Most Long-Term Disability policies cover you no matter what injury or disability prevents you from working. 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 Long-Term Disability 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 all the 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 forEmployment 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.
Since disability plans can be hard to interpret, it’s particularly useful to get a consultation with a lawyer with extensive experience in long-term disability cases as soon as your benefits have been denied or terminated. A lawyer can help explain your legal options and try to get your benefits back on track.
CLG Injury Law offers a free consultation where you can discuss your case with a disability lawyer. The consultation is confidential and there is no obligation. We have offices in all three Maritime Provinces and can be reached at 1-844-CANTINI.