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I have been on LTD since March 2019 and I applied and received CPPD in May 2020 which was paid retroactively. The insurance company, Industrial Alliance, withholds 50% each month for the overpayment. I should be finished paying them back this Dec. On Thursday, I got a call from my Claims Manager. She is accessing my ability to do ANY job at the 24-month mark. The GP that I have had for almost 20 years retired at the end of January. I have a new Dr in the same office and she has access to my file. My questions are: I have not seen a psychiatrist since my original diagnosis of MDD. It was a video conference and there was no mention of further meetings. Will that harm my case if the Case Manager deems that I will be cut off LTD? Will having CPPD and also being approved for disability waiver from OMERS help my case? My former Dr. said that I have followed all recommended treatments and that I am unable to work in any capacity. I continue to see my new Dr every 6 weeks. While I have not been denied, I know that insurance companies do all they can to get you off their payroll.

You are doing everything right. You should not be cut off LTD if you are unable to work in any occupation for which you are suited for by training, education or experience. Typically that means that if you can’t earn at least 60-65% of your pre-disability income in another occupation then your LTD payments should continue and you should NOT be cut off. It’s good that your former doctor confirmed that you’re following all prescribed/reasonable treatments. That’s a condition of every LTD policy. However, you’re also right that insurers often find excuses not to pay, so you must remain vigilant and confirm your conversations with your adjuster in writing (via email) and continue seeing your new doctor. If you run into any difficulties or have further questions, call or email me directly at my contact info below.
Sivan Tumarkin
Direct Tel (Toll Free): 1-888-990-9646     Email: sivan@stlawyers.ca     Web: www.stlawyers.ca
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