Why Are Some Disability Benefits Cut-off from the Policy Holder?

Many people with a long-term disability policy receive a notice after 2 years, saying that their benefits may be cut-off. This is when own occupation policy changes to an any occupation policy.

The same type of letter might be received by a policy holder that has completed a continuing disability review (CDR). In either case, the policy holder might be able to restore the delivery of benefits by meeting with an expert in vocational training. After 2 years, a minimum level of training might allow the formerly-disabled worker to return to the workplace, in a slightly-different position.

Types of CDRs

If a work review finds that a policy holder can earn more than expected with a substantial gainful activity, then that same policy holder will get cut-off from the disability benefits.

If a medical review finds that a policy holder has undergone substantial medical improvement, then he or she may no longer satisfy the requirements for receiving disability benefits. In that case, the policy holder’s long-term disability benefits will be cut-off. By the same token, a lack of improvement can push an insurance company to continue with the delivery of long-term disability benefits.

How frequently are CDRs given?

It depends on the severity of the condition that has caused the policy holder to qualify for long term disability benefits. Someone with a less-severe condition could expect to have more frequent CDRs.

The ways that the result of a CDR can trigger a cut-off of long-term disability benefits:

Personal injury lawyer in Sarnia knows that failure on the part of the policy holder to cooperate with the plans for a CDR. That lack of cooperation can trigger a cut-off of the long-term disability benefits.

Showing a failure to have followed either the suggestions for taking prescribed medicines or for undergoing a specific treatment. Such evidence can push an insurer to call for a cut-off of disability benefits.

A final reason for the cut-off of long-term disability benefits

Someone that has used fraudulent means to obtain long term disability benefits should not feel as though he or she has a free ride, until attainment of retirement age. If a review exposes the fraudulent nature of the condition claimed by the allegedly disabled individual, then he or she might need to deal with a cut-off of the disability benefits.

Remember, someone receiving fraudulent benefits might feel eager to pursue a personal injury claim following a motor vehicle accident. During pursuit of that claim, the injured victim would be expected to undergo an independent medical examination (IME). The physician doing that IME might note that the patient’s abilities exceed those possessed by someone that has a long-term disability.