It can be very stressful to navigate disability insurance, either long term disability or short term disability
A Denied Claim
Appealing The Decision
If your insurance claims are denied, it is best to consult a legal professional with experience and knowledge to explore all of your options, as insurance companies can flood you with many complicated documents. A denied claim may force an employee to make the difficult decision of returning to work, even if they do not feel physically or mentally able to do so. Although this may not be an ideal situation, the employee can seek accommodation upon returning to work. Employers are required to accommodate employees who have a disability, whether physical or psychological. This duty is derived from either the Ontario Human Rights Code or the Canadian Human Rights Act. Common accommodations include minor changes to the physical work environment, changing the job requirement or changing the shift schedule. Employers have a duty to accommodate up to the point of undue hardship, which is actually a very high threshold where the employer suffers economic damage.
If your claim is denied, the insurance company will often include information about appealing the decision. Note that this is usually an internal review, so the insurance company’s decision will often stay the same. It is important to be aware of the potential delay that appealing the decision can have on your case. There are very strict time limits on when you can commence a lawsuit against the insurance company, and appealing the decision could push you very close to those time frames.
If your disability insurance claim has been denied, please contact Ball Professional Corporation as soon to understand your options whether that is moving to have your benefits reinstated as quickly as possible, seeking accommodation in the workplace or commencing a civil lawsuit.
Please note that the above information does not constitute legal advice. It is general information about the law. If you require legal advice with an employment issue, please contact the experts at Ball Professional Corporation.
Canadian Employment Law
Mr. Ball is author of the authoritative and definitive text Canadian Employment Law - published by Canada Law Book (a division of Thomson Reuters). The text is used and cited by lawyers, law schools and judges across Canada.
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