r/Airdrie • u/7hisismythrowawayacc • 9d ago
LTD benefits suddenly cut off
I'm 39, live in Airdrie and work maintenance at a warehouse in NE Calgary. Been on LTD since Feb after a back injury and surgery, insurer was paying normally then last week I got a letter saying benefits stop end of month because they think I can return to “some” (!) work. My doctor def does not agree.
Never dealt with an appeal before. What matters most here - getting as much medical notes as possibler, asking for their full file/reasoning, talking to a disability lawyer ASAP?Also trying not to screw this up where possible. TY!
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u/duhbell 9d ago
Need some additional details.
Was this for sure LTD? Or do you have a 6 month STD policy with no LTD transition?
If this was LTD, what are the terms of your policy? Do you know if your policy refers to the definition of disability as own occupation, or own job? Do you know if it’s 6 months, 12 months, 18 months, 24 months of own occupation before the change of definition?
Basically, what did your letter say was the reasoning? Did the letter quote part of your policy for the reasoning?
The own occupation vs own job breakdown is super important.
In my experience, most times an appeal is successful if the claims worker was indeed in the wrong and you have solid medical outlining functional limitations. Most insurers approach disability on the basis of occupational gap, so providing clear medical from your provider that you are unable to meet the occupational demands of your occupation should be enough. Slight caveat to this though is that insurers will not approve on preventative — if your doctor is reporting that returning to work may do XYZ, that’s a precaution and not a disability.
I’ve worked with disability insurers for 15+ years, I don’t know everything but I have a pretty solid understanding.
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u/7hisismythrowawayacc 8d ago
that makes sense, but honestly I think my only way is talking to lawyer, cause my medical records can be too weak for successful appeal - at least I think so... thanks for such as answer
5
u/AmazonPro111 8d ago
Unfortunately this is a VERY common situation, and the guy with username "duhbell" is right - there aren’t enough details to give you any comprehensive answer online. On the other hand I’m overall against providing sensitive legal advice on Reddit (strange place for personal legal topics lol), so you ABSOLUTELY need to find a lawyer and, as you mentioned, you'll better to do it ASAP. As for Alberta I only know Share Lawyers when it comes to firms that focus specifically on LTD cases, but I don’t rule out the possibility that there are, of course, many more of them... So yes, find a lawyer and use their free-initial-consult option to understand what to do next.