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What are the Eligibility Criteria for Long-Term Disability After a Debilitating Injury?

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What are the Eligibility Criteria for Long-Term Disability After a Debilitating Injury?

Don’t delay discussing your matter with us to find out how to build a winning case.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.
criteria for long term disability

Living with a long-term disability or debilitating injury is devastating. It affects your ability to work and your ability to live, leaving you with anxiety about what the future holds. Life can be unfair, but that doesn’t mean you and your family are on your own. When you’re facing an injury or life-changing illness in Ontario, Canada, look for a local disability lawyer you can trust to safeguard your interests.

Unsure if you qualify for compensation? Here are some facts about long-term disability and debilitating injury.

What Qualifies as a Long-Term Disability?

Debilitation from injury or illness is usually broken down into short- or long-term disability. Short-term disabilities are defined as any injury or illness that keeps you from working for six months or less, including any sick leave from your job. In order to qualify for long-term disability and debilitating injury benefits, your conditions must be severe enough to keep you out of the workforce after your short-term coverage ends. This is usually divided into two types of disability.

Coverage for inability to work at any occupation means that you’ll only receive benefits if you’re unable to work at any profession at all. That means you have a chronic illness or other debilitating injury that will prevent you from performing any kind of occupation that someone else with your education or ability level would reasonably be expected to perform. For example, if you’re unable to wait tables or perform another job that requires mobility because you’re fully or partially paralyzed or suffer from chronic back pain, but you can still use a computer or work as a call center associate, you would not be able to collect benefits.

Benefits for workers unable to work at a regular job or their own occupation are available to employees who can no longer perform the work for which they’re trained or have experience. So, that same employee who is disqualified above may still be able to file an insurance claim as long as they’re no longer able to perform at their primary occupation. This type of policy usually has a limitation of two to five years, at which time their eligibility or disability type may be reclassified to “any occupation”.

It’s often up to you to prove your eligibility to collect long-term disability and debilitating injury benefits. You’ll have to provide medical evidence of your disability and inability to work by providing medical records and statements from your primary care doctor and any specialists you’re seeing. This includes vocational counselors, occupational therapists, licensed mental health practitioners, and medical experts with experience treating your type of illness or injury.

The insurance company may also require you to see medical experts of their choosing. There may also be exclusions regarding pre-existing conditions or other criteria they insurers will try to use to disqualify you.

You’ve Been Injured, What Next?

Most employers provide coverage for disabling illnesses or injuries under a group policy. Those who are self-employed, unemployed, or don’t have coverage through their job can purchase disability protection on their own by purchasing an individual plan. Older workers might also be covered under the Canada Pension Plan (CPP) or Quebec Pension Plan (QPP) if you’ve paid into them long enough.

However, these plans will only pay up to 70 percent of your income, and the benefits may run out after only two years. Insurance companies will do their best to avoid paying claims without a fight, and how they view long-term disability varies from provider to provider. Your benefits can also be reduced if you have multiple insurance plans or obtain income from other sources.

That’s when you need to find a qualified long-term disability and debilitating injury lawyer

Applying for disability benefits is a long process that involves a lot of paperwork. An experienced lawyer knows how to navigate the claims process, and it’s their job to make sure you have everything in order. A law firm will go over your policy and medical reports to prove your coverage and eligibility to collect benefits for chronic, debilitating conditions that include:

– Chronic pain
– Accident-related injuries
– Work injuries
– Back pain
– Depression/anxiety disorder
– Cancer
– Arthritis

Disability Lawyer in Ontario

If your injury claim been denied by an insurance company, your best bet is to contact a long-term disability lawyer serving the Greater Toronto Area. They will fight to protect your rights.

Disclaimer: The content of this article is a general guideline made available for educational purposes only and is not intended to be used as legal advice for the reader’s specific situation nor in general. By reading our blog and website content, the reader acknowledges the above and understands there is no lawyer-client relationship created between you and Himelfarb Proszanski through this content. To get specific legal advice, we encourage you to book a free consultation with one of our lawyers to clarify the legal aspects of your situation.

Timing is Critical. Help is Free.

Don’t delay discussing your matter with us to find out how to build a winning case.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

Timing is Critical. Help is Free.

