What Makes You Qualified for Disability Benefits?

Dealing with an injury or illness that prevents you from working can be extremely difficult and frustrating. Fortunately, disability insurance benefits can provide crucial support by supplementing your lost income. However, like any insurance, there are specific qualifications you must meet to obtain these benefits.

So, what makes you qualify for disability benefits? We’ll help you understand the necessary criteria and explain how Share Lawyers can assist you in securing the benefits you deserve.

Need more information on what makes you qualified for disability benefits? Share Lawyers’ experienced team can answer your questions.

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What Makes You Eligible for Disability Benefits

It’s natural to wonder what makes you qualified for disability benefits if you’re facing an illness or injury that might prevent you from working. However, most won’t know precisely what prerequisites need to be fulfilled to be eligible for this safety net.

Many people assume that disability benefits are only for those who are bedridden or unable to perform daily tasks. However, this is a small percentage of those who qualify for disability benefits.

Generally, any illness or injury that prevents you from performing the essential duties of your occupation (being unable to work) will qualify for disability benefits.

However, specific coverage qualifications will depend on the terms and conditions outlined in your insurance policy.

Regardless, there are standard criteria and processes that most insurance providers in Canada will follow.

1. Policy Details and Coverage

  • Policy Activation: Your policy must be active, and you must have been paying premiums as required by the policy.
  • Elimination Period: Most policies have an elimination period, also known as a waiting period, which must pass before benefits start. This period can last from a few weeks to several months.

2. Definition of Disability

  • Own Occupation vs. Any Occupation: Policies typically define what constitutes a qualified disability based on the inability to perform duties of your occupation or any occupation.
    • Own Occupation: “Own occupation” policies are generally more lenient and provide benefits if the insured cannot perform their specific job duties.
    • Any occupation: “Any occupation” policies are less lenient because they require you to be unable to perform any job that you are reasonably suited for by education, training, or experience.

3. Medical Evidence

  • Doctor’s Certification: A medical professional must confirm that you meet your policy's definition of disability. This typically includes submitting medical records, test results, and a detailed statement from your doctor about your condition and its impact.
  • Continuous Proof of Disability: Your insurance company may require continuous evidence of your disability, including periodic medical updates and examinations.

4. Exclusions and Limitations

  • Pre-existing Conditions: Many policies do not cover disabilities resulting from pre-existing conditions if these were not disclosed when applying.
  • Specific Exclusions: Some policies exclude certain disabilities, such as those caused by self-inflicted injuries, substance abuse, or criminal activity.
  • Duration of Benefits: Policies often limit how long benefits are provided, either for a specific number of years or until a certain age.

Generally speaking, if you have a disability that prevents you from working and you fulfill the criteria outlined here, you should qualify for disability benefits. However, even if you qualify for benefits, your insurance company may still deny your initial claim.

What To Do if You Qualify But Your Claim is Denied

Insurance companies often deny valid disability claims to cut costs, leaving many deserving individuals without the benefits they need. They use confusing tactics and technicalities that can be overwhelming if you’re unfamiliar with disability law.

If this happens to you, Know that there is hope. Reach out to an experienced disability law firm like Share Lawyers right away. We’ll assess your claim and guide you through the appeal process to secure the benefits you deserve. With our support, your chances of success will significantly improve.

Share Lawyers Won’t Let Your Insurance Company Win

We understand how frustrating it is to face a denial despite following all the steps. That’s why we advocate for Canadians like you, fighting to secure disability benefits after a denial. Now that you know that any illness or injury that prevents you from performing the duties outlined in your policy makes you eligible for benefits, it’s time to start your claim.

With over 35 years of experience, you can count on us to diligently appeal your denial and guide you through the entire process. It all starts with a free consultation, and you won’t owe us anything until your benefits are secured.

Still need more information on what makes you qualified for disability benefits? A quick conversation with one of our lawyers will help you understand your situation and provide a path forward.

Contact Share Lawyers today and let our 35+ years of experience work for you. We can help you win your case againstCanada Life, Desjardins, Manulife, RBC Insurance, Sun Life, and other insurance companies. Our legal team offers a free consultation and works on a contingency basis. There are no fees unless you win your case.

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