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The Impact of Pre-existing Conditions on Injury Claims: How pre-existing medical conditions can affect the outcome of personal injury claims.

The Impact of Pre-existing Conditions on Injury Claims

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In Canada, navigating personal injury claims can become significantly more complex when the claimant has pre-existing medical conditions. Understanding the impact of these conditions on injury claims is crucial for both legal professionals and claimants to ensure fair compensation and legal representation. This blog post delves into how pre-existing conditions can affect the outcome of personal injury claims in Canada, highlighting the challenges and considerations involved.

The Legal Framework

Canadian personal injury law operates under the principle that individuals should be compensated to the extent that they are worse off due to the negligence of another party. However, when claimants have pre-existing conditions, insurers and courts must decipher to what extent the claimed injuries are attributable to the incident in question versus the pre-existing condition. This determination is critical in deciding the amount of compensation awarded.

Disclosure of Pre-existing Conditions

Full disclosure of pre-existing medical conditions is a pivotal part of the claims process. Claimants are encouraged to be transparent about their medical history, as failing to disclose these conditions can lead to accusations of fraud or misrepresentation, potentially jeopardizing the claim. A thorough disclosure allows legal professionals to accurately assess the impact of the accident on the claimant’s health and argue for appropriate compensation.

The “Thin Skull” Principle

A cornerstone of Canadian personal injury law is the “thin skull” rule, which posits that defendants must take their victims as they find them. If a claimant has a pre-existing condition that makes them more susceptible to injury, the defendant is still liable for the full extent of the injury caused by their negligence. This principle ensures that individuals with pre-existing conditions are not discriminated against in the legal process.

Challenges in Proving Aggravation

One of the main challenges in injury claims involving pre-existing conditions is proving that the incident aggravated the condition. Medical expert testimony often becomes essential in these cases. Healthcare professionals may need to differentiate between the symptoms and limitations caused by the pre-existing condition and those resulting from the accident. This can involve detailed medical examinations, reviews of the claimant’s medical history, and sometimes, expert witnesses in court.

Mitigating Factors

Insurance companies may attempt to minimize compensation by arguing that the injuries claimed are primarily related to pre-existing conditions rather than the incident itself. In these situations, claimants and their legal representatives must provide compelling evidence that the accident exacerbated the condition or caused additional injuries. Documentation, such as medical records and expert opinions, plays a crucial role in substantiating these claims.

Pre-existing medical conditions significantly influence the outcome of personal injury claims in Canada. The interplay between legal principles, such as the “thin skull” rule, and the practical challenges of proving aggravation of these conditions underscores the complexity of these cases. For claimants, the key to navigating these complexities lies in transparency, comprehensive medical documentation, and the support of skilled legal professionals. By understanding the impact of pre-existing conditions on injury claims, individuals can better advocate for their rights and secure the compensation they deserve. 

Contact our local Cambridge legal team today to discuss your unique case and gain insight into next steps you can take.

Navigating Long-Term Disability Claims: Common Pitfalls and Strategies for Success

Navigating Long-Term Disability Claims: Common Pitfalls and Strategies for Success

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The journey through a long-term disability claim can be arduous, with the potential for unexpected obstacles leading to claim denials. Understanding the common reasons for such denials and taking proactive steps to avoid them is essential for individuals seeking the financial support they need during challenging times. In this comprehensive guide, we’ll explore the prevalent pitfalls that may result in long-term disability claim denials and offer practical advice on how to strengthen applications and prevent potential issues.

1. Inadequate Medical Documentation: The Linchpin of Disability Claims

One of the primary reasons for long-term disability claim denials lies in inadequate medical documentation. Insurance companies rely heavily on medical evidence to assess the legitimacy of a claim. To avoid this pitfall:

Advice: Ensure that your medical records provide a clear and comprehensive picture of your condition. Regularly communicate with your healthcare providers, keeping them informed about your symptoms and limitations.

Strategy: Establish a strong relationship with your treating physicians. Request detailed medical reports that explicitly outline your diagnosis, symptoms, treatment plans, and the impact of the condition on your daily life.

