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Bills stack up. Particularly around the Holiday season. Unless you’re independently wealthy or have amassed considerable savings, you’re ability to pay off these bills comes through income generated from working (or very generous monetary gifts!). What could be worse than being unable to return to work on account of a disability; or losing your job because you can’t work.

Most LTD Policies pay a monthly benefit at rates of 80%, 70%, or 66% or your net pre-disability income. This leaves a significant shortfall; even if your LTD claim has been approved by the LTD insurer. If you’re lucky, you may have one of those few policies which pay out LTD benefits at a higher percentage. But, those policies are expensive and few and far between.

Many clients want to know how they can speed up the processing and response time of their LTD claim. How can they get approved faster; so that their debt burden is more manageable?

If our LTD lawyers knew the answer to these questions, we would share it with the world. Unfortunately, there is no science behind the speed at which your LTD claim will get approved or denied. A lot of it depends on the insurance adjuster on the other end; the nature of your disability; the culture of the insurance company you happen to be dealing with; along with the amount of medical records involved in your LTD claim. The fewer records which an insurer has to review, the less time it ought to take to deliver a decision on your claim.

But, we see a number of instances where the LTD insurer requests more and more records. One set is just never enough for them to make a decision; one way or another. Some see this approach as thorough; and the LTD insurer is just doing their job. Others see it as frustrating; and an effort by the insurer to latch on to a document to deny a meritorious claim.

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Winter is upon us! Break out the parkas, toques and winter boots and get ready for some blistering cold. This week we are expecting some sub 20 degree weather in Southwestern and Eastern Ontario. Don’t get me started about what it’s like up there in Northern Ontario. It’s been chilly since the beginning of October (so they say).

The drop in temperature presents safety hazards created by winter snow conditions. Ice accumulation makes for some slippery conditions which can be dangerous.

It’s around this time that our law firm sees a spike in calls for slip and fall accidents.

The focus of this installment of the Toronto Injury Lawyer Blog Post will be the “Do’s and Don’ts after you or a loved one has sustained a slip and fall accident“.

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When a client walks through our doors, they will meet with me, Brian Goldfinger; the owner and directing lawyer of Goldfinger Injury Lawyers. I’m the Goldfinger in the Goldfinger Law.

My firm employs other lawyers, paralegals and clerks who assist me. But there are no hidden partners or agents outside of my law firm who you are being passed along to for the legal work on your case. If we take on your case, we will do the work. Your file, along with your personal and confidential information stays with our law firm. It doesn’t get passed along to another lawyer or law firm who you’ve never met or heard of.

What you see is what you get. No games. No gimmicks. Our clients have responded well to this approach; which has helped our law firm grow, one satisfied client at a time. We currently boast four offices across Ontario, with the ability to serve clients across the province.

All our law firm does is Plaintiff side personal injury law. We do not practice on behalf of large insurance companies which defend people. Nor do we practice in any other areas outside of the field of Plaintiff side personal injury and insurance law. Our practice is devoted to suing on behalf of injured accident victims and disability claimants so that they can get the results, compensation and benefits which they deserve.

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There was a great comedy sketch on the Rick Mercer Report last night regarding Winter Driving during the first snow fall of the season.

The Canadian husband and wife drivers experienced a sort of amnesia; such that they forgot how to drive when it snowed. These grizzled Canadians had experienced countless winters before; but driving during that first snow fall of the season was like their first time driving in snow…EVER!

The husband said that he began to lose control of the car because of the snow, and then thought it would be a good idea to drive faster, break harder, and follow other cars more closely because of the snow fall. Thinking this would be a great way to regain control of his car when it began to slide.

The wife suggested turning her lights off during the snow fall to make driving in the snow easier.

They said, that with every snow flake, their memory of Canadian Winter driving got worse and worse. It was because every snow flake was “different”, and they had to adjust their tactics for each flake. They ended up doing the exact opposite of what they ought to have done. Comedy ensued.

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Our law firm gets a variety of calls from people who have had their Long Term Disability claims denied.

These people have A LOT of questions about how to best proceed with their Long Term Disability Claim after their claim has been denied. Some of the questions our lawyers hear are:

What do I do now that I’ve been denied?

How can I fight the insurance company? Can I do so on my own?

Do I need a lawyer?

How much will it cost to get lawyer?

How long will it take to get my LTD benefits re-instated or have my case settle?

Why is the insurance company being so hard on me?

Are they like this to everyone?

All of these questions are certainly valid; understandably so. This is probably your first time applying for LTD Benefits. And it’s also probably your first time getting denied as well.

Our lawyers would be pleased to answer all of these questions, if not more, via free phone consultation toll free at 1-877-730-1777 or via email at info@goldfingerlaw.com.

The topic we wish to address in today’s installment of the Toronto Injury Lawyer Blog is the questions whether or not to appeal your Long Term Disability Claim. Whether to appeal, or not to appeal is a tactical move that shouldn’t be taken lightly.

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Long Term Disability Plans are what they call in the insurance industry “living policies” or “living benefits“. You need to be alive in order to recover on going LTD Benefits.

