Long Term Disability Claim (LTD)

Published on: June 12, 2025

Long Term Disability Denials

You know when you’ve been approved for Long Term Disability Benefits. That approval will usually come first verbally, and then be formalized in writing.

While, getting something in writing from the long term disability insurer might feel good, it doesn’t mean anything until the payments start coming in.

That rings true in real world examples:

Let’s say you hear from your adjuster that benefits have been approved. Great!

Then, you receive a letter from the insurance company which formalizes the approval in writing. Great again!

But, as Jerry McGuire would say “Show me the Money“.

When the insurer does examines your file, looks at how much money you made, and how much money you’ve received from other collateral sources, it turns out that the benefit owing to you amounts to ZERO! That means that the long term disability insurer’s approval amounts to no tangible benefits for you; even though you’ve been approved. The reality is that you’ve been approved for nothing!

In that same example, it might be that the insurer had been paying you long term disability benefits. Then, they stopped because you received collateral benefits (like CPP Disability Benefits). Then, having reviewed your file, along with the amounts paid to you in long term disability benefits vs. the amounts paid to you in CPP Disability benefits; it turns out that the long term disability insurer over paid you. Now, they are seeking a repayment of benefits due to the over payment. This means that you owe the long term disability insurer money. Imagine that: a person owing an insurance company money for a over payment (completely unrelated to payments of insurance premiums).

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Published on: May 22, 2025

HBC Bankruptcy and Long Term Disability Benefits

By Goldfinger Injury Lawyers

After hearing the news that long time retailer Hudson’s Bay Company declared bankruptcy, my mind immediately went to the employees at HBC. The part timers. The full timers. The seasonal employees. The student employees. The “lifers”. The night shift employees. The early birds who stock the shelves. The office workers. The shipping and receiving crew. The janitorial staff. Everyone who makes the stores work.

I know that life well.

Before I became a personal injury lawyer, I worked retail at Sears Canada while I was in undergrad at York University. I worked in the hardware department and in the paint department. I saw the ins and outs of a large department store. I learned all sorts of things about paint, tools, brushes, stains, lawnmowers, power washers, dehumidifiers…. You name the home appliance/tool, I knew about it.

But, more importantly, I learned a lot about people from all walks of life, and how large publicly traded companies work and treat their workers.

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Published on: April 30, 2025

It can be a Long Road for Long Term Disability Cases in Ontario

By Goldfinger Injury Lawyers

It’s not mistake that Long term disability claims use the word “long“. Long is used for good reason.

Long is meant to define the duration of the period from the claimant’s first day off work, to the time period they are eligible to receive long term disability benefits. It’s a “long” period in contrast to a “short” period as found in short term disability claims.

Long also defines the duration for which the claimant is eligible to receive long term disability benefits. That period is longer than you would find in short term disability cases. In most long term disability cases, the eligibility period, or payment period, generally goes up to the age of 65. But, this is fact dependent upon the wording contained in the long term disability policy. In contrast, the duration of short term disability benefits is generally a few months (90 days, 120 days). This too is fact dependent and is specific to the wording of the policy. In any event, the use of the word “long” is meant to distinguish from the use of the word “short” in the case of disability policies.

For personal injury lawyers, and for many disability claimants, the use of the word “long” can also mean something completely different. It can be seen as a reminder to the claimant that it may take a long time to get an answer from the insurance company on whether or not the claim for benefits has been approved or denied.

In other circumstances, it can take a long time for the claimant to get paid their benefits, even after they’ve been approved.

For lawyers, the use of the word “long” is a gentle reminder that long term disability cases take time get through the Courts, or to ultimately resolve by way of Judgment or out of Court Settlement. Make no mistake, there is nothing “short” about a long term disability case once it’s been litigated.

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Published on: December 5, 2024

Every Long Term Disability Policy is Different

By Goldfinger Injury Lawyers

The fine print matters. It especially matters in long term disability claims.

The overwhelming majority of personal injury cases are tort cases. They are not predicated on a contract.

Car Accident Cases

Dog Bite Cases

Slip and Fall Cases

Assault Cases

Product Liability Cases

All of these claims are based on negligence in tort law. They are not based on a contract.

Long Term Disability cases are very different because they are entirely based on contracts. That means that the wording of the long term disability policy (the contract) is very important to whether or not the case succeeds, or fails. One word in the contract can change the entire case.

A Plaintiff can be very seriously injured. But, if the wording of the long term disability contract is not in their favour, they might not win the case.

It’s important for a Plaintiff to know that the wording of every long term disability policy is different. This is significant because just because somebody you know won their long term disability case does not mean that you will win your case as well. There are so many different variables which go in to winning (or losing) a long term disability case. The wording of the long term disability policy is a great place to start.

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Published on: April 25, 2024

OTIP Long Term Disability Claims

By Goldfinger Injury Lawyers

This might seem like a very niche topic for the Toronto Injury Lawyer Blog as it relates specifically to Ontario teachers seeking to claim, or who have been denied long term disability benefits by The Ontario Teachers Insurance Plan (OTIP)

The reality is that there are a lot of teachers out there. Teachers have access to long term disability benefits and tend to read blog posts like this. Teaching is a difficult profession where bad days get noticed very quickly by the students and aren’t tolerated. Going in to teach a class day in day out in pain when you aren’t there 100% mentally isn’t good for anyone.

OTIP long term disability polices are some of the most complicated long term disability policies out there. It’s not because OTIP is trying to be difficult towards its membership, or has intentionally made the policies complicated to confuse teachers and to trick them out of getting benefits. It’s just that there are a lot of moving parts for teachers, and a lot of money at stake.

