My Doctor Has Determined That I am Disabled. What Steps Do I Take Now?

Disability claim process usually starts with your doctor’s determination that you are, in fact, disabled. And not just disabled, but disabled from work. If this happens, you should contact your employer. Inform your employer that you will not be attending work by the reason of your disability. Find out from your employer how to apply for disability (assuming you have access to disability benefits via your employer’s group insurance policy).

Disability Claim Process

As part of the disability claim process, you will be required to complete a disability claim form, and to have your doctor complete an attending physician statement supporting your disability. Completed disability forms will then need to be submitted to the disability insurer. The sooner the disability insurer receives the necessary documentation, the sooner you might start receiving disability benefits: short-term disability benefits at first (which, generally, provide coverage for a short period of time, up to 6 months), and long-term disability benefits after (which, generally, provide coverage to age 65, as long as you stay disabled from work).

Individual Insurance Policy

The above disability claim steps, applicable to disability claims under a group disability insurance policy, are the same in the disability claim process involving an individual disability insurance policy that you might have purchased. Contact your individual policy insurer, request a disability claim form and submit it to your disability insurer for consideration of your disability claim. In fact, it would be advisable to apply for disability benefits under group disability insurance policy and an individual one: you might be entitled to receive disability benefits under both policies at the same time. It is always a good practice to review your disability insurance policies to learn about the specific terms applicable to your situation.

Success of your disability claim hinges upon a favorable opinion of your treating doctor(s), who will be asked by the disability insurer for records and reports supportive of your continuing disability.

Other Options

It is important to remember that while being involved in a disability claim process, especially where the disability benefits are under dispute, you may seek immediate financial support from your employer via accumulated sick days and vacation time, and from the government via Employment Insurance benefits, Ontario Disability Support Program benefits and Canada Pension Plan – Disability benefits. It would be prudent to explore all of these venues to ensure that you have some money to pay your bills while fighting the disability insurer for the benefits.

If your disability insurer denies your claim, you can appeal and/or sue in court. The appeal (and there might be several) is normally reviewed by the disability insurer that denied your claim in the first place. If you decide to sue the disability insurer, it will need to be done in court, and you would likely need disability lawyer’s assistance to navigate you through this process. Again, you should review your disability policy to learn about important deadlines and your rights in general. If you cannot get clear answers on how to proceed (and the insurance policy wordings tend to be difficult to understand) it would be advisable to contact a Toronto disability lawyer for help.