In their most basic form, these LTD policies are there to protect an insured person in the event of serious disability which prevents that person from working at their own occupation, or at any gainful occupation.

If an insured person meets the test for disability, and they have filed all of the proper paper work, then in a perfect world; that person will receive long term disability benefits for the period for which they are disabled.

The amount of the monthly LTD benefit depends on your policy along with your pre-disability income. Some polices have a set monthly benefit amount like $1,000/month; regardless of income. Other policies base the monthly benefit amount on a percentage of your monthly pre-disability gross or net income, depending on the wording of your policy (ie 66.67% of your gross income averaged in the year before your disability).

All of these calculations sound simple enough. But have you ever read the fine print of these policies? Have you ever paid attention to how long some LTD policies can be?

The devil’s in the details, and the wording of these LTD policies can rise up and have a negative impact on your long term disability case.

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The road to recovery can be a long one following a serious accident. You’ll need all the help you can get; and sometimes the help provided through the publicly funded OHIP system just isn’t enough.

Treatment like physiotherapy, occupational therapy, massage, psychological counselling, speech language pathology and chiropractic treatment in the majority of cases aren’t covered by the OHIP system.

Sometimes insurers will pay for this sort of treatment while the case is still open; in order to support your wellness and rehabilitation.

In car accident cases, these treatments can be paid for by way of an accident benefit claim via OCF-18 Treatment Plan. The car insurer will only pay for the treatment provided that they deem the treatment to be both “reasonable and necessary“. Unfortunately, the insurer gets to act as Judge, Jury and Executioner in deeming whether or not the proposed treatment via OCF-18 Treatment Plan is “reasonable and necessary“; which can be very frustrating for clients.

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Many of our clients suffer from fibromyalgia, depression and chronic pain. These injuries arise and present themselves in a wide variety of ways. Each case is fact specific. We never know how these injuries will present themselves or manifest.

Our lawyers see fibromyaligia, depression and chronic pain in the context of car accidents, long term disability (LTD) claims, motorcycle accidents, slip and fall cases and assault claims.

Even though the starting of these points of these claims may be different, the end result is similar. An inability to work, function, or engage in your normal routine of daily living.

The struggle of having to explain to family, friends and loved ones the nature of your injury and how it impacts you life, when the injury is invisible is taxing. It would almost be easier if you had a broken leg. That way, everyone would see what’s wrong with you. Having to describe the pain and depression is difficult and hard for others to understand or sympathize with.

Insurers know this. That’s why in chronic pain, depression and fibromyalgia cases we see lawyers for insurance companies file Jury Notices right away. They know that they can play upon the subjective nature of chronic pain, fibromyalgia and depression in order to defeat your claim. Their goal is to have the jury disbelieve your version of the events along with your pain, such that your case will get dismissed.

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The most important form to get treatment (physio, chrio, massage, occupational therapy, counselling, speech language etc.) after a car accident in Ontario is called the OCF-18 Treatment Plan.

This is a magical form. If the OCF-18 Treatment Plan is completed properly; then your treatment will be approved and paid for by the car insurance company.

If the OCF-18 Treatment Plan isn’t completed properly, then your treatment will be denied and you may have to pay for treatment out of your own pocket. Having Treatment Plans denied can be incredibly frustrating on your road to recovery following a serious car accident.

What’s incredible and rather perplexing for the lawyers at our office is given the importance of the OCF-18, how many times this form is updated, revised or changed. There are so many different versions of the OCF-18 it’s getting hard to keep up. Just 27 days ago (October 1, 2016), the OCF-18 Treatment Plan form was revised and changed yet again! Keep in mind that the OCF-18 is just one of the many OCF forms required in an accident benefit claim. There are over 18 other forms you may need to use during the course of your accident benefit claim.

If you visit the Financial Services Commission of Ontario website (FSCO, which is the home of the OCF forms for car accidents), you will see that there are different versions of the OCF-18 Treatment Plan, along with a wide other variety of OCF Claim Forms. For Example:

There is a Revised OCF-18 Effective October 1, 2016

There is an OCF-18 Effective June 1, 2016

There is an OCF-18 Effective November 1, 2014

There is an OCF-18 Effective February 1, 2014

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It’s not very often that judgments from the criminal court system impact personal injury and car accident cases.

It’s particularly rare when a criminal case which was decided in British Columbia, has such a far reaching effect that it impacts the way and timing in which personal injury cases are heard in Ontario.

But the case we are about to review is no ordinary case…..

Today’s installment of the Toronto Injury Blog will focus on a unique decision from the Supreme Court of Canada in R. v. Jordan [2016] SCJ No 27 (QL).

This was an appeal which went all the way up to the Supreme Court of Canada, from the BC Court of Appeal, and the BC Supreme Court.

The accused, Mr. Jordan, was charged with various charges in a dial a dope operation. He was charged in December 2008. His trial ended in February 2013. What’s a dial a dope operation? It doesn’t really matter for the context of this analysis.

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