What Are Long-Term Disability Benefits?

What Are Long-Term Disability Benefits?

Long-term disability benefits essentially act as a type of income-replacement. You will receive the disability benefits as long as “your LTD insurer” decides that you are unable to work. Once you have qualified for your long-term disability benefits, you will be provided with periodic payments for as long as you are unable to work or as long as your benefits are valid for. Although policies are similar, it is important to understand what you qualify for. That’s why it’s always smart to get in touch with a lawyer who understands and specializes in long-term disability like De Rose.

It’s important that you have a suitable long-term benefits plan in the unfortunate chance that you find yourself suffering from an unexpected illness or injury and are unable to work.

How Do I Qualify for Long-Term Disability Benefits?

It depends. Many illnesses or injuries that prevent you from working for a prolonged period of time may qualify, but it depends on the plan you have in place. Physical illness or injury such as cardiovascular disorders, bodily injury, acquired brain injuries or cancer can leave you unable to work at your current job or any job. Mental illnesses such as major depression, PTSD, severe OCD or many others also qualify for long-term disability benefits.

The bottom line is, you must meet the definition of your policy.

When Do I Qualify for Long-Term Disability Benefits?

It also depends. Long-term disability benefits come into effect once you’ve already used up your short-term benefits. For instance, a short-term disability insurance plan or more commonly, Employment Insurance (EI) which you pay into every paycheque and is paid out by the government. After you’ve become disabled, there is typically a 90 to 120 day period which is called the elimination, waiting, or qualifying period before your long-term benefits come into effect.

There are two different kinds of tests that are common in a group policy and sometimes both tests apply to one policy. These are “regular or own occupation” and “any occupation”. You can read more about what those mean here.

Not many private policies exist. The percentages vary, and qualification dates vary. There is no standardized formula for this type of benefit. That’s why it’s very important to talk to a lawyer to properly understand your policy and what these different terms mean.

How Do I Check My Long-Term Disability Insurance Policy?

Fortunately, many employees have access to long-term disability insurance. Sometimes this insurance is automatically included through your employer via payroll, but other times it’s up to the individual to privately purchase their own long-term disability insurance from an insurance company or broker. This is especially important as more and more Canadians opt for freelance or self-employed jobs. While no one plans to fall ill for an extended period of time, long-term disability insurance is a crucial thing to have.

How Do I Apply for Long-term Benefits?

This is a form doctors don’t fully understand – MVA forms are standard and most doctors understand those. The first LTB application is incredibly important, and the medical report is critical. It must immediately meet the contractual obligations.

You have to contact your insurance and they will send you a form that must be filled out by a medical professional. It is EXTREMELY important that your medical professional understands why you cannot work. If the details aren’t filled out with specific details about why you can’t work, your claim may be denied.

That’s where we come into play. It’s important you contact us before you speak with your doctor. We can help you understand what obligations need to be met for your specific contract and how to properly talk to your doctor to get your forms filled out the way they need to be, before you submit them. If this is done improperly, you may be denied and will have to restart the process from the beginning.

You can’t afford to have a denial, and then contact a lawyer. This will delay you from getting your coverage and leave you without income and higher medical expenses for much longer.

In order to access your long-term benefits, you need to meet with your doctor and possibly other medical professionals to provide medical evidence that you are disabled and unable to work. This evidence will need to be provided on an ongoing basis to continue receiving your benefits. Whether your claim involves invisible illnesses such as chronic pain or mental illness, or objective injuries which are injuries that can be seen, the medical evidence is still required to process your claim.

It’s important to make sure that you provide your adjuster with all of the required medical records that support your claim. Many adjusters are working on multiple claims at any given time and it is not their responsibility to request records from every clinic you’ve been to. If you have test results that further your case, it’s very important you obtain them and send them to your adjuster personally. This improves your chances of being approved and can possibly shorten your approval time.

Was Your Disability Claim Denied?

If your benefits have been denied, it’s very important that you get yourself a long-term disability lawyer. Criteria above may not have been met; filling out the forms, not having all of the forms, etc. This process is time sensitive due to most being unable to afford being without income. Seriously financial consequences could occur if you wait.

Long-term disability insurance is meant to provide financial assistance to you in your time of need. When an insurance company wrongfully denies your claim, you need to seek competent legal advice as quickly as possible. Your best choice is to hire an experienced long-term disability lawyer to review your rights and remedies. They will work with you to make sure your benefits are reinstated.

Why Choose De Rose Lawyers?

Long Term Disability Insurance is out passion – we care about getting the best outcomes for our clients. We believe that people want to work and take pride in their jobs. We know that if you’re claiming your benefits, it’s because you have to and truly need the money. It’s not an easy process to complete and insurance companies’ prey on people not understanding their rights and take advantage of that. They know they can wait you out and will try everything to do so. De Rose believes you need this money and we will work tirelessly to get you what you’re entitled to.

At De Rose Lawyers, we have over 40 years of combined experience working for innocent victims who have been wrongfully denied their benefits. We are here to help you get the long-term disability compensation you deserve and to make sure the maximum benefits owed are paid to you and your family.