As a lawyer, you’ll likely have clients facing disability-related challenges, even if disability law isn’t your focus. This guide will help you recognize when a client might need specialized legal assistance.

Basics of Canadian Disability Law

Disability law in Canada covers several key areas, including income support (CPP Disability), Employment Insurance (EI), Disability Tax Credits (DTC), group insurance, private insurance, and human rights protections. Its purpose is to ensure that people with physical or mental disabilities receive fair treatment, necessary accommodations, and financial support.

Canadians who can’t work due to ongoing physical or mental health problems may be eligible for disability benefits and often don’t know their rights or where to begin.

When Can a Disability Lawyer Help?

If your clients have chronic physical or mental health conditions affecting their employment, they may be eligible to receive disability benefits from group insurance (through their employer) or privately purchased insurance (for professionals and self-employed). Many of these policies cover both short and long term disability benefits.

• Long-Term Disability (LTD): If a condition extends beyond the STD period, LTD benefits replace 60-70% of pre-disability income. Navigating LTD claims can be complex, and insurance companies often deny or terminate these benefits, requiring legal intervention.

• Short-Term Disability (STD): Provided through an employer’s insurance plan or government EI benefits, STD benefits cover up to six months if someone can’t work due to illness or injury. Medical proof of temporary disability is required.

Common Reasons Insurance Companies Deny Claims

Insurance companies deny many legitimate claims, often citing:

• Insufficient Medical Information: They may argue that there isn’t enough medical evidence to support the claim.

• Does Not Meet the Definition of Disability: Insurers often claim that applicants aren’t “sufficiently” disabled or are capable of returning to work, despite a doctor’s opinion to the contrary.

• The Insurer’s Doctors Disagree: Insurance companies may have their own doctors review the claim or require applicants to consult with them.

• Pre-existing Conditions Clause: Insurers frequently use this clause to deny claims if the applicant hasn’t had coverage long enough (e.g., less than a year).

• Surveillance: Some companies conduct surveillance, including monitoring social media or hiring private investigators, to dispute claims. Their conclusions aren’t always accurate.

When these disability claims are denied, our clients feel overwhelmed and alone. Some try to appeal or reapply, using up valuable time and energy.

What Should You Do Next?

If your client is dealing with a denied or challenging disability claim, here’s how to proceed:

• Encourage Your Client to Hire a Disability Lawyer: A disability lawyer understands the nuances of these cases and can prevent your client from falling into legal traps or loopholes. They level the playing field by holding insurance providers accountable and ensuring your client’s rights are protected.

• Assist with Evidence Gathering: You may have access to critical documents, like medical reports or employment records, that can support the disability claim and streamline the process.

• Stay Involved in Strategy: Disability claims often overlap with other areas of law, such as family, employment, or criminal matters. If a client’s disability impacts their ability to work, pay support, or meet legal obligations, collaborating with a disability lawyer strengthens the overall case.

By recognizing when disability law intersects with your client’s situation, you ensure they get the specialized support they need. This collaboration leads to better outcomes and helps protect your client’s rights against unfair insurance practices.