Working With Your Doctor: How to Build Medical Evidence That Supports Your Long-Term Disability Claim

Perhaps you’re preparing, for the first time, to file a Long-Term Disability claim in Ontario, Canada. Or, perhaps you’re concerned that disability benefits you are now receiving are in danger of being cut off. Dealing with mountains of paperwork while coping with a mental and physical health condition can be overwhelming, to say the least. What, exactly, does your doctor need to say? How much “evidence” is going to be “sufficient”? Do you need to have a legal advisor involved in the process?

All your life, you’ve taken pride in being self-sufficient. It’s incredibly frustrating to depend on others for support and help. Now, it’s important to focus on restoring some measure of financial stability to your life by claiming – and keeping – all the benefits you deserve. Working with your doctor is going to be the key to success….

What is a doctor’s proof of disability letter?

In filing a disability claim, you will need a detailed report from a medical professional who knows you well enough to provide details about your medical condition, your treatment history, and the extent to which your condition prevents you from doing the kind of work in which you’re trained.

This paperwork is also referred to as an Attending Physician Statement. 

The specific form need will depend on where you were employed prior to the disability. The “proof of disability letter” might involve the doctor’s completing one or more of these forms: 

1. Medical Review Package

The Ontario Disability Support Program (ODSP) – benefits come from the Ontario provincial government, and the Medical Review Package is what must be completed and submitted. 

2. Form ISP-2519

The Canada Pension Plan Disability Benefits come from the Federal government of Canada; Form ISP-2519 is the proof of disability report needed. Service Canada reimburses up to $85 to a healthcare professional for filling out the medical form; patient may need to pay any additional charge. The CPP disability benefits application may be submitted on paper or online.

3. Claim form from a private Long-Term Disability Insurance company

Each company will have its own claim form, which you may request directly. If a group policy through an employer is involved, the Human Resources Department should be able to provide the form.

A Proof of Disability letter in Canada is much than just a “note from your doctor”…

While the Proof of Disability letter represents a statement from your main physician (a qualified medical professional who has known you and been involved in your care for the longest period of time), the report will include:

• Records from any medical professionals who’ve treated you, including specialists and psychiatrists
• Records of lab tests (blood tests, biopsies, and imaging studies)
• Records of medications prescribed
• Records of surgeries
• Recommended treatment plans – and whether you’ve followed those plans
  
  

Notes from you to your doctor:

Even the most caring and careful doctor cannot know what you are experiencing as a result of your condition.  Think about how your symptoms are affecting your day-to-day activities. Sharing this information allows your doctor to better describe the scope of your disability in the Proof of Disability Letter:

• Are there things you are able to do, only it now takes you much longer to do them?
• Are you having the most trouble functioning in the morning or at night?
• What new symptoms have you been noticing? 
• Household details – Who resides with you? Is anyone dependent on your for financial support? Are you receiving help and support from anyone in your household?

Make sure “enough is enough”; remember the 3 reasons for a “no”:

In the formal letters insurance companies issue denying a claim for disability benefits, one or more of these reasons is typically offered:

1. The definition of disability was not met
2. The medical evidence was insufficient
3. There was documentation missing

Is the “no” ever coming from the doctor?

Yes, doctors in Ontario, Canada have the right to refuse your request to fill out your disability claim forms, for any of the following reasons:

• The doctor may have no experience or expertise in the particular condition that is causing your disability. (For example, a mental illness is what is causing your inability to function at work; this doctor is not trained to treat mental disorders)
• The doctor has not been treating you for long enough to have sufficient knowledge about your disability.
• The doctor does not believe you meet the criteria needed to qualify for disability benefits.