Gastrointestinal Surgery and Disability Claims

Posted by Share Lawyers on May 3rd, 2017

41-year-old Jade was a nurse in the emergency department of a major hospital in North York. Things at work were stressful - the hours were irregular and she was constantly on her feet. Jade lived alone and was often too exhausted to cook for herself when she was done a shift at the hospital. She relied on take-out  and frozen dinners for most meals.

Jade had struggled with weight issues for the majority of her life. She often tried restrictive diets, which only lasted a few weeks at a time. After each unsuccessful attempt at losing weight, however, she went through long periods of ignoring her caloric intake and mindless eating. 

In early 2009, after several months of eating unhealthily, Jade began experiencing intense stomach pains and heartburn. She sought advice from her physician, and after having a gastrointestinal ultrasound, was told to seriously consider gastrointestinal surgery for Gastroesophageal Reflux Disease.

With Jade’s hospital connections, she was able to plan and book her surgery quickly. As a nurse, she understood that her health should be her top priority.

The surgery went well and Jade was soon back at work. But almost a year later, Jade began to experience some disturbing side effects. One day she felt nauseous at work and had to excuse herself and take a cab home. Two days later, she took sick two hours into the work day, and had to go home sick.

The following week was followed by even more frequent occurrences of intense nausea. Deciding that this was now more than a random series of events, Jade decided to see her physician again. After running some tests, her physician prescribed her some medicine to help with the symptoms. She would have to schedule a consultation with her physician at least four times a year, but at least the nausea would be manageable and she could continue working. This was the case for the next  couple of years.

Last year Jade’s condition worsened. Her symptoms were now impacting her work, personal and social life. She was experiencing more frequent episodes of illness and was putting on weight as a result of all the stress. With all of this happening, situational depression hit hard. Jade didn’t want to admit it but she had to make a decision between her health and work. She finally understood the severity of her condition, and ultimately decided that it was time to stop working.

She gathered the necessary documents and made her claim for long-term disability benefits. Jade was in complete disbelief when her claim was denied. She had never missed a payment especially since her surgery in 2009 - she always anticipated her situation even though she dreaded it. After multiple back-and-forths, the insurance company stated that her claim was denied because the surgery had been back in 2009 and she had  worked for over a year afterwards.

Jade was unwilling to accept this answer. While doing some research happened to come across a Share Lawyers blog post about long-term disability claims. After a consultation meeting, the Share Lawyers team immediately got to work on her case to get the insurance company to approve the claim.

An agreement was reached at mediation Share Lawyers was able to negotiate a lump sum settlement. Jade felt that she had been bullied by the insurance company and so was very happy with the understanding and care she received at Share Lawyers. Now she could focus on her health, knowing that her benefits would support her during her recovery.

This information is brought to you by Share Lawyers, Ontario's Leading Disability Insurance Lawyers.

[All names and identifying details have been changed to protect the confidentiality of all involved.]

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Joined: January 3rd, 2017
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