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I worked as an electrician and was injured (not work related injury) and ended up being on LTD at the age of 26. I am now past the any occupation period, but the problem is my diagnosis, I have a rare nerve condition and chronic pain, and I can no longer do my job or any other job due to my disease and how it is affecting my day to day life, my insurance company is doing everything they can to push me off LTD, including acting in bad faith, I was considering going back to school with accommodations (note taker, extended time, recorded classes, virtual attendance) and make a career switch into something that will enable me to run my own practice at my own pace as I am in my early thirties and I do not feel like I have a purpose at all, I was thinking something like massage therapist, or occupational therapist, physiotherapist, or even a therapist, but the insurance company is not approving this under vocational rehab provision, despite the sole purpose of me going back to school is to improve my life and reach gainful employement. my condition is unstable, and it includes chronic pain, migranes, brain fog and severe insomnia and severe weakness. this is my second request to them in writing and they will not approve it, and they inform me of their refusal by phone. I am considering going back to school even if they do not approve, because I am wasting my life to my illness instead of pivoting around my disability and brain dysfunction, and doing something for my future. Will I be in breach of contract? or do i have enough to say they are acting in bad faith, their comments of me being young and getting back up on my feet soon, their dismissiveness of me wanting written communication, isolating me, lying about things like their assigned therapist and physiotherapist saying no additional intervention needed, vs what the physiotherapist said that he requested additional treatment and the insurer refused to cover it. My drs support me going back to school, but the case manager said if you can go back to school why cant you go back to work. If I go back to school, and they cut off my benefits, do I have reasons to sue them for acting in bad faith?
Unfortunately, we can't say for certain. Each insurer and case manager handles these situations a little differently, and much depends on the wording of your policy as well as your specific medical history and experience with the insurer.
The insurer may well take the position that if you can attend school, especially full time, you can work in an alternative occupation. We'd suggest speaking with your doctors first to find out what they would support. If you do go back to school and run into problems with your benefits, reach out to us as soon as possible. We'll review your case as a whole and advise you on next steps (at no charge).
The insurer may well take the position that if you can attend school, especially full time, you can work in an alternative occupation. We'd suggest speaking with your doctors first to find out what they would support. If you do go back to school and run into problems with your benefits, reach out to us as soon as possible. We'll review your case as a whole and advise you on next steps (at no charge).