Before You File: The Long-Term Disability Claim Preparation Guide for Ontario Workers
Learn how to prepare your Long-Term Disability (LTD) claim before filing: essential timelines and expert tips for Ontario workers.
As a recently disabled Ontario worker, you’ve (very understandably) been wrestling with feelings of uncertainty and helplessness. Used to being in charge of your own life, you find it difficult to contemplate depending on others for support – financial or otherwise. Â Despite those frustrations, you’re a person of action, prepared to take the next step – which is filing a Long-Term Disability Claim.
From what source or sources can you expect benefits?
Depending on where you were employed prior to the disability, you may be claiming benefits through one or more of these three programs:
- the Ontario Disability Support Program (OOSP)
- the Canada Pension Plan Disability Benefits (CPP)
- a private Long-Term Disability Insurance
First, though, you have many questions about the process of LTD claim preparation itself:Â
- How do I prepare myself for the process of filing a claim?
- What medical records do I need before filing a Long-Term Disability claim?
- How do I gather evidence before I apply?
- How long it is likely to take to file a Long-Term Disability claim here in Ontario?
- Do I need legal help? Can I prepare a LTD disability claim without a disability lawyer?
- How do I find a Long-Term Disability lawyer in Ontario?
It’s difficult to concentrate on all these details. So much to think about…Your whole life is undergoing change, and if you’re like others adjusting to a disability, you’re experiencing sorrow, loneliness, and even anger as you contemplate a future very different from what you’d been expecting. Still, you know it’s crucial to proceed with care in order to qualify for the financial benefits you know you’re going to need.
What’s true and what’s not – dismissing disability myths and misinformation
- It is not true that you can qualify for disability benefits only if you cannot do any work at all. Your education, skills, experience, and age will all be considered in addition to your medical diagnosis and prognosis, along with your overall ability to function and participate in your own care.
- It is not true that only those with visible and physical disabilities qualify for benefits; mental illnesses (bipolar disorder, depression, or PTSD, for example) can cause an inability to function at work.
- It is not true that one source of Long-Term Disability benefits is intended to provide the full amount of pre-disability income. The Canada Disability Benefit is designed to supplement the income from other sources of help, such as the Ontario Disability Support Program and/or private or employer-provided LTC benefits.
- It is not true that once you’ve qualified for LTD benefits, they can never be stopped; you can expect regular reassessments of your situation.
As Robert Konduros of Hilborn & Konduros, Disability, Employment and Personal Injury Lawyers, expresses his mission: “We navigate the complexities of the legal landscape.”
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What medical records do you need before filing an LTD claim in Ontario?
In order for your application for LTD benefits to get the consideration it deserves, it is up to you to clearly demonstrate that it is your physical or mental medical condition preventing you from doing the kind job you were trained and educated to do (or, later, any job for which you’re reasonably suited based on your experience and education). What’s more, any medical conditions that were present before the disability must be fully disclosed.
Medical support is critical in applying for disability benefits. You’re going to need records of:
- notes from family doctor visits
- imaging results (X-rays, MRIs, CT scans, EMGs, EKGs)
- lab test results
- medications
- documentation of therapy sessions (chiropractic, massage, aquatic, occupational, speech or language therapy)
- notes from any specialists or mental health professionals who have been consulted about your condition
- hospital records
- rehab session records
The more organized your file, the easier it will be for the insurance company to review the information and “rule” on it.
Getting approved for Long-Term Disability benefits in Ontario, Canada – a reality check
Under the Canada Disability Benefit program, if you qualify, you will begin receiving payments the month after your application is approved. Realistically, though, the approval rate for first-time disability claims in Ontario, Canada is not high, and more than half are initially denied.
The process of navigating the disability claims system, with all its deadlines and legal procedures, can be daunting, particularly while you’re coping with so many unexpected life changes. Having expert legal help; can significantly improve your chances for a successful disability claim in Ontario.
 A disability lawyer can act as your advocate
Your disability lawyer:
- understands the regulations
- ensures that your medical evidence is presented completely and effectively.
- helps you understand your rights and options
- makes sure your paperwork is complete and filed on time
- negotiates with your insurance company
- if needed, advocates for your rights in court
LTD Claim Preparation Checklist for Ontario Workers:Â
- Review your Long-Term Disability insurance policy or your employer’s group benefits plan. Notice the definition of disability and the waiting (elimination) period before benefits start. Check to be sure your policy was in force at the time your disability began.
- Ask your employer (Human Resources Department?) and/or the insurance provider for the application forms (there will be parts of the application for the employer to complete).
- Gather the medical evidence from your doctors, including each specialist or therapist who treated you or who is now treating you.
- Keep detailed records of every meeting, letter, email, and text message that related to your case.
- Be prepared for an insurance adjuster to contact you via telephone or email to confirm the information on your claim.
“Know before you go” – filing a disability claim is no easy process
Despite your feelings of frustration and uncertainty, you’re prepared to face the future by taking the necessary actions to get financial support. You realize you’re going to need help navigating all the complexities of filing a claim, and it makes sense, as you begin the process, to meet with an experienced Ontario disability lawyer to plan the most effective way to successfully present your Long-Term Disability claim.
FAQs: LTD Claim Preparation in Ontario
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Medical reports, therapy notes, lab results, imaging scans, medication lists, employer statements, and all correspondence with insurers.
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