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Denied Disability: What Are the Strengths and Weaknesses of My Case?

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Denied Disability: What Are the Strengths and Weaknesses of My Case?

Don’t delay discussing your matter with us to find out how to build a winning case.

Please enable JavaScript in your browser to complete this form.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.
denied disability himelfarb proszanski

If you have been denied disability in Ontario, it is important to understand that you still have options. Many denials are based on simple misunderstandings that could be quickly cleared up. Other cases might not be so simple, but that does not limit your chances of recovering benefits under a short- or long-term disability policy.

Denials are common. After all, insurance companies will always put their bottom line above everything else. In some cases, this could mean the unfair denial of benefits. It is important not to be discouraged. Not only are denials common, but so are appeals. The success of your case will depend on the potential strengths and weaknesses of the claim.

Potential Strengths and Weaknesses

No two disability claims are exactly alike. They each have strengths and weaknesses that increase or decrease your chance of a successful claim. One of the most important strengths of a disability claim is possessing proper documentation. By having all of the documents necessary to process the claim, you could protect yourself against unfair denials. Another important benefit is having demonstrable injuries. Some conditions are undetectable, which can make a claim challenging.

One of the biggest disadvantages involves missing filing deadlines. If you filed your claim after the deadline, the insurance company could have a powerful excuse to deny it. Additional weaknesses could include missing documentation or inconsistent statements made to the insurance company.

To fully appreciate how these strengths and weaknesses impact your claim, it is helpful to understand the appeals process in general.

The Denial Process

It is the responsibility of your insurance provider to inform you of your denied disability claim. This notification comes in the form of the denial letter, which the insurance company will send to you and your employer separately.

This document is important. The letter will provide you with basic information on the reason your claim is denied. Typically, it will cite the section of your insurance policy that requires the denial. The letter will also come with an effective date. This date is crucial, as it starts the clock running on your right to appeal.

There are two types of appeals when it comes to denied benefits. These include internal and external appeals. An internal appeal involves asking the insurance company to take a second look at a denied claim. An external appeal typically involves filing a lawsuit and putting the denial in the hands of the courts.

Internal Appeals

An internal appeal is little more than asking the insurance company to re-consider your denied claim. It should not come as a surprise, then, that these appeals often result in the same outcome as the original decision. That does not mean they are never worthwhile. Some denials are specifically based on a lacking document or a request for additional information. In some cases, providing that information through an internal appeal could result in the reversal of a denied claim.

This can be helpful if you were still in the process of compiling medical documents as the deadline to appeal approached. Filing an incomplete claim protects your rights and could allow you to provide the information later during an internal appeal.

External Appeals

For many, taking the decision out of the hands of the insurance company entirely is in their best interest. This involves filing a legal claim against the insurance company based on their failure to uphold their end of the contract.

Once your case is in the legal system, you have important rights that were not guaranteed to you during the internal process. While taking legal action against an insurance company might seem intimidating, successful appeals are common. In the end, an external appeal could provide you with the best chance for a positive outcome in your denied disability.

Denied Disability? Here’s What to Do

If you were denied disability in Ontario, It is important that you take immediate action. While you have the right to fight this denial, any delay could result in you being denied for disability permanently.

First and foremost, keep every piece of communication you receive from the insurance company. The denial letter and any additional letters could have important information you will need to pursue your claim.

Next, take steps to compile the documentation related to your denial. This could include anything from your medical records to any written notices sent to your employer.

Finally, you could benefit from the advice of a lawyer. Whether it is guiding you through the internal appeal process or filing a lawsuit, a lawyer could assist you with the technical requirements that you might not be aware of.

Disclaimer: The content of this article is a general guideline made available for educational purposes only and is not intended to be used as legal advice for the reader’s specific situation nor in general. By reading our blog and website content, the reader acknowledges the above and understands there is no lawyer-client relationship created between you and Himelfarb Proszanski through this content. To get specific legal advice, we encourage you to book a free consultation with one of our lawyers to clarify the legal aspects of your situation.

Timing is Critical. Help is Free.

Don’t delay discussing your matter with us to find out how to build a winning case.

Please enable JavaScript in your browser to complete this form.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

Timing is Critical. Help is Free.

Don’t delay discussing your matter with us to find out how to build a winning case.

Please enable JavaScript in your browser to complete this form.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

