What Qualifies for Long Term Disability
Statistics show that nearly one-third of people who suffer a severe disability continue to work. If you’re one of those people, you may be wondering, “what qualifies for long term disability insurance?”
This is both a common and complicated question; 22 percent of Canadians, 15 years and older report having at least one disability, and eligibility qualifications are not clear. Oftentimes, the qualifications have more to do with the level of impairment than the diagnosis.
Many medical conditions can potentially qualify you for disability benefits but it depends on the degree of disability and whether the disability meets the requirements of your benefits plan and program.
What qualifies for long term disability?
A medical condition that prevents you from doing your regular job is what qualifies you for long term disability benefits. Some common injuries and medical conditions are:
- Fibromyalgia and chronic pain
- Mental health problems
- Back and neck injuries
- Cancer
- Mood disorders
- PTSD
- Migraines/chronic headaches
This isn’t an exhaustive list of medical conditions that may qualify for long term disability benefits. Some that may qualify but are often overlooked include:
While some conditions may not appear to be disabilities, they can still adversely affect a person’s quality of life. They may need care, support, and be unable to work, and may need expert legal assistance to ensure their claim is approved.
What are the challenges in qualifying for long term disability?
Each medical condition comes with its own challenges.
Mental illness, for example, isn’t always visible in a diagnostic test. In many cases, insurance companies will reject a physician’s assessment as not being persuasive enough.
“Insurance companies do not tell you that they look for any and every way to not pay benefits,” says Samantha Share, Assistant Managing Director at Share Lawyers. “They often will refer to the fact they have had their medical consultant review the claim and base their decision to deny benefits on the document review opinion of that unnamed medical consultant.”
With one in three workplace disability claims in Canada related to mental illness, this is alarming.
All long term disability insurance policies are not the same
If you’re wondering what qualifies for long term disability benefits, you must establish that your medical condition prevents you from being able to do your job or any job for which you are qualified. However, different insurance companies, such as RBC Life Insurance, Manulife and Sun Life, for example, use different (but similar) language in defining what constitutes total disability under their respective long term disability policies. It is important to review and understand the specific definition of total disability that would apply to your claim.
Use this free online tool to determine how an experienced lawyer can help you navigate your claim.
Have your disability benefits been denied? Here’s your best next step
Claimants with denied disability benefits should use one of the free online tools available to find out if they have a valid disability case and should contact a disability lawyer. The longer they wait, the longer they will be without income.
“A disability lawyer can get the appeal or lawsuit process started right away,” Samantha Share reminds us. “They also can make suggestions as to alternate forms of income that may be available to the claimant during the waiting period.”
Denied your long term disability claim?
Contact Share Lawyers today and put our experience to work for you. Our 35+ years of experience can help you win your case against Canada Life, Desjardins, Manulife, RBC Insurance, Sun Life, and other insurance companies. We offer free consultations and there are no fees unless you win your case. Watch our web show, Your Disability Lawyers, on YouTube, or listen to the podcast on Google Podcasts.
