Lupus and Long-Term Disability Benefits in Canada

Living with lupus can be challenging due to its unpredictable nature as well as its potential impact on your daily life and work responsibilities. For individuals with lupus who are facing denials of long-term disability (LTD) benefits, understanding their rights and seeking legal assistance can be crucial in obtaining the financial support they need for their ongoing care and well-being.

At Preszler Injury Lawyers, our long-term disability lawyers have experience assisting individuals with lupus and other disabilities pursue the benefits they need. Whether you are beginning the claims process from scratch or require assistance filing an appeal, our team may be able to help you. To schedule your free initial consultation and discuss your legal options, contact us today.

Understanding Lupus

Lupus, formally known as systemic lupus erythematosus (SLE), is an autoimmune disease where the immune system mistakenly attacks healthy tissues and organs. This disease can lead to a range of symptoms that affect the:

• Skin
• Joints
• Kidneys
• Heart
• Lungs
• And other organs

Lupus can cause chronic inflammation, pain, fatigue, organ damage, and varying degrees of disability depending on disease activity and individual health factors.

Lupus and Long-Term Disability

Living with lupus often involves managing symptoms such as joint pain, fatigue, rashes, fever, and organ involvement. These symptoms can fluctuate in intensity and frequency, impacting an individual’s ability to work consistently or perform certain job duties over time. LTD benefits can provide crucial financial support for individuals experiencing significant limitations due to lupus-related symptoms.

Most LTD policies cover disabilities that prevent individuals from performing the material duties of their own occupation or any suitable occupation based on their skills, education, and experience. Lupus, especially when accompanied by severe symptoms that affect work capacity, may qualify for LTD benefits. Individuals whose claims qualify may receive up to 70% of their regular income as they recover or learn to manage their symptoms. Depending on the severity of the disability, individuals may continue to receive LTD payments until the age of 65.

Filing a Long-Term Disability Claim for Lupus

To support your lupus disability claim, you may need:

• Medical Documentation: You should be prepared to submit detailed medical records documenting your lupus diagnosis, symptoms, disease activity, treatment plans, and functional limitations impacting work capacity.
• Treatment History: You may need records of prescribed medications, hospitalizations, specialist consultations, laboratory tests, and ongoing medical management related to lupus and its complications.
• Functional Assessments: These are reports from healthcare providers or vocational experts assessing how lupus symptoms and associated limitations affect your ability to perform job-related tasks safely and effectively.
• And More.

The type or amount of documentation that you’ll need to submit to file your LTD claim will be different depending on your policy and the circumstances of your illness/disability. If you’re unsure about how to proceed with your application, it is recommended that you speak with an experienced long-term disability lawyer as soon as possible. This way, you can ensure you don’t miss any important deadlines and submit all required documents correctly.

Can My Lupus Benefits Be Denied?

LTD benefits for lupus may be denied due to various reasons such as:

• Insufficient Medical Evidence: Lack of detailed documentation supporting the severity of lupus-related symptoms, functional limitations, and the impact on work capacity.
• Occupational Definitions: Differences in interpretation regarding job roles, physical demands, and suitability for alternative occupations based on lupus-related health status and functional abilities.
• Policy Restrictions: Policy exclusions, waiting periods, or limitations specific to pre-existing conditions, chronic illnesses, or autoimmune diseases like lupus.

Denials of lupus LTD claims can occur due to challenges in proving ongoing disability, demonstrating work-related limitations, or facing policy-related restrictions. Insurers may also question the necessity of ongoing treatments, accommodations, or job modifications needed due to lupus-related symptoms.

What To Do If My LTD Benefits Have Been Denied?

If your LTD benefits for lupus have been denied, there are several steps you can take to continue pursuing benefits. You should:

• Review Your Policy: Understand the denial reasons, appeal procedures, and timelines outlined in your LTD policy.
• Gather Strong Documentation: Compile comprehensive medical records, functional assessments, treatment history, work restrictions, and any correspondence related to your claim and denial reasons.
• Appeal with Support: Submit a detailed appeal with robust medical and vocational evidence supporting your ongoing disability and work limitations due to lupus.
• Seek Legal Assistance: Consult with an LTD disability lawyer focusing in lupus-related claims. A lawyer can review your case, provide legal guidance, advocate during the appeals process, and escalate the case to litigation if necessary to secure the benefits you’re entitled to.

Contact our Long-Term Disability Lawyers About Your LTD Claim or Denial Today

Dealing with LTD benefit denials for lupus can be daunting, but legal support can help you navigate the claim or appeal process with more confidence. Contact Preszler Injury Lawyers today to discuss your situation, understand your rights, and pursue the necessary steps to appeal and resolve your LTD denial, ensuring you receive the financial support essential for managing lupus and maintaining your well-being.