When you enroll for Group Benefits at your workplace, if you are being provided with LTD Benefits (Long Term Disability Benefits), you should make sure that you check that you have the amount of coverage you think you have.
LTD Benefits Could Be Limited
By way of an example, take the following situation.
Jane works as an administrative assistant in a professional office. When she started working, she was given forms to fill out to enroll in the Group Benefits, including LTD benefits. Jane’s salary is $45,000.00 and she understands that her LTD benefits are supposed to be based on 60% of her salary, or $2,250.00 per month.
What she doesn’t know or understand is that her LTD benefits are subject to a “Non-Evidence Limit” of $1,250.00 per month. This means that unless Jane completed some additional forms, which includes some medical questions, her LTD coverage would be limited to $1,250 per month, even though 60% of her salary is $2,250.00 per month.
Apply For Coverage Using Necessary Forms
Often employers aren’t made aware of this requirement either, or they may forget to provide the necessary forms to allow people to obtain the higher coverage. Assuming Jane had no prior health problems, it is very likely that she would have been able to obtain the extra coverage. If the failure to apply for this coverage was because she ignored the form (or didn’t bother with it) even though she was provided with this option, then the problem is Janes.
If, however, her employer failed to provide her with this information, the employer may be liable for the difference between the non-evidence limit and the coverage up to the 60% mark.
Now if Jane simply didn’t want to apply for this coverage, or forgot to, it creates a situation that may result in her LTD benefits being worth almost nothing. Depending on Jane’s contributions into the Canada Pension Plan, if she becomes disabled, the policy would require her to claim for CPP-D benefits, which could be as high as approximately $1,300. As most policies provide for a direct offset for CPP-D, if Jane was entitled to receive $1,300 from CPP-D, she would be entitled to receive nothing from her LTD insurance policy.
Check The Fine Print
To sum up, if you are an employee with LTD benefits, check the fine print to make sure you have the coverage you think you have. If you are an employer or a broker, make sure you are properly administering the plan for your employees so that you don’t end up having to make up the difference.
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A note from our long term disability lawyers
Taking a medical leave from work is not an easy decision to make. Concerns about providing for yourself and your family and keeping your job may cause you to want to push through your pain, but this won’t make your problems go away. Stopping work is often the smartest decision for your long term health and well-being, and your disability benefits are there to provide you with financial support until you can return to work.
If you have made the tough decision to stop working and apply for your short term disability or long term disability benefits, you may feel overwhelmed by the process and have questions that your employer and your insurance company are not able or willing to answer. Share is There to see you through and answer your questions.
Our Disability law firm knows what you have been going through
We understand that things have not been easy for you over the last little while. Your health has been suffering, you are unable to work, and now your insurance company, who was supposed to be there in your time of need, has decided they will not pay your disability benefits or respect your disability claim. These benefits exist to provide you with the financial support you need so that you can focus on your health and rebuilding your life. It is unfortunate that your insurance company has not lived up to its promise. If your disability claim has been denied, we will fight to get you the benefits you are entitled to. Our disability lawyers have helped thousands of Canadians get their long term disability benefits over the past 35 years, and we can help you too.
Our experienced disability lawyers can fight back on your behalf
Share Lawyers believes that every client who is dealing with a disability claim deserves superior personal service. To achieve that goal, we have developed our team of experienced, compassionate, and caring long term disability lawyers, law clerks, and administrative staff to meet all of your needs. Our team of experienced long term disability, life insurance, employment, and critical illness insurance lawyers have made successful claims against many insurance companies, third-party administrators and employers.
If you are unable to work, your disability benefits should be there to provide you with the financial support you need. While your insurance company may be focused on finding ways to avoid paying your claim, our focus is on what is in your best interest. When Share Lawyers gets involved, you have an entire team of lawyers that are there to support you and to fight for what is yours.
Our disability claim lawyers fight for your disability insurance claim by relying on our many years of experience to apply the best strategic planning and approach in each case, using the latest technology available. Experience matters, and with Share Lawyers, you are in the best hands with 35 years of success on your side.
In this video, we explain the role of a long term disability lawyer and how we can support you when you have been denied your long term disability benefits.