If you are suffering from a long-term disability or serious illness and are unable to work as a result, it is important that you get the financial assistance you need to support yourself and your family. This support may either come from the Government of Ontario or it may come from the long-term disability insurance that you hold either as an individual or through your employer.
Unfortunately, navigating your long-term disability claim can be complex and filled with red tape – making an already stressful situation even worse. To help you through the claim process and qualify for the financial benefits that you are entitled to, here are a few things you need to know.
What is considered a long-term disability?
Unfortunately, in Canada, there is not a clear definition as to what is considered a disability and the definition may vary depending on the insurance policy. In Ontario, there is even a difference between what insurance companies and what the government sees as a long-term disability. The Ontario Government defines a long-term disability as one that lasts more than 15 weeks. Most insurance policies define it as lasting more than six months.
It should also be noted that a long-term disability is not necessarily the same as a permanent disability. When you are able to return to work, your insurance policy will either stop paying out or the amount you receive in payments will be significantly reduced.
What support can I expect if I have a long-term disability?
In Ontario, you are not required by law to hold your own long- or short-term disability insurance, nor is your employer required to provide it.
The Canadian government offers two kinds of support: Employment Insurance (EI) which provides financial support during the first 15 weeks, and Canada Pension Plan (CPP) disability benefits which can be accessed after EI ends. In both cases, you can expect to receive 55% of your average weekly income up to a maximum of $51,300 per year for long-term disability claims.
If you have your own long-term disability coverage, you may expect to receive between 60-85% of your average weekly income.
Another major difference between long-term disability payments from the government and those from insurance companies is that an insurance company will begin payments as soon as any short-term disability payments end. With government payments, it can take up to a year after EI payments end to start receiving CPP payments.
What will I need when I make a claim for long-term disability payments?
When making a claim, it is extremely important that you carefully read through each section of the claim form so that you know what information is required. When applying for a claim with an insurance company, you’ll need to check the policy for the specific claim procedure.
When applying for government support, you will need the following:
- Ensure that you or your employer have made all necessary contributions and payments to the CPP program.
- To have worked between 420 and 700 hours is the last 52 weeks.
- Able to prove that you have a disability as defined by CPP.
What questions will be asked on my claim form?
When applying for long-term disability insurance, you will be required to supply medical documentation. There will also be a number of questions which might include:
- When did symptoms first appear?
- When did the injury or illness prevent you from working?
- Have you ever had this injury or illness before?
- Describe how the injury or illness prevents you from working.
- What treatment are you currently receiving?
- Names of physicians or specialists you have seen or will be seeing for your injury or illness.
- When do you expect that you will be able to return to work?
- Provide details of your savings and investments.
Are you making a long-term disability claim? Hoffman Law can help.
If you are unable to work because of an injury or illness, it is essential that your long-term disability claim is handled in the most effective way possible. An experienced lawyer from Hoffman Law can assist to ensure that you are able to receive the full benefits you are entitled to. Have questions? Contact for a free consultation at 416-631-0000.