Which medical conditions qualify for disability benefits in Ontario?

The answer may not be as straightforward as you would think

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 disability benefits in Ontario’?

This is both a common and complicated question. It’s common because 22 per cent of Canadians, 15 years and older report having at least one disability. And it’s complicated because the eligibility qualifications are not clear.

So, what conditions qualify for disability benefits?

Many medical conditions can potentially qualify for disability benefits but it depends on the degree of disability and whether the disability meets the requirements of your benefits plan and program. The determining factor is the level of impairment, rather than the name of your diagnosis.

What are the challenges?

Each medical condition comes with its own challenges. Mental illness, for example, is an invisible ailment that can’t be seen in a diagnostic test. In many cases, an insurance company will often 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,” said 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.

Disability insurance policies are not all the same

To qualify 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 (to name a few) use different (but similar) language in defining what constitutes total disability under their respective long term disability policies, and 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.

What medical conditions qualify for long-term disability?

Assuming you don’t have an excluded condition, you can qualify for long-term disability benefits if your medical condition prevents you from doing your regular job. 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

Medical conditions that may qualify for long term disability benefits and are often overlooked include, scar tissue, spinal cord injuries and nerve damage, bowel disease and gender dysphoria.

While some conditions may not appear to be disabilities, they can still adversely affect a person’s life. They may need care, support, and expert legal assistance to ensure their claim is approved.

Have your disability benefits been denied in Ontario? What is your 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 not wait to call a disability lawyer. The longer they wait, the longer they will be without income. Samantha Share said, “A disability lawyer can get the appeal or lawsuit process started right away. 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. Join us on Facebook and become a Top Fan for a chance to win each month.


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.

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