A Guide to Filing for Long Term Disability Claim

Apart from the disability programs run by the government of Canada such as the CPP and the various provincial disability programs, many Canadians have other forms of long term disability insurance. The process of filing a disability claim under these programs is quite different from the one involved when dealing with the government. The chances of having your claim denied are also high since you are dealing with private insurance companies that are often more interested in making profits than your welfare. Nevertheless, it would be unfair to blame these companies whenever they deny a long term disability claim. You may be responsible for making an incomplete claim. With the proper measures in this article, you will be able to make a completed and correct claim.

What is Long Term Disability Insurance?

Long term disability insurance is a form of insurance purchased by your employer as a group policy. You can also purchase a long term disability insurance individually. The purpose of this insurance is to provide a form of income protection in the event that you are incapable of working for a prolonged period of time due to an illness or an injury. You will receive the benefits for the first two years if you are unable to perform the job that you were performing immediately before you got disabled. Thereafter, you will only receive the benefits if you cannot take part in any gainful employment.

When do you file Long Term Disability Claim?

You should begin thinking of how to apply when you are disabled and your doctor agrees that your condition cannot allow you to work. You will need to explain your illness or injury to your doctor because this is the only way the doctor can understand your condition. For example, the doctor may not be able to measure chronic pain, however your descriptors of your daily pain can help the doctor identify the illness.

You need to file your claim as early as possible because forms may need to be submitted sometime before the end of the waiting period. If you delay in submitting your application, you will not get your benefits as early as you should. Additionally, there are deadlines that you have to meet for your claim to be successful. Your policy booklet will usually have the details such as application deadlines. If in doubt about anything, contact a disability benefits lawyer.

How to File a Long Term Disability Claim

Other than the application form, the documentation that you need to make a long term disability claim to a private insurance company are relatively the same, whether in Ontario, Quebec or any other province. Similarly, although each company has its own standard application form, they often seek similar information. Here are the steps:

  1. Get a Report from Your Doctor/Physician. This is the most crucial document when filing for long term disability. The insurance company relies on the contents of the report in assessing your eligibility. You should, therefore, ensure that the medical report clearly explains the true state of your health, otherwise, you may not succeed in your claim.

  2. Apply for Sick Leave. Once you have the support of your doctor, you should then seek the support of your employer. Being on an infinite sick leave will ensure that you continue receiving your salary as you wait for your long term disability benefits. Long term disability claims take months to be approved and may even take longer if your first application is denied and you have to appeal or institute a civil suit. It would be rather difficult to be without income for such a duration. Additionally, some group benefits are conditional on you being employed. Therefore, you must never quit your job, always prefer to be on leave. Although it’s advisable to secure the support of your employer, some employers may not be mindful of your condition. Getting sick leave is your right, just make a written application and attach your doctor’s note then proceed for leave.

  3. Filling the Application Forms. You obtain the application forms from your employer, for group insurance, or the insurance provider if you have taken out the insurance personally. Make sure you fill the form as accurately as possible. Be legible and consistent. Avoid contradicting yourself as this could mean that you are not sure of what you are saying. What you fill in the form should be consistent with the supporting documents. If you are not sure how to file your application, you should consult a lawyer.

  4. Take a Break and Review your Application. Do not fill in the forms in a hurry; take your time. If you check your application the following day, you will be able to see some mistakes that you would otherwise not see. Check both the application form and the supporting documents such as the medical report to ensure everything is in order and there is no contradiction. You are now ready to submit your application.

  5. Submit the Application. Once you are satisfied that your application and all necessary documents are in order, you can submit it to the insurance provider. The company will assign a claim adjudicator to handle your application. Co-operate with the adjudicator as much as reasonably possible. You should be getting feedback after one or a few months. If the waiting period is inordinately long, make sure you follow up to know what’s going on.