's the only info I have, don't know if it helps.uni
~ it's always worth it ~Comment
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Hello Uni. You are correct, at least for some plans. However every plan differs. Some are for life if you qualify, some may be only for 6 mths no matter what and of course some people have no plan. Take Care. paul m"Alone we can do so little;
Together we can do so much"
Helen KellerComment
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Thanks guys! I just found out that my LTD benefits have been approved and will continue until I'm 65. Relief doesn't begin to describe how I'm feeling!Comment
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That is great news macduffy!Comment
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That's terrific news! A relief I'm sure.AJ
Humans punish themselves endlessly
for not being what they believe they should be.
-Don Miguel Ruiz-Comment
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Hello Macduffy. Congrats. I will give you a few hints about not accidentally screwing up your benefits.
You probably get your meds through your LTD provider. A temptation a few years down the road may be to see how well you can do without your meds or perhaps reduce the amount that you take. Your LTD provider may notice this and say "ah ha this person is getting better" . So always get your prescriptions filled.
Secondly, a few years ago there was a woman in Quebec who got cut off because she posted pictures of herself on facebook having a good time on a sun holiday. So if you are using social media, watch what you post as all it takes is an eager beaver claims adjuster to decide to try and earn a few brownie points and get someone cut off.
We actually discussed the case on this forum and I never heard whether she won her court case to get her benefits back or not. The story ran on CBC http://www.cbc.ca/news/canada/montre...hotos-1.861843
Once again, congrats on getting your LTD benefits. Take Care. paul m"Alone we can do so little;
Together we can do so much"
Helen KellerComment
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I'm glad to hear your benefits have been approved Macduffy - that's wonderful news!
Paul, I remember that woman's case too. I wouldn't be at all surprised if it's still in the courts.uni
~ it's always worth it ~Comment
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Where did you apply for short term disability? And are you in Ontario?Comment
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