OUR CLIENTS

What They Say About Us

Sherene AlySherene Aly
16:02 23 Mar 24
I was very pleased with my decision to retain David and his team for my case. Melissa Gizzo was simply amazing and was able to secure a fair settlement for me.
T TT T
17:46 16 Feb 24
Experienced and excellent law firm. Their lawyers are wonderful, articulate, dilligent, amicable, calm, respectful, responsible, resourceful and have good human and customer relationships Especially DAN HOLLAND 👌 He is an amazing lawyer as regards dealing with any of the Accident case.I was involvedIn an accident in 2019 February. He was God sent as he dutifully and relentlessly worked hard until the case was settled
LizLiz
22:43 18 Jan 24
I highly recommend Dan Holland as a disability lawyer. His commitment to my case made the process seamless. Dan's clear communication and ability to simplify complex legal matters made it easy for me to understand every step. He demonstrated genuine concern for my best interests, making him not only a skilled attorney but also someone easy to talk to.Dan’s support extended beyond legal expertise; he alleviated my stress during the long-term disability case. His calm approach and unhurried demeanour ensured that there was no rush in our collaboration. This, coupled with his dedication, made the entire experience more manageable, fostering confidence in his ability to handle the case with meticulous care.I wholeheartedly endorse Dan for anyone seeking a lawyer who not only gets results but also prioritizes your peace of mind.
Neeshanth SritharanNeeshanth Sritharan
21:49 01 Jan 24
My mom was involved in an accident impacting her daily life and ability to work. Dan Holland has worked with us during the duration of our case and has been helpful in fighting for her and supporting us, and organizing the things we needed. Our family is incredibly grateful of the outcome Dan was able to obtain for us. I would highly recommend him!
Faiza HamidFaiza Hamid
01:26 22 Dec 23
I'm so happy I chose Mena Brar and her team represet us . We could not ask for a better team she is so kind, loyal, and honest. she spoke to me as an equal and made me feel as if my case was definitely important and that I deserved to be fairly compensated. I appreciate you. Did it for me and how this will help me get back on track with my life. keep helping others. You are doing amazing works, Mena Brar. I wish you all the best.
Brenda FurtadoBrenda Furtado
23:38 12 Dec 23
Many thanks to Silene Malhao for settling my husband's TORT claim and to Mena Brar for settling his accident benefits claim. These ladies made themselves available any time we had a question. They were very understanding and compassionate. We were completely taken care of throughout this process. We would definitely recommend this team to friends and family!
ShaunaShauna
15:52 06 Dec 23
We are so happy that we had David and his team represent us. We couldn't have asked for a better team. Not only is David incredibly skilled and experienced, he is kind and compassionate and it is clear how much he cares for his clients. Megan was also absolutely amazing to work with and was always on top of everything and there to answer any questions we had! Thank you!
Andrew CoutoAndrew Couto
23:10 21 Nov 23
I'm so happy I chose David as my lawyer. I spoke to a few lawyers before finding David and I noticed majority of them spoke to me in a way that felt demeaning or that my case wasn't big enough or important enough to take. One phone call with David and my opinion on lawyers changed. He spoke to me as an equal and made me feel as if my case was definitely important and that I deserved to be fairly compensated. The whole process was wonderful. From dealing with David's law clerk Ingrid whom is an amazing and kind woman to his legal assistant Melissa whom is another amazing kind and talented young woman. I was so stressed about this case but from day 1 they helped ease that stress and always answered all my questions promptly and respectfully. I couldn't believe David got me to mediation within 6 months of being cut off my LTD and got me a settlement way beyond my expectations. I can't say enough good things about this law firm but I guarantee you that if you need a lawyer to fight for you David is your guy! . Believe me when I say this is the law firm for anyone dealing with personal injuries especially LTD denial claims. Thank you so much to David, Ingrid and Melissa you truly don't know how much I appreciate all you did for me and how this will help me get back on track with my life. Keep helping others you guys are doing amazing work! I wish you all the best!
Rose RegazziRose Regazzi
21:15 11 Oct 23
I sustained a relatively painful injury, affecting me long term.I wouldn't otherwise had pursued it, as it involved a relatively large corporation, but felt it necessary to do so. However, many lawyers were daunted, with one, who actually referred me to HIMPRO.I was connected with Dan Holland, who reviewed the case, provided with me realistic expectations, sound advice and had a willingness to move forward and represent me.His calm and professional demeanor, brought me to a place of reassurance. His ease in addressing all facets of this process, clearly demonstrated a wealth of experience. There was never any hesitation, when being challenged, and felt my best interest was always in the forefront.This case has since been resolved, to my complete satisfaction.Without reservation, HIMPRO (and Dan Holland, in particular), would be the only firm I would recommend for these type of cases.
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HIMPRO is a leading law firm with full service personal injury and disability insurance lawyers. We have been recognized by Best Lawyers and assigned the highest rating, AV Preeminent, from Martindale-Hubbell. We provide a combined century of trial experience which has led to the successful settlement of over 10,000 cases with combined settlement value in excess of 3/4 billion dollars. Our mission is to win your case. At HIMPRO by Himelfarb Proszanski LLP we build winning cases. That’s the HIMPRO Advantage™.

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LOCATION

Toronto Disability Lawyers
480 University Ave
Suite 1401
Toronto ON
M5G 1V2
(416) 599-8080

Brampton Disability Lawyers
2 County Ct Blvd
Suite 400
Brampton ON
L6W 3W8
(905) 595-6760

Hamilton Disability Lawyers
1 Hunter St E
Ground Floor
Hamilton ON
L8N 3W1
(905) 777-8002

Kitchener Disability Lawyers
22 Frederick St
7th Floor
Kitchener ON
N2H 6M6
(519) 772-7659

Oshawa Disability Lawyers
21 Simcoe St S
Oshawa ON
L1H 4G1
(289) 634-5554

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