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

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.