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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. 

The Importance of Keeping Accurate Medical and Expense Records When Pursuing a Claim

The Importance of Keeping Accurate Medical and Expense Records When Pursuing a Claim

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After an injury, the last thing on your mind may be record keeping. But keeping accurate and detailed records of your medical and other expenses is crucial if you are seeking compensation for an injury or disability benefits. 

Your treatment will probably come with extensive and often unexpected expenses and keeping track of each one of these is essential.This information will be part of the evidence to support a personal injury claim. When it comes to long-term disability, any successful claim application must substantiate the injury as something that makes it impossible to return to work as well as the costs associated with your ongoing medical treatment. 

Accurate Records are Critical to Your Recovery

An essential part of your recovery or benefits will rely on having these comprehensive and organized expense records as well as all your medical information. These records should include things such as 

  • All expenses for treatment and prescription medications
  • All expenses for hospital and doctor visits
  • Costs for any medical equipment required
  • Results from any medical examinations
  • Any prognosis you may have been given
  • Statements from any attending physicians or other health care professionals
  • Any other medical records

If you have made any payments for procedures or have paid any expenses out of pocket related to your injuries, ask for receipts. These should include any transportation costs or other incidentals as they relate to your injury and care. Even if you aren’t sure of the importance of a document, it is better to keep it anyway and err on the side of caution. 

If you are filing a claim for injuries that were caused by someone else’s negligence, you may eventually choose to pursue compensation through a tort claim against that party. Having this information is critical to help your lawyer calculate what your damages are worth and the amount of your suit. 

Getting the Right Legal Assistance

When pursuing a long-term disability insurance claim or a personal injury claim, having comprehensive and organized records is critical to getting you the compensation and benefits you deserve. Contact the skilled team of Cambridge personal injury lawyers at Hilborn and Konduros if you have questions about a personal injury or long-term disability claim and what evidence and documents you will need. 

Own Occupation Vs. Any Occupation -- How the Disability Standards in Ontario Can Affect Your Benefits

Own Occupation Vs. Any Occupation — How the Disability Standards in Ontario Can Affect Your Benefits

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Long-term disability in Ontario has been a crucial lifeline for individuals who cannot work due to a physical or mental disability. But it is critical to understand the terms by which you are covered and whether that may change during the course of your disability. 

In Ontario, disability is measured by two standards. These standards will be set out in the terms of your individual policy. One is if you are unable to work in your own occupation, and the other if you cannot work in any occupation. Being unable to work in your own occupation may be the first standard you are measured against, but you may later be measured against the any occupation standard. 

In other words, you may have qualified for long-term disability benefits only to find that you will need to requalify under different conditions in the future if you are still collecting disability. 

How Courts Have Defined Both Standards

When it comes to insurance laws and policies, the courts have had to define the difference between the two standards for purposes of long-term disability.

For disability under the Own Occupation standard, the court has defined that to mean that 

  • You may be able to work, but you cannot do the essential duties of the occupation in which you were working. 
  • You may be able to perform some tasks of that occupation, but you are not able to do them in their entirety. 
  • A reasonable person in your circumstances would not be able to perform the tasks of your occupation

When the Own Occupation period has ended, usually after two years of disability, your insurance company may want you to meet the Any Occupation standard. The courts define this to mean

  • You cannot work in any occupation that you are reasonably qualified for given your education and experience. 
  • You may be able to work in another occupation given a period retraining but substantial retraining may be required. 
  • You have returned to work but were found to be incapable of doing your job due to your disability.

What standards you will be required to meet and how you will be required to meet them is critical to getting the disability benefits you need and deserve. These, however, will be entirely dependent on the precise terms of your individual disability policy. This is when you need the guidance of a Cambridge long-term disability lawyer. At Hilborn and Konduros, we can help you understand the terms of your long-term disability insurance. Contact us or call us at (519) 658-6341 to schedule a consultation. 

Getting Fairly Compensated for a Whiplash Injury Lawyers

Getting Fairly Compensated for a Whiplash Injury

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Unfortunately, getting fairly compensated for a whiplash injury can be challenging. Because it is a soft tissue injury and doesn’t have any outward symptoms, whiplash has gotten a bad reputation for fraudulent injury claims. In fact, most lawyers are now reluctant to even use the term “whiplash” for that very reason, instead referring to the injury as a neck strain or cervical muscle strain. Regardless of the name, it is one of the most common car accident injuries and can be serious and painful. If you have sustained a whiplash injury in an accident, you should be entitled to compensation for your damages.

Getting Prompt Medical Attention is Critical

In many cases, whiplash injuries are not immediately symptomatic. With any injury, but especially a soft-tissue injury, you will want to get prompt attention to have it medically documented. The treating doctor will understand what to look for, even if you have no immediate symptoms. Because adjusters look at whiplash claims suspiciously, the more medical documentation you have, the better your chances of getting fairly compensated. 

