Total Disability: What Does That Mean in a Disability Claim?

In Ontario, long term disability policies can be a lifesaver for anyone suffering from significant injuries. These policies can be purchased privately but also frequently appear as workplace benefits. These policies are designed to pay you benefits if you sustain a severe illness or injury that keeps you from working for long periods of time.

These benefits come in the form of monthly benefit payments. For lesser injuries, these benefits are available until you are ready to return to work. However, some injuries are so severe that they are identified as a total disability.

Understanding Total Disability

Some disabilities will allow you to return to work in a limited capacity. These working disabilities could prevent you from working in your chosen line of work but would allow you to perform less physically demanding tasks.

The word “total” gives the impression that these benefits are only available if you are entirely unable to perform any task related to any job. This is not the case. The legal standard for an injury to be total does not take the word literally. A better way of looking at it is that your injuries are so severe that any attempt to return to work would hamper your ability to pursue management or a cure of your condition. In other words, it is not in your best interest medically to pursue employment.

What is Total Disability?

Unsure of what is total disability? Every long-term injury or illness is different. However, your insurance policy will provide you with detailed explanation of what makes a disability total. While there is no checklist used to identify these injuries, some common examples include:

• Loss of vision
• Loss of hearing
• Loss of speech
• Loss of hands, feet, or limbs
• Paralysis

Ultimately, the language of your insurance policy will determine what results in a disability becoming total. If you have questions or concerns about being treated fairly throughout this process, you could benefit from discussing your options with an experienced lawyer. Insurance companies may try to take advantage of you during the claims process but working with a lawyer and understanding the specific language of your policy can go a long way in protecting your claim.

Terminated Claims of Total Disability in Ontario

Unfortunately, it is not uncommon to receive disability benefits only to receive notice they are being terminated. Learning that your disability benefits were terminated can be especially difficult if your doctor has advised you not to return to work. This seemingly impossible situation is not hopeless, however. Termination of benefits for total disability in Ontario can be appealed.

To start, ensure the termination of your benefits is not a mistake or clerical error. The letter informing you of your termination could explain the reasons for your termination. In some cases, it is relatively simple to get your benefits back. Often, it is as simple as providing forms or other medical documents that had previously been requested.

In other cases, your insurance company may be unclear on what the problem is. They could cite documents or information not in your control, or they could simply claim they see no evidence that you are still disabled. In these cases, obtaining the guidance and counsel of a seasoned benefits lawyer could be the difference in getting the benefits you need and struggling to make ends meet. Returning to work early may seem like an easier solution but doing so could complicate your recovery.

Have you looked at your policy to see how it defines forms of disabilities? You might be surprised with what you see. Reading over the specific language of your policy and taking avantage of the knowledge of a disablility lawyer could go a long way towards avoiding being taken advantage of.