2. Failure to Meet the Definition of Disability

Disability insurance policies come with specific definitions of what constitutes a disability. Sometimes, claims are denied because the applicant’s condition doesn’t align with the policy’s definition. To avoid this pitfall:

Advice: Familiarize yourself with the definition of disability in your policy. Understand the criteria for eligibility and make sure your medical documentation clearly supports your claim within these parameters.

Strategy: Work closely with your healthcare providers to gather evidence that directly addresses the policy’s definition of disability. Be meticulous in detailing how your condition prevents you from performing the duties of your occupation.

3. Pre-existing Conditions and Waiting Periods

Many disability policies have waiting periods before benefits kick in, and they may exclude coverage for pre-existing conditions during this time. Failure to adhere to waiting periods or disclosing pre-existing conditions can lead to claim denials.

Advice: Review your policy thoroughly to understand waiting periods and pre-existing condition clauses. Disclose all relevant information truthfully during the application process.

Strategy: Plan your claim application carefully, ensuring that you meet waiting period requirements. Be transparent about any pre-existing conditions, providing all necessary details and medical history.

4. Lack of Objective Evidence

Some claims fail due to a lack of objective evidence supporting the severity of the claimed disability. Insurance companies may be skeptical of conditions that are primarily self-reported without accompanying objective evidence.

Advice: Whenever possible, seek objective medical tests and assessments that can quantify the extent of your impairment. This may include diagnostic tests, imaging, or assessments by specialists.

Strategy: Work collaboratively with your healthcare team to incorporate objective evidence into your medical records. Ensure that your medical documentation reflects not only subjective symptoms but also the measurable impact of your condition.

5. Insufficient Follow-Up and Communication

Maintaining open lines of communication with both your healthcare providers and the insurance company is crucial throughout the claims process. A lack of follow-up or timely communication can lead to misunderstandings and, ultimately, denials.

Advice: Stay proactive in updating your healthcare providers about your condition and any changes in your symptoms. Respond promptly to requests for information from the insurance company.

Strategy: Keep a detailed record of all communications related to your claim. Maintain a log of appointments, conversations, and correspondence with healthcare providers and the insurance company to ensure transparency and accuracy.

6. Failure to Comply with Treatment Plans

Insurance companies may deny claims if the claimant fails to comply with prescribed treatment plans without a valid reason. Failure to follow recommended treatments can raise questions about the severity of the condition and the individual’s commitment to recovery.

Advice: Collaborate closely with your healthcare team to develop a treatment plan that is both realistic and beneficial. If you are unable to comply with specific aspects of the plan, communicate openly with your healthcare providers about the challenges you face.

Strategy: Clearly document any challenges or adverse reactions to treatments in your medical records. Demonstrate that you are actively engaged in your healthcare and that deviations from the treatment plan are reasonable and well-supported.

7. Lack of Vocational Evidence

In cases where disability claims involve the inability to work, providing evidence of vocational limitations is crucial. Failure to demonstrate how your disability affects your ability to perform the duties of your occupation can result in claim denials.

Advice: Clearly articulate the specific job duties of your occupation and how your disability impacts your ability to perform these duties. Seek vocational assessments or opinions to support your claim.

Strategy: Work with your healthcare providers to obtain detailed opinions on how your disability specifically impairs your ability to carry out the essential functions of your job. Provide job descriptions and any relevant vocational evidence to strengthen your claim.

Empowering Your Long-Term Disability Claim Journey

Successfully navigating the intricacies of long-term disability claims requires a proactive and informed approach. By addressing these common pitfalls head-on and implementing the recommended strategies, individuals can significantly enhance the likelihood of a successful claim outcome. Remember, seeking the guidance of legal professionals experienced in disability claims can provide invaluable support throughout the process. In the pursuit of financial assistance during challenging times, knowledge and diligence are powerful allies.