Begin Your Claim Process Immediately

Call your insurance company as soon as possible to begin the claim process. Although your injury may get better on its own, it may not. The sooner you begin the process, the more seriously the insurance company will view the claim. 

This does not mean that you should accept a quick insurance settlement, however. Before you accept any settlement, you need to know the full extent of your injuries and damages. 

Log Losses and Expenses

For any insurance claim, you will need to document any expenses, lost wages, property damages, and other losses. Insurance adjusters want to see proof of loss, and you should be fully prepared for this since many of these costs will be reimbursable. 

Proving Whiplash

If another party was at fault for your accident, you will need to prove fault in order to file a lawsuit to get fairly compensated.Having a skilled car accident lawyer on your side is essential when you have been injured in a car accident that was the fault of another driver. Contact the car accident lawyers at Hilborn and Konduros for a no-cost consultation at (519) 658-6341 to understand your rights.

Links Between Traumatic Brain Injuries and Dementia

Links Between Traumatic Brain Injuries and Dementia

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According to Brain Injury Canada, by the year 2031, traumatic brain injury is expected to become the most common form of neurological conditions affecting our population, right up there with Alzheimer’s and dementia. The interesting thing is that we now know that there is a link between the two. 

A traumatic brain injury is one caused by a blow or jolt to the head. While mild TBIs were thought to temporarily affect brain cells, with more serious brain injuries having long-term consequences, ongoing studies have found that certain types of TBIs may increase a victim’s risk of developing dementia years after the initial injury took place. 

Even a History of Moderate TBIs Can Create a Greater Risk for Dementia

One of the most important studies showed that older adults with a history of a moderate traumatic brain injury had a 2.3 times greater risk for Alzheimer’s than those without a history. Those with a history of a severe TBI showed a 4.5 greater risk for dementia. In addition, a study published by the Journal of Neurology found that a history of TBIs can accelerate the age at which cognitive decline can happen. 

While there is no current evidence suggesting that a history of mild TBIs shows any greater risk for dementia, the current emerging data shows that repeated injuries such as those experienced in contact sports show a higher risk of chronic traumatic encephalopathy, another form of dementia. 

Chemical Changes in the Brain

While further research will be needed to fully understand the link between traumatic brain injury and dementia, we are beginning to understand how TBIs change brain chemistry. Within hours of a traumatic brain injury, levels of beta-amyloid, a hallmark Alzheimer’s protein, increase in the brain. Chronic traumatic encephalopathy shows deposits of another Alzheimer’s hallmark, tau protein. 

While not everyone who experiences a traumatic brain injury will go on to develop dementia, it’s important to get any head trauma looked at immediately by a health care provider after an injury or accident. If you or a loved one has sustained a TBI in an accident, let our Cambridge personal injury lawyers help. Contact us for a no-cost consultation. (519) 658-6341

How Will COVID-19 Impact Long-Term Disability in Ontario?

How Will COVID-19 Impact Long-Term Disability in Ontario?

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COVID-19 has disrupted life as we knew it one short year ago. We have continued to see the health and economic consequences of the virus throughout Canada and learn more about its potential repercussions each day. 

As we learn more, it appears that the pandemic may have an impact on long-term disability in Ontario and worldwide. While our government has taken important steps to curtail the spread of the virus, for those 808,000 Canadians who have been infected, some will likely be suffering serious health effects both short-term and long-term. This may have a significant impact on long-term disability claims in the future. 

According to Mary Ann McColl, academic lead for Canadian Policy Disability Alliance and an epidemiologist at Queens University, “This is a whole new source of disability.”

Understanding the Consequences of COVID-19 Long Term

Worldwide, we are still trying to understand the effect that COVID-19 will have on our health in the future. The Lancet published information indicating that people who were hospitalized for COVID-19 but were discharged were still suffering from symptoms six months later. The Mayo Clinic has published a list of serious long-term and chronic issues that may be caused by the virus, including

  • Heart damage — imaging has indicated that COVID-19 recovery patients have shown lasting damage to the heart, even if they only suffered a mild case of COVID-19
  • Lung damage — COVID-related pneumonia has been shown to cause damage to alveoli in the lungs as well as scar tissue that can cause breathing issues.
  • Brain damage — COVID-19 has been shown to cause strokes, seizures, and Guillain-Barre syndrome in COVID-19 sufferers. It is even suggested that COVID increases the risk of developing Parkinson’s disease as well as Alzheimer’s. 

Depending on the terms of the policy, long-term disability benefits may be available to you if you are unable to work because of the complications and long-term effects of COVID-19. If you aren’t sure about your rights to long-term disability, contact the Ontario long-term disability lawyers at Hilborn and Konduros at (519) 658-6341 to understand if you may be covered.  

Why You Should Never Delay Treatment After an Accident in Ontario

Why You Should Never Delay Treatment After an Accident in Ontario

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Especially during these times of COVID-19, injury victims may be reluctant to seek medical treatment after an accident in Ontario. Unfortunately, this can not only cause you to suffer from your injuries needlessly, but lack of immediate medical attention after an accident can derail any claim you may file subsequently for your injuries. 

