Long-Term Disability

When applications for Long-Term Disability benefits in Ontario are being considered, the difference between success and failure can often be found “on paper.” Were all eight critical documents submitted in timely fashion? Were there any important details inadvertently omitted?

As a recently disabled worker in Ontario, Canada, you’ve got a lot on your plate. Frustrated by the prospect of needing to depend on others for support and help, you’re determined to restore some measure of financial stability to your life by claiming all the benefits you deserve. Here are some steps to follow in the process of applying for Long-Term Disability benefits:

Step One: Determine the source(s) from which you might qualify to receive Long-Term Disability benefits.

Depending on where you were employed prior to the disability, you may be claiming benefits through one or more of these three programs:

1. the Ontario Disability Support Program (ODSP) – benefits come from the Ontario provincial government
2. the Canada Pension Plan Disability Benefits (CPP) – benefits come from the Federal government of Canada
3. a private Long-Term Disability Insurance company – benefits come through a policy issued to you or to your employer

Important to understand:

• Each program has its own paperwork that needs to be completed;
• Each plan has different criteria for eligibility.
• Qualifying for benefits under one of these programs can impact the amount for which you qualify under one program may be reduced if you are receiving benefits from a second program.

Step Two: Begin the process of gathering information to support your claim. The “what” and the “then + when”:  

Your Long-Term Disability “evidence package” is going to include documentation that essentially addresses two aspects of your disability: the “what” and the “when”.

The “what”:

These are documents and forms that explain what your reality is now, providing details about your medical condition and about how your ability to do the kind of work for which you have been trained is now limited.

Included in the “what” portion of your evidence package will be:

1. Records of treatments you are now undergoing, and of what medications you are taking.
2. 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?
3. Income verification and financial records (what assets do you own? What sources of income do you have now?)
4. Daily living impact evidence (What daily activities can you no longer perform?)

The “then + when”:

These are documents that show the details of your “past”, including your education and training history, and what jobs you’ve held from the beginning of your career and up to the present.

Included in the “then and when” portion of your evidence package will be:

• Record of Employment from the Canada Revenue Agency
• Detailed job descriptions of all prior jobs, along with performance reviews from employers
  Treatment and medication history
• financial records – pay stubs, tax returns, bank statements
• Record of all prior disability claims and benefits

Step Three: Take a breath; ask the questions; dismiss the myths; deal with the realities.

So much to think about… so many steps and details. It’s difficult to concentrate at a time when your life is undergoing such dramatic change. It’s understandable to experience sorrow and even anger, possibly facing a future very different from what you’d been expecting. For that very reason, before proceeding, it’s important to separate fiction from fact about the process of filing a Long-Term Disability claim.

Twin myths to dismiss:   

• Myth: You can qualify for disability benefits only if you cannot do any work at all. Reality: 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.
• Myth: Only those with visible and physical disabilities qualify for benefits. Reality: Mental illnesses (bipolar disorder, depression, or PTSD, for example) can cause an inability to function at work.

Timeline in real time

• 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.