Navigating the Complex Terrain: The Crucial Role of Legal Support in Long-Term Disability Claims

Navigating the Complex Terrain: The Crucial Role of Legal Support in Long-Term Disability Claims

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The journey through a long-term disability claim can be a labyrinth of complexities, and individuals facing the challenges of disability often find themselves in need of expert guidance. In this blog post, we explore the critical role of legal support in long-term disability claims, shedding light on when and how to seek representation. Understanding the benefits of having legal support during the claims process can be instrumental in ensuring a smoother and more successful path toward securing the financial assistance individuals need during challenging times.

When to Seek Legal Representation: Recognizing the Signs

  1. Initial Claim Denial:

    • Scenario: Your initial long-term disability claim has been denied by the insurance company.

    • Why Legal Support is Vital:

      • Legal professionals can conduct a thorough review of your case to identify potential reasons for denial and strategize on how to address them.
      • They bring a nuanced understanding of disability law, ensuring your rights are protected and that the insurance company adheres to its contractual obligations.

  2. Appealing a Denied Claim:

    • Scenario: You’ve decided to appeal a denied long-term disability claim.

    • Why Legal Support is Vital:

      • Legal representation provides you with an advocate who understands the intricacies of the appeals process.
      • Lawyers can compile compelling evidence, strengthen your case, and present a persuasive argument on your behalf.

  3. Complex Medical Conditions:

    • Scenario: Your disability involves complex medical conditions that may be challenging to articulate on your own.

    • Why Legal Support is Vital:

      • Legal professionals work with medical experts to ensure that the nuances of your condition are accurately represented.
      • They can bridge the gap between medical terminology and legal requirements, presenting a comprehensive and compelling case.

  4. Vocational Challenges:

    • Scenario: Your disability affects your ability to perform the duties of your occupation, and vocational evidence is crucial to your claim.

    • Why Legal Support is Vital:

      • Lawyers can collaborate with vocational experts to provide clear evidence of how your disability impacts your ability to work.
      • They possess the expertise to effectively communicate vocational limitations to insurance companies and, if necessary, in a legal setting.

  5. Navigating Legal Jargon:

    • Scenario: The legal language in your insurance policy or during the claims process is difficult to interpret.

    • Why Legal Support is Vital:

      • Legal professionals are well-versed in the language of disability law and insurance policies, ensuring that you fully understand your rights and obligations.
      • They can interpret complex clauses and provisions, preventing misunderstandings that might jeopardize your claim.

How to Seek Legal Representation: Steps to Empower Your Claim

  1. Research and Choose the Right Attorney:

    • Recommendation: Research attorneys specializing in disability law and choose one with a proven track record in long-term disability claims such as our firm, Hilborn and Konduros in Cambridge, ON.

    • Benefits:

      • Specialized knowledge ensures that your attorney is familiar with the nuances of disability law.
      • A successful track record indicates the lawyer’s ability to navigate the complexities of disability claims.

  2. Consultation and Case Evaluation:

    • Recommendation: Schedule consultations with potential attorneys to discuss your case. Contact Us to sit down with our experienced team and take next steps.

    • Benefits:

      • A consultation allows you to assess the attorney’s understanding of your case and their proposed strategy.
      • Attorneys often offer case evaluations, providing insights into the strengths and weaknesses of your claim.

  3. Clear Fee Structure and Agreements:

    • Recommendation: Clearly understand the attorney’s fee structure and the terms of the representation agreement.

    • Benefits:

      • Transparent fee structures ensure that you are aware of costs from the outset.
      • A clear agreement outlines the scope of legal representation, preventing misunderstandings later in the process.

  4. Collaboration and Case Preparation:

    • Recommendation: Work closely with your attorney, providing all relevant documentation and information.

    • Benefits:

      • Collaborative efforts lead to a thorough case preparation, maximizing the strength of your claim.
      • Attorneys can identify potential challenges early in the process, allowing for proactive strategies.

  5. Negotiation and Settlement:

    • Recommendation: Allow your attorney to handle negotiations with the insurance company on your behalf.

    • Benefits:

      • Legal professionals bring negotiation skills to the table, maximizing the chances of a favorable settlement.
      • They can leverage their experience to navigate settlement discussions effectively.