Don’t delay discussing your matter with us to find out how to build a winning case.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

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What They Say About Us

Bryan Pilon
23 hours ago
HIMPRO recently represented me for an insurance claim. They are a great firm, and more importantly, genuinely good people. I highly recommend them. From the beginning, they handled my case professionally and compassionately. Mena was amazing, her attention to detail and understanding made the process so much better. David and Silene also worked on my file and they were both honest, and highly knowledgeable lawyers. I felt fully informed and I was able to trust their judgement completely. My case was resolved in a very reasonable time given my circumstances. In my opinion, you will not be able to find a better group of people to handle your legal issues.
She Silva
2 weeks ago
I’m very happy with David and his team. Very professional and knowledgeable. Reputable law firm.
Patricia Gooden
2 weeks ago
Excellent communication skills from the Receptionists to my Lawyer and the Clerks. I will always appreciate all the support and good work that they are doing i am very grateful to have them supporting me, especially Dan Holland a very patience and professional person. Thank you.
Yoav Gurevich
2 weeks ago
Lauren and Alisha provided prompt and honest feedback when reviewing the terms of my employment contract. They consistently prioritized my what's best for my situation throughout the entire process. Highly recommended.
I am so grateful to have had this incredible team on my side after my wrist was broken in in a car accident, They guided me through the complex legal process and assured I received the maximum settlement possible. I discovered first hand that our legal system demands victims have experts guide and advise them if they have any hope for a fair resolution. A huge thank you to Silene, Ingrid, Spencer and the rest of the awesome team for all their support.
Phillip
Miranda Beasley
2 weeks ago
Alex Kluchuk from HIMPRO worked hard to get me the best result possible. The firm is communicative and thorough, and I'm grateful I had them on my side. I would definitely recommend them!
Barbara Stewart
3 weeks ago
They helped me navigate my car accident claim. I am grateful that they made the process easy and that they were there to help every step of the way
Rajni Kathuria
3 months ago
David, Mena and Silene were all professional and extremely helpful in getting my case resolved. Mena was quick to get back to me when I had any questions. I had a great experience with all of them.
Ayodeji Osikoya
4 months ago
My wife and I were involved in an accident in 2023, and we were fortunate to have HIMPRO Personal Injury and Long-Term Disability Lawyers represent us. From day one, their team showed outstanding professionalism, compassion, and dedication.

We especially want to thank David, Alex, and Mena for their incredible support throughout the process. They were always available to answer our questions, kept us informed at every stage, and genuinely cared about our well-being. Their guidance made a stressful time much easier for us to handle.

Thanks to their hard work and expertise, we achieved a great outcome, and they are still working diligently to obtain additional compensation from the insurance company and pursue the catastrophic designation for my wife.

We are deeply grateful for everything the HIMPRO team has done for us. If you ever need experienced, trustworthy, and compassionate lawyers who will truly fight for you, we highly recommend HIMPRO.
Haris Sheikh
4 months ago
A Magician , Passionate and Tough Negotiator: David Himelfarb proves what he told me in the first meeting on my MVA case. I fully endorsed David to anyone looking for a sincere and results oriented personal injury lawyer.

HIMPRO BY HIMELFARB PROSZANSKI

HIMPRO is a leading law firm with full service personal injury and disability insurance lawyers. We have been recognized by Best Lawyers and assigned the highest rating, AV Preeminent, from Martindale-Hubbell. We provide a combined century of trial experience which has led to the successful settlement of over 10,000 cases with combined settlement value in excess of ¾ billion dollars. Our mission is to win your case. At HIMPRO by Himelfarb Proszanski we build winning cases. That’s the HIMPRO Advantage™.

CONTACT

LOCATION

Toronto Disability Lawyers
480 University Ave
Suite 1401
Toronto ON
M5G 1V2
(416) 599-8080

Brampton Disability Lawyers
2 County Ct Blvd
Suite 400
Brampton ON
L6W 3W8
(905) 595-6760

Hamilton Disability Lawyers
1 Hunter St E
Ground Floor
Hamilton ON
L8N 3W1
(905) 777-8002

Kitchener Disability Lawyers
22 Frederick St
7th Floor
Kitchener ON
N2H 6M6
(519) 772-7659

Oshawa Disability Lawyers
21 Simcoe St S
Oshawa ON
L1H 4G1
(289) 634-5554

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