Are You Eligible to Make an LTD Claim?
Are You Eligible?
What if My Disability Didn’t Happen at Work?
Even if you receive your LTD coverage through your employer, you don’t need to have been injured at work to qualify for long- term disability benefits. LTD insurance isn’t there to compensate you for workplace accidents – it’s to replace your income if you become unable to work.
What Qualifies as a Long-Term Disability?
Most LTD policies cover you no matter what injury or disability pre- vents you from working – the key point is that you aren’t able to work.
Some policies, however, exclude certain specific illnesses; others may exclude illnesses that are compensable under a workplace compensation claim.
Note that the disability must have happened since the time your LTD insurance was active, so any disability you had before you got your insurance will be excluded.
How Disabled do I Have to Be to Qualify?
Generally, you will qualify for LTD benefits if you are not able to do all (or most) of the duties of your current job.
Some policies say you must be “completely disabled” to qualify for benefits. That’s usually just a different way to state the point above – that you must be unable to perform the normal functions of your usual job. It doesn’t necessarily mean that you must be completely unable to do any part of your job at all – just that your disability is such that it would be better for you to stop working so you can focus on getting better.
Certain policies also require that, to qualify, you must be unable not only to do your current job, but any job for which you are qualified. Your policy documents will have full details.
When Can I Apply for Benefits?
You need to be off work for several months before you can access LTD coverage – this is called the “elimination” or “qualifying” period and it generally ranges from 90 to 180 days (3 to 6 months). Your policy will specify the exact waiting period that applies to you. The waiting period exists to ensure that injuries are truly “long term” and not something that will heal in a few weeks.
In the short term you may have access to Short-Term Disability coverage (also called a Weekly Indemnity benefit plan) – those benefits will be available after a much shorter waiting period. If you don’t have access to Short-Term Disability or Weekly Indemnity benefits, you may qualify for Employment Insurance Sickness Benefits through the Government of Canada. These can provide you with up to 15 weeks of sick benefits that usually provide up to 55% of your weekly income.