  6. Litigation if Necessary:

    • Recommendation: Be prepared for the possibility of litigation if a satisfactory settlement cannot be reached.

    • Benefits:

      • Legal representation in court ensures that your case is presented comprehensively and persuasively.
      • Attorneys are skilled in legal procedures and courtroom advocacy, providing a strong defense of your claim.

The Benefits of Having Legal Support: A Closer Look

  1. Expertise in Disability Law:

    • Legal professionals specializing in disability law bring a depth of expertise that is invaluable when navigating the intricacies of long-term disability claims.

  2. Advocacy and Negotiation Skills:

    • Attorneys act as strong advocates for your rights, leveraging their negotiation skills to secure the best possible outcome for your claim.

  3. Interpretation of Complex Policies:

    • Legal support ensures that you fully understand the terms and conditions of your insurance policy, preventing misunderstandings that could lead to claim denials.

  4. Strategic Case Preparation:

    • Attorneys strategically prepare your case, identifying potential challenges early and building a robust argument to strengthen your claim.

  5. Objective Review of Denied Claims:

    • In cases of claim denials, legal professionals can conduct an objective review of the decision, identifying weaknesses and avenues for appeal.

  6. Protection of Legal Rights:

    • Lawyers ensure that your legal rights are protected throughout the claims process, preventing unfair practices and securing a fair evaluation of your disability.

  7. Efficient Handling of Administrative Tasks:

    • Legal representation takes care of administrative tasks, allowing you to focus on your health and well-being rather than getting bogged down in paperwork.

Conclusion: Empowering Your Claim Journey

In the intricate world of long-term disability claims, legal support acts as a guiding force, navigating the complexities and advocating for your rights. Recognizing the signs that indicate the need for legal representation, understanding how to seek it, and appreciating the benefits it brings can empower individuals seeking financial assistance during challenging times. At Hilborn and Konduros, we specialize in disability law and are not just advocates; we are allies, standing by your side to ensure a fair and just outcome in the pursuit of long-term disability benefits. Contact Us today to discuss your case.

Hilborn & Konduros Long term disability benefits lawyer Cambridge

Tips for Choosing the Right Attorney for Your Long-Term Disability Denial Case

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When it comes to long-term disability denial cases, selecting the right attorney with specialized expertise is crucial. Here at Hilborn & Konduros, we understand the significance of this decision. In this post, we will explore valuable tips for choosing an experienced attorney. With our focus on specialization, reputation, communication, resources, trust, and the benefits of legal representation, we provide comprehensive support for long-term disability denial cases.

  1. Specialization and Experience:

At Hilborn & Konduros, we are a law firm dedicated to long-term disability denial cases. Our experienced team has handled numerous complex disability claims, ensuring we stay up-to-date with the evolving laws and regulations in this field. With our proven track record of successful outcomes, we possess the knowledge and expertise necessary to effectively handle challenging denial cases.

  1. Reputation and References:

Our attorneys at Hilborn & Konduros have built a strong reputation in the legal community and among our clients. We prioritize professionalism, integrity, and client satisfaction, which is reflected in the positive reviews and testimonials we receive. Our extensive referral network showcases the trust and confidence placed in our abilities.

  1. Case Evaluation and Strategy:

Here at Hilborn & Konduros, we approach each long-term disability denial case with meticulous evaluation and strategic planning. Our attorneys conduct comprehensive assessments to identify the strengths and weaknesses of a claim. By developing personalized strategies, we aim to present compelling arguments and maximize the chances of success.

  1. Fee Structure:

During consultations, we at Hilborn & Konduros maintain transparency regarding our fee structure. We work on a contingency basis, meaning we only receive payment if we win your case. We engage in clear discussions about the percentage or flat fee, as well as any additional expenses, ensuring transparency and providing clarity from the outset.

  1. Communication and Availability:

Effective communication is one of our priorities at Hilborn & Konduros. Our attorneys are known for being accessible and responsive to our clients’ needs. We ensure concerns are addressed promptly, and we provide regular updates on case progress to keep our clients informed throughout the legal process.

