When Should I Speak with an Employment Lawyer about a Long-Term Disability Dispute?
Sometimes, employees experience a medical condition that forces them to take a long medical leave of absence as a result of an injury or illness, which naturally causes significant concern and financial hardship. In those cases, employees may have a few options available to them, including:
- using up an employer’s sick leave benefits as part of their employment contract
- applying for employment insurance (EI) sickness benefits (which can provide up to 15 weeks of payments)
- applying for short-term disability (provides temporary income replacement for employees unable to work due to a medical condition, illness or injury (usually for up to 120 days)
- applying for long-term disability benefits (a form of income protection in the event that an illness or disability leaves an employee totally or completely unable to return to work)
Many employees in Ontario who receive health benefits through their employer participate in long-term disability coverage (also called “LTD” insurance). Typically, LTD insurance obtained through an employer will involve the employer and employee both paying their share of the monthly premium.
What is LTD insurance? Generally speaking, this is one type of insurance coverage that pays an employee