Injuries That Can Worsen With Time

Although some injuries may seem minor after an accident, things such as traumatic brain injuries or soft tissue injuries can become apparent days or even weeks after the accident. According to the National Institute on Neurological Disorders and Stroke, whiplash, a common injury in a car accident, will often take several days to become apparent. Things such as brain bleeds can cause symptoms as elusive as a headache but can have life-threatening implications. 

Waiting to get medical care can worsen the severity of an injury, particularly ones that rely on critical immediate diagnosis to curtail their severity. 

How a Delay in Treatment Can Hinder Your Injury Claim

After an accident, your insurance company will look at the actions you took immediately after the accident when considering a settlement for compensation. Unfortunately, injured parties who do not seek medical attention immediately after their accident can be seen adversely by the insurance company. Insurance may use it to show that your injuries were not as severe as you claim. This can result in a reduction of benefits or even a denial of your claim. 

If you seek further compensation from the at-fault driver, the driver will only be liable for the injuries directly sustained in the accident. If you delay treatment, you run the risk of your condition worsening and the at-fault driver not being considered responsible. 

If you have been injured in a car accident in Ontario and are having difficulty getting fairly compensated by insurance, contact the personal injury team at Hilborn and Konduros at (519) 658-6341 to get important legal advice about your options. 

How a Slip and Fall Claim Against a Municipality Differs From One Against a Private Owner in Ontario

How a Slip and Fall Claim Against a Municipality Differs From One Against a Private Owner in Ontario

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We are in the middle of winter, which is slip and fall weather here in Ontario. Unfortunately, slip and fall accidents can result in serious injuries. As an injury victim, you may be able to file a slip and fall claim against the property owner. But what if you sustain your injury on public property?

A Slip and Fall Accident on City Property

In Ontario, walkways and other areas on city property are often in a state of disrepair and can be icy in the winter. This can lead to slip and fall accidents. But unlike private properties, Ontario’s Municipal Act governs a slip and fall accident on any city property. These are handled differently than if you had sustained an injury on private property. 

A Different Standard of Care 

A slip and fall accident occurring on private property is governed by the Occupiers’ Liability Act and requires proof of the owner’s negligence for a successful claim. But for the city to be held liable for an injury on public property, Ontario’s Municipal Act requires that the injured party prove that there was gross negligence involved. Consequently, since the standard of care is different, not all slip and fall accidents on city property may be eligible for an injury claim. 

A Time Limit to File

There is also a 10-day time limit for a slip and fall claim to be filed in order to succeed against a city or municipality. The city must be advised by registered mail of a slip and fall occurrence within ten days of the accident. Failure to do that can potentially void a claim against the city for your injuries. 

Slip and fall accidents can cause severe injuries and extensive costs. You may be able to hold the city accountable, but a slip and fall claim against a municipality is often challenging to prove. If you have suffered a slip and fall accident on municipal property in Ontario we may be able to assist you with a claim against the city. Call the personal injury lawyers at Hilborn & Konduros Law Firm for a free consultation at (519) 658-6341 to discuss your case. 

Things You Must Know About Pain and Suffering Claims in Ontario

Things You Must Know About Pain and Suffering Claims in Ontario

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If you have been injured in Ontario, you may be eligible for compensation for your damages. This can include compensation for what is called “pain and suffering.” 

The term pain and suffering is a blanket legal term that refers to physical and emotional pain and turmoil that you have suffered as the result of your injuries. Unfortunately, pain and suffering is highly subjective and can be difficult to quantify for purposes of an injury claim. 

What Will Be Considered When Determining a Pain and Suffering Award?

Here in Canada, compensation for pain and suffering is not an easy thing to pursue. An injured party must exhibit serious physical, mental, or psychological impairment to be awarded pain and suffering compensation. 

When considering a pain and suffering claim, the court will consider many things, including:

  • The nature of the injury
  • The severity of the injury
  • The severity and duration of the pain 
  • Emotional suffering
  • The injured party’s age
  • Any disability
  • Any loss of life expectancy
  • Any loss of amenities
  • Impairment of life
  • Impairment to family, marital or social relationships

as well as other things that the court may consider relevant to the claim. 

Caps on Awards

There are also caps on pain and suffering awards in Ontario to consider. In 1978, the Supreme Court imposed caps on the amount of compensation that could be awarded in these claims. These are adjusted periodically for inflation and are currently at $390,883. But awards are usually far below this except in the most serious of cases. 

Getting Legal Assistance

Substantial documentation is needed to prove pain and suffering in Ontario. As an injured party, the onus of proof is yours which can be difficult if you are suffering severe disability from your accident. Having the guidance of a skilled Ontario personal injury lawyer is critical. Contact the personal injury lawyers at Hilborn & Konduros Law Firm for a free consultation at (519) 658-6341 to discuss your case. 

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