Understanding LTD Elimination Periods in Ontario: When Can You Actually File Your Long-Term Disability Claim?
Coping with an injury or lingering illness, you’ve been unable to work. Initially determined to get back on your feet and back to work quickly, you’re beginning to realize it’s not happening. Whether  you’re still on unpaid sick leave, or have begun receiving Canadian Employment Insurance Sickness Benefits, you are now to the point of needing to file long-term disability claim.
 It’s all so overwhelming…you’ve never dealt with a severe disability before, certainly not with applying for long term disability insurance benefits.. Anxious about missing deadlines, filing too early — or too late –you need clear, practical answers. How does the elimination period work on long-term disability insurance? When is the optimum point to actually file your claim? What are the procedures? What rights do you have when it comes to claiming benefits?
Understanding the purpose of long-term disability insurance
When short term benefits end, including:Â
- short-[term disability insurance
- sick leave from an employer
- Canadian EI (Employment Insurance Sickness Benefits),
that is when long-term disability insurance can begin.
Long-term disability insurance is meant to replace between 60% and 85% of the income you were earning before the onset of your illness or injury.
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From what sources might you be claiming long-term disability benefits?
- Your employer’s group disability insurance plan
Your employer may offer long-term group disability insurance intended to replace a percentage of the monthly income of an employee who has become unable to work due to a major illness, accident, or injury. (Depending on the plan, benefits may be guaranteed to last for a prescribed period of time or even up to an employee’s age 65.
- The Canada Pension Plan Disability Benefits Plan (CPP)
If you are under age 65, have been contributing for years to CPP, and have a mental or physical disability that now is preventing you from doing any kind of substantially gainful work, you can claim benefits through this plan.Â
- The Ontario Disability Support Program (ODSP)
The Ontario Provisional Government provides money to help disabled employees with living expenses, health benefits, and employment support.
What is this thing called the “elimination period”?
Even if the insurance company (or government plan administration)Â Â agrees that, due to the severity of your illness or injury, you are unable to work and therefore qualify to receive long-term disability benefits, there will be a waiting period, or “elimination period”, before regular benefit payments actually begin.
- CPP – The plan has a waiting period for benefits to become payable; you must have been totally disabled and have used up all sick leave credits before qualifying for CPP benefits.
- ODSP – The waiting period is usually 90 – 120 days, beginning when you become unable to work and ending before long term benefits begin.
- Employer group long-term disability plan (or self-employed long-term disability plan – the elimination period usually lasts 90 to 180 days.
Must I wait until the elimination period has expired before filing a long-term disability income claim?
It is natural, even healthy, to continue to hold out hopes for recovery from your condition. On the other hand, you realize that your inability to work is going to last for an extended period of time. Since no long-term disability benefits will be paid until the elimination period has expired, why is it important to begin the claims process now?Â
- The administrative review process for your claim can take weeks or even longer. You may receive requests for more documentation and will need time to gather the needed information.
- Failing to file in a timely manner can give an insurer reason to deny your claim.
- You do not want to face a gap in income between any short-term disability benefits for which you may qualify and the start of long-term benefits.
Financial survival during the long-term Ontario disability elimination period
 If ever there was a time to get pro-active about your finances, the elimination period is that time…
- Narrow your budget down to the essentials – housing, utilities, food, and medicine. Cut out all non-essentials.
- Take stock of your resources, including: emergency savings and short-term disability benefits.
Contact your credit card company(ies) and mortgage lender to see if they can adjust your payments until you have qualified for long-term disability benefits.
Remember, you must be able to demonstrate that you are disabled throughout the elimination period. That means doing no work at all – of any kind – to help cover expenses.
With decades of experience dealing with all these authorities, Rob Konduros knows that the elimination period is a crucial phase in the disability benefits application process. Every detail has to be “done right”; any denials can be appealed — providing the information was properly submitted and in timely fashion.
Far from imposing yet another financial burden on individuals already struggling through the disability elimination period, “My clients don’t pay unless they win“, Rob Konduros explains.
Should I consult an Ontario disability lawyer during the disability elimination period?
Given your reduced ability to handle the daily challenges — both physical and financial — of your life, navigating the complex disability claims process can be a daunting prospect. An experienced Ontario disability lawyer can provide reassurance, helping you avoid pitfalls and mistakes as you’re preparing to qualify for long-term disability benefits.
Fact is, a high percentage of long-term disability claims are rejected on the first try; many of those benefit denials happen because of mistakes on the paperwork and the documentation.
An Ontario disability lawyer can help you navigate your complex new world, which may well end up including:
- your employer’s Human Resource department
- multiple medical providers and therapists
- one or more long-term disability companies
- the Superior Court of Justice
- the Court of Appeals for Ontario
When filing for long-term disability benefits in Ontario, Canada, it’s important to understand the way the elimination period works, and how to successfully “work through” that period in making your claim.
FAQs: LTD Elimination Periods in Ontario
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Many policies are 90‑180 days, but your policy controls.