  1. Resources and Support:

At Hilborn & Konduros, we are well-equipped with the necessary resources and support to handle long-term disability denial cases comprehensively. We have access to expert witnesses, medical professionals, and administrative support to strengthen our clients’ claims. By leveraging these resources, we build strong cases that can withstand scrutiny.

  1. Litigation Experience:

While negotiation and administrative appeals are often pursued, we at Hilborn & Konduros have substantial litigation experience when cases require courtroom advocacy. Our attorneys are adept at presenting persuasive arguments, cross-examining witnesses, and handling the complexities of litigation. Our clients can have confidence in our ability to effectively represent their interests in court, if necessary.

  1. Compatibility and Trust:

Building trust and establishing strong client relationships are fundamental values at Hilborn & Konduros. During initial consultations, our attorneys actively listen, demonstrate empathy, and prioritize understanding the unique circumstances of each client. This compatibility and trust provide a solid foundation for a collaborative attorney-client partnership.

Benefits of Legal Representation with Hilborn & Konduros:

Legal Expertise: Our attorneys at Hilborn & Konduros possess in-depth knowledge of long-term disability laws and regulations. We navigate the complexities of the legal landscape, ensuring our clients’ rights are protected while maximizing the likelihood of a favorable outcome.

Case Evaluation: With our experience, we evaluate the strength of our clients’ claims, identify potential issues, and craft tailored strategies. This individualized approach increases the chances of success and allows us to address the unique aspects of each case.

Negotiation and Advocacy: At Hilborn & Konduros, we excel in negotiation and advocacy on behalf of our clients. We skillfully engage with insurance companies to ensure our clients’ interests are represented and seek fair settlements. If necessary, we are prepared to escalate the matter to litigation, advocating for our clients’ rights in court.

Reduced Stress: Dealing with a long-term disability denial can be emotionally challenging. By entrusting your case to our capable team at Hilborn & Konduros, you can alleviate stress and focus on your well-being. We handle the legal aspects, keeping you informed and providing support throughout the process.

Choosing the right attorney for your long-term disability denial case is a critical decision that can significantly impact the outcome. At Hilborn & Konduros, our attorneys specialize in long-term disability denial cases, bringing a wealth of experience and expertise to the table. With a strong reputation, effective communication, access to resources, and a client-centered approach, we strive to provide comprehensive legal representation.

By evaluating each case diligently, developing tailored strategies, and advocating on behalf of our clients, we aim to secure favorable outcomes. Our commitment to professionalism, trust, and open communication ensures that you receive the support you need during this challenging time.

If you are facing a long-term disability denial, we encourage you to reach out for a consultation with our experienced attorneys at Hilborn & Konduros. Let us guide you through the complexities of the legal process and fight for the justice you deserve. Together, we can work towards achieving a positive resolution for your long-term disability claim. Contact our team today.

Long-Term Care and Rehabilitation for Catastrophic Injury Victims: Canadian Resources and Rights

Long-Term Care and Rehabilitation for Catastrophic Injury Victims: Canadian Resources and Rights

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Suffering a catastrophic injury can have life-altering consequences, affecting not only the injured individual but also their loved ones. In Canada, individuals who experience catastrophic injuries have rights and access to resources that can aid in their long-term care and rehabilitation. In this blog post, we will explore the importance of long-term care and rehabilitation for catastrophic injury victims in Canada, as well as the available resources and the rights they have in the pursuit of recovery.

Understanding Long-Term Care:

Long-term care plays a vital role in supporting the needs of catastrophic injury victims. It involves the provision of ongoing medical assistance, personal care, and rehabilitative services to individuals with severe and often permanent impairments. Canadian healthcare systems, both at the federal and provincial levels, provide various long-term care options tailored to the specific needs of the injured person.

Rehabilitation Services:

Rehabilitation services are critical for maximizing the recovery and quality of life for catastrophic injury victims. These services encompass a wide range of therapies, including physical therapy, occupational therapy, speech therapy, and psychological counseling. Rehabilitation aims to restore functionality, promote independence, and help individuals regain their physical, cognitive, and emotional well-being.

