Can I Claim Long-Term Disability Insurance After I Am Forced to Leave My Job?June 13, 2020
Long-Term Disability Benefits
Even after your employment ends you can still claim long-term disability benefits under your former employer’s disability policy as long as an illness or injury that caused your disability occurred while you were still employed.
MacIvor v. Pitney Bowes
Ontario Court of Appeal in MacIvor v. Pitney Bowes, 2018 ONCA 381 decided that with respect to “past” claims disability coverage does not terminate when your employment terminates. Mr. MacIvor was injured in an accident in 2005 while he was employed at Pitney Bowes. Mr. MacIvor had disability coverage with Manulife as part of his work benefits. He took 4 months off to recover from the accident. His job performance deteriorated upon his return to work, and he quit his job in 2008. He started a new job at Samsung only days after. He was not doing well at Samsung, however, and was fired in 2009. He then tried to apply for long-term disability benefits at Samsung but was told that because his injury took place while he was working for Pitney Bowes, he should apply under Manulife policy. Mr. MacIvor complied. Manulife denied his claim. Manulife argued that Mr. MacIvor’s disability coverage under their policy ended when he resigned from Pitney Bowes job. The trial judge agreed with Manulife. Ontario Court of Appeal reversed the trial court decision, finding that Mr. MacIvor could claim for disability benefits under Manulife policy because his disability arose from 2005 accident, which occurred while he was still employed with Pitney Bowes.
The court reached the same conclusion in Ferguson v. Halton, 2018 ONSC 5675. Mr. Ferguson took a leave of absence claiming to be disabled and never returned to his job at Halton. Mr. Ferguson had access to long-term disability benefits as part of his work benefits. Halton terminated his employment in 2007. Mr. Ferguson filed an application for long-term disability benefits after he had been fired. The application was denied, and Mr. Ferguson sued. The court found that long-term disability policy at Halton should provide coverage for Mr. Ferguson’s claim because his claim arose from the medical condition that occurred while he was still employed with Halton.
To sum up, these court decisions stand for a proposition that even after your employment ends you can still access your former employer’s long-term disability policy with respect to disability claims that arise from an injury or illness that occurred while you were still employed. Such coverage would not extend to “future” claims – claims that arise from an injury or illness that takes place after your employment has been terminated.
Recovering Disability Benefits
Establishing disability coverage for past claims after your employment ends is only half the battle. In order to successfully recover disability benefits, you would still have to persuade insurers that you are “totally disabled”. Test for total disability is set out in your insurance policy.
Court decisions reviewed above demonstrate the importance of policy wording interpretation and its application to facts in disability cases. If you find yourself in a situation similar to that of Mr. MacIvor or Mr. Ferguson, it would be advisable to have an experienced disability lawyer review your disability policy to weigh your chances of success.
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