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I’ve been off work with a serious medical condition for nearly two years. My long-term disability insurer has just informed me that, although I have not recovered, they are ending my benefits after I

I’ve been off work with a serious medical condition for nearly two years.  My long-term disability insurer has just informed me that, although I have not recovered, they are ending my benefits after I have been off for two years.  Can they do this?

Most Long-Term Disability benefit policies provide for benefits until the age of 65, or until a worker is no longer “Totally Disabled”.  What your insurer is likely referring to is the change in the definition of “Totally Disabled” that occurs after a worker has been off work for 2 years.

While there are variations in policies, most plans follow a similar outline; for the first two years, a person is entitled to benefits when they are unable to perform their pre-disability occupation.  In other words, they get benefits if they can’t do their usual job.  After two years, a person is entitled to benefits only if they are unable to perform any job for which they are reasonably suited by way of training, education and experience.  This second test is considered more difficult to meet.

Unfortunately, this change of definition is a common source of contention between insurers and people with a disability.  Insurers often seem overly optimistic about a person’s ability, despite their ongoing medical condition, to re-enter the workforce in a new job.  This can be true even when a person has spent nearly their entire working life in a single field, with a single employer, and has few other marketable skills.

If you insurer has informed you that your disability benefits are being terminated for any reason, it is important that you consult with a lawyer who handles these types of claims to determine your options and legal rights.
Brian Simo
Brian Simo
P: 905.572.5819
bsimo@rossmcbride.com