Canadian Healthcare System:

In Canada, healthcare is primarily administered at the provincial and territorial levels, resulting in some variation in available resources and services across the country. Provincial health insurance plans, such as OHIP in Ontario or MSP in British Columbia, typically cover necessary medical treatments and consultations. Catastrophic injury victims should familiarize themselves with the specific programs, benefits, and coverage options available in their province.

Accessing Rehabilitation Programs:

Rehabilitation programs are offered through various channels in Canada. Publicly funded programs, such as those provided by hospitals, rehabilitation centers, or community-based organizations, aim to deliver comprehensive rehabilitation services. Private rehabilitation facilities and practitioners are also available, and individuals may have the option to access their services using private insurance coverage or out-of-pocket payments.

Insurance Coverage:

Insurance coverage plays a significant role in facilitating long-term care and rehabilitation for catastrophic injury victims. Depending on the circumstances surrounding the injury, individuals may be entitled to benefits from various insurance policies, including auto insurance, workers’ compensation, or private disability insurance. Understanding the terms, limitations, and application processes of these insurance policies is crucial to ensure access to the necessary resources.

Legal Rights and Compensation:

Catastrophic injury victims in Canada have legal rights and options to seek compensation for their injuries. Personal injury lawsuits can be pursued against responsible parties, such as negligent drivers, employers, or product manufacturers. These legal actions aim to secure financial compensation to cover medical expenses, long-term care, rehabilitation costs, lost income, and other damages incurred as a result of the injury.

Long-term care and rehabilitation are fundamental aspects of the recovery process for catastrophic injury victims in Canada. By understanding the resources available within the Canadian healthcare system, accessing rehabilitation programs, exploring insurance coverage options, and asserting their legal rights, individuals can optimize their chances of receiving the necessary care and support. It is important for victims and their families to seek guidance from healthcare professionals and legal experts specializing in catastrophic injury to ensure they receive the comprehensive care and compensation they deserve.

Premises Liability: Understanding Your Rights as an Injured Visitor in Canada

Premises Liability: Understanding Your Rights as an Injured Visitor in Canada

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When you visit someone else’s property, whether it’s a private residence, a commercial establishment, or a public space, you expect a safe environment. Unfortunately, accidents can happen, and if you sustain injuries due to hazardous conditions or negligence on the property, you may have the right to seek compensation. In Canada, premises liability laws govern these situations, protecting the rights of injured visitors. In this blog post, we will explore the concept of premises liability and help you understand your rights as an injured visitor in Canada.

Understanding Premises Liability:

Premises liability refers to the legal responsibility of property owners or occupiers to maintain a safe environment for visitors. In Canada, property owners have a duty of care to ensure that their premises are reasonably safe and free from hazards that could cause harm to visitors. This duty applies to both private individuals and businesses.

Types of Hazards:

There are various types of hazards that can lead to injuries on someone else’s property. Some common examples include slippery floors, uneven surfaces, inadequate lighting, broken steps or handrails, falling objects, or negligent security. If you sustain injuries due to any of these hazards, the property owner or occupier may be held liable for your damages.

Proving Negligence:

To establish a successful premises liability claim, you must demonstrate that the property owner or occupier was negligent in their duty of care. This involves proving the following elements:

1. Duty of Care: The property owner had a legal obligation to maintain a safe environment for visitors.

2. Breach of Duty: The property owner failed to fulfill their duty by either creating a hazard or failing to address an existing one.

3. Causation: The hazard directly caused your injuries, and the property owner’s negligence was a significant contributing factor.

4. Damages: You suffered physical injuries, emotional distress, medical expenses, loss of income, or other damages as a result of the accident.

Notice Requirement:

In Canada, there is a notice requirement for premises liability claims. This means that you must notify the property owner or occupier about your injuries within a reasonable timeframe. It’s important to report the incident as soon as possible and document the details, including photographs of the hazardous condition, witness statements, and any medical treatment received.