For starters, teachers on average earn a very good and stable income. They generally receive regular raises, and they have access to rehabilitation benefits to help them get better. Teachers are unionized employees as well which adds another layer of potential confusion (like why isn’t my union helping me pursue the long term disability claim?).

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Published on: March 13, 2024

Getting cut off LTD Benefits just before age 65?

By Goldfinger Injury Lawyers

The first long term disability case I had experience with came well before I was a personal injury/disability lawyer.

It happened before I was in law school. It happened to my mom.

She had just gone through multiple surgeries and had not recovered properly, or at all from them. She had been approved for Long Term Disability just before the surgeries took place. She was around 62 years old. After the surgeries, she remained on disability benefits. But shortly there after the long term disability insurer asked that she attend a few “independent” medical assessments with the insurance company’s doctors. She obliged.

Following those assessments, my mom was cut off her long term disability benefits. She was 63 years old, and her benefits were set to expire at the age of 65. She remained at home, in significant pain, and unable to manage her day to day activities of daily living, let along return to any form on employment.

We soon found out that these “independent” doctors who she saw were not really independent. These doctors did minimal to no work through the public OHIP system. Instead, most of their work was generated by referrals from auto insurers, long term disability insurers and WSIB. These doctors did not have a roster of patients who they routinely saw to cure their ailments. Instead, they had institutional clients like insurers, or assessment centres, who referred them people to see on a one shot only basis. After the assessment, they had an army of clerks who would generate reports. The person would arrive at the office for their one and only time to see the doctor. The doctor would check them over, and then someone would generate the report. That report, more often than not went in the favour of the insurer who had referred to doctor the patient in the first place. The doctor would not bite the hand that feeds them so to say.

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Published on: December 13, 2023

Qualifying for Long Term Disability vs. Qualifying for Canada Pension Plan Disability

By Goldfinger Injury Lawyers

Long Term Disability Law can be rather complicated.

It’s complicated because Long Term Disability is based in contract, and every contract is different.

For many people, understanding the words and concepts contained in these long term disability contracts is hard to grasp, and confusing. I can’t say that I blame them.

Take a dog bite case for example. If a dog attacks you, and causes injury to you, then the owner of the dog ought to be held responsible for your injuries and losses.

Long Term Disability cases don’t work that way. Simply because you are disabled, or unable to return to work, does not necessarily mean that you are entitled to long term disability benefits.

And, even if you are eligible for long term disability benefits, the quantum of that benefit, along with the payment duration will be in question as well.

There are a lot of fluctuating variables when assessing and quantifying a long term disability case. We call these moving targets. Those targets don’t move as often, or as frequently, with a straight tort claim, like a dog bite case, as they do with a long term disability claim.

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Published on: March 29, 2023

Quick income sources after a serious accident

By Goldfinger Injury Lawyers

The purpose of this instalment of the Toronto Injury Lawyer Blog is not about settling a personal injury case fast.

Rather, it’s about what money can be claimed, and recovered relatively quickly, after an innocent accident victim cannot return to work and earn an income after a serious accident.

Getting paid benefits quickly to supplement one’s lost income, because one cannot work after a serious accident is a very common concern for clients. Legitimately so. A Plaintiff goes from earning a gainful income one day; to being disabled and unable to do so the next. The bill collectors don’t care that you’ve been involved in a serious accident. All that they care about is that their bills get paid.

It’s our hope that this instalment of the Toronto Injury Lawyer Blog gives you some insight on sources to claim benefits in order to make ends meet.

Before we examine those sources, here are a few practical tips to claiming benefits:

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Published on: March 2, 2023

New Disability Bill May Have Unintended Consequences which will benefit Insurance Companies

By Goldfinger Injury Lawyers

This is an example of how governments with the best intentions can still screw things up.

It’s quite noble for the federal government to want to help people with disabilities make ends meet. Get people with disabilities more money in their pockets so that they can pay their bills, live independently, and with dignity.

So, the Federal Government unanimously passed Bill C-22 “An Act to reduce poverty and to support the financial security of persons with disabilities by establishing the Canada disability benefit and making a consequential amendment to the Income Tax Act”. Yes, that is the full legal name of the Bill because legislators and lawyers tend to get oh so creative and descriptive when naming a new Bill!

The Bill does not go into specifics about how much people would receive. Nor does it go into specifics about how you would qualify for the benefit.

But it does detail that if you qualify for assistance, you would receive money in the form of a disability benefit.

People should know that receiving money, from any source has consequences. There are never “no strings attached”; especially when receiving money from the Government.

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Published on: December 29, 2022

Brian Goldfinger and the Case of the Wicked Long Term Disability Release

By Goldfinger Injury Lawyers

More often than would think, insurance companies seek to add terms to a Full and Final Release which they would not otherwise be able to get in Court.

A Full and Final Release is a legal document which gets signed when a case gets settled outside of Court.

This is standard. Anyone who settles their case outside of Court in a personal injury or long term disability action will be asked by a Defendant to sign such a Release.

Generally, the Release will contain provisions detailing the amount of the settlement, terms that the settlement is final and binding on both parties, that the Defendant is prepared to pay the settlement amount, but does not admit liability, that the Plaintiff cannot sue again over this specific cause of action and that should s/he do so, that the Release will be relied upon to dismiss the case with costs; and that the terms of the settlement are confidential, but can be disclosed to lawyers, accountants and financial planners.

These terms are expected to be contained in a Release by plaintiff side personal injury lawyers. But sometimes (more often than you would expect) sophisticated insurers and their insureds try to get terms into the Release which fall well outside of the scope of the litigation. The Defendant is trying to get through the backdoor, what they cannot get through the front door.

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