Seeking Legal Representation:

If you have been injured on someone else’s property, it is advisable to seek legal representation from a personal injury lawyer experienced in premises liability cases. They will assess the circumstances of your injury, gather evidence, and guide you through the legal process. At Hilborn & Konduros, our skilled lawyers will help protect your rights, negotiate with insurance companies, and pursue fair compensation on your behalf.

As an injured visitor in Canada, it’s crucial to understand your rights under premises liability laws. Property owners have a duty to maintain safe premises, and if they fail to do so, they may be held liable for injuries sustained by visitors. By proving negligence and seeking legal representation, you can assert your rights and pursue compensation for your injuries, medical expenses, and other damages. If you have been injured on someone else’s property, consult with a personal injury lawyer to understand the specifics of your case and take the necessary steps to protect your rights.

What is Your Duty to Disclose When Applying For Long-Term Disability?

What is Your Duty to Disclose When Applying For Long-Term Disability?

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While most applicants for long-term disability benefits do so through an employer’s policy, many have taken out disability and critical illness policies on their own. And if certain health issues have not been disclosed on the application, these policyholders may be out of luck when it comes to collecting benefits. 

Qualifying for These Benefits

Private insurance policies require you to submit an application to qualify for their coverage. They will make decisions on your qualification ability as well as your premium amounts by examining your application in detail. Qualification and premiums will be dependent on many factors, including your age, health, lifestyle choices, and other risk factors.

Weighing Their Risk

Insurance companies are for-profit businesses, and their goal is to provide less benefits than they take in premiums. Consequently, their underwriters focus sharply on potential risk when considering an applicant. This risk is assessed by how you have responded to questions on your application. If an applicant doesn’t tell the truth on their application, the company can’t assess risk. They also may use that information to deny benefits to you should you need them. And in most cases, those denials are upheld in court if you decide to legally pursue it. 

Your Duty to Disclose

When you are applying for life insurance, critical care insurance, or individual long-term disability insurance, you are required by law to tell the truth about your health. Under Section 183 (1) of the Insurance Act, an applicant for insurance must disclose “every fact within the person’s knowledge that is material to the insurance….”

Getting Legal Guidance

If you have been denied long-term disability benefits or other insurance benefits unfairly, you may have legal recourse. But if the denial involves your own duty to disclose, you may be out of luck. Getting legal guidance is critical. If you believe you have been unfairly denied insurance benefits, the Cambridge ON long-term disability lawyers at Hilborn and Konduros may be able to help. Contact or call us at (519) 658-6341 to schedule a complimentary consultation to discuss your case.

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Don’t Ruin Your Chance For Long-Term Disability

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If you’ve been injured or have suffered an illness that makes it impossible to work, long-term disability benefits can offer you and your family some protections and offset financial hardships. But you first need to be approved for benefits by the insurance company.

Filing a claim and filling out crucial paperwork can be overwhelming and complex. Before you file an application, you should first consider things that will set you up for success. 

Applying in a Timely Manner

Yes, you are suffering, but you must apply for benefits as soon as possible. Your long-term disability benefits are critical to you, and the sooner you have access to them, the better for you. In most cases, the insurer has a timing provision tied to the last day you worked. You don’t want to jeopardize your ability to get needed benefits by letting the clock run out and giving the insurer an excuse to deny your application. 

Have a Discussion With Your Doctor

Your benefits are subject to your doctor completing a medical certificate supporting your need for disability benefits. Consequently, it’s important for you to have a discussion with your doctor beforehand to ensure that the medical certificate will support that need and not lead to a denial of benefits. 

Describing Your Disability

In the application for LTD, you will be asked for a description of your disability, your pain, injuries, and functional status. You want to be concise and brief, letting your medical records do the talking. The more information you include, the greater the risk of contradicting yourself or providing the insurer with a reason to deny the application. In addition, you want to be careful of anything you say to your adjuster, as conversations are likely to be recorded. 

Yes, There Will Be Frustrations

Unfortunately, big insurance companies are bureaucratic behemoths, and your policy is probably fraught with lots of rules and procedures. These are to protect the company, not you. But if you want benefits, you need to play by their rules. If not, you can be found in non-compliance and risk not getting the benefits you desperately need. 

Don’t take chances with these essential benefits. Contact the Cambridge, Ontario long-term disability lawyers at Hilborn and Konduros for a no-cost consultation at (519) 658-6341 to understand your responsibility and rights regarding long-term disability benefits.

The Difficulties of Getting Long-Term Disability Benefits for Some Illnesses and Injuries

The Difficulties of Getting Long-Term Disability Benefits for Some Illnesses and Injuries

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If you suffer from an injury or a medical condition that prevents you from working or performing your job, you may be entitled to long-term disability benefits. 

Unfortunately, insurers often deny benefits for those who suffer from illnesses and injuries that don’t manifest in clinically measurable symptoms. These can include soft tissue injuries, whiplash, traumatic brain injuries, chronic fatigue, fibromyalgia, post-traumatic stress disorder, and other physical and mental illnesses and injuries. 

How Long Term Insurance Companies Deny Benefits

While each long-term disability insurance policy is different, most policies require that the policyholder be able to prove their illness or injury, that it prevents them from doing their job, and that they have been receiving ongoing treatment for it for a significant period of time. After the claim is filed, the insurance provider then determines, based on the evidence, whether the policyholder is entitled to disability benefits. 

Unfortunately, some of these medical conditions are often difficult to quantify through traditional diagnostic or imaging methods. In this case, it is critical for an individual who is suffering from a debilitating illness or injury to compile as thorough an application and to provide enough information and evidence as possible to support a disability claim. 

What Evidence Can Help Support Your Long-Term Disability Claim

The more evidence you can compile to support your long-term disability claim, the better. Any supporting information should include

  • All your medical records and results surrounding the injury or illness
  • Any diagnoses made by your providers
  • Any statements by the associated physicians or other providers
  • A detailed description of what your job duties are
  • A statement from your employer
  • Any other records or documentation that provides evidence that you can no longer perform your duties at work due to your illness or injury

Navigating a long-term disability claim by yourself can be overwhelming, particularly if you feel you have been unfairly denied. Having a skilled Cambridge long-term disability attorney in your corner can help you get the benefits you deserve if you are unable to work. At Hilborn and Konduros, we may be able to help. Call us at (519) 658-6341 or contact us to schedule a no-cost consultation to discuss your options.

Living With Spinal Cord Injuries in the Aftermath of an Accident

Living With Spinal Cord Injuries in the Aftermath of an Accident

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After an accident, recovery from injuries often takes a great deal of medical care, time, and patience. But for those who have suffered from a spinal cord injury, the option of living as they were pre-accident may no longer exist. Spinal cord injuries can have a wide range of severity, but in most cases, nerves that sent and received messages from the brain are now damaged. This leads to a loss of function and sensation in areas of the body, depending on where the injury took place. 

An Unfortunate Prognosis

In many cases, a spinal cord injury prognosis is not a good one. Paralysis is only one of the ways that the health of individuals with spinal cord injuries is affected. Life expectancy can be diminished between 15 to 30 years from average. Spinal cord patients are at a higher risk of many diseases such as cardiovascular disease, blood clots, pneumonia, gastrointestinal issues, sexual dysfunction, bladder and bowel dysfunction, and chronic pain. 

The Cost of Care for a Spinal Cord Injury Patient

Although an average of 60 percent of spinal cord injury patients cannot hold employment, the cost of their case can range from $1.5 million to $4.7 million over the course of a lifetime, depending on the age of the patient and the type of injury. According to the Christopher and Dana Reeve Foundation, expenses can range from nearly $350,000 to over $1 million in the first year alone. 

Getting Compensated for Spinal Cord Injuries

Although compensation can never make up for the catastrophic physical and financial impact of a spinal cord injury, a financial recovery can ease the burden. If you or a loved one has suffered a spinal cord injury due to the negligence of another, you may be able to collect compensation from the at-fault party for those injuries. Contact the experienced Cambridge personal injury lawyers at Hilborn and Konduros for a no-cost consultation to understand your rights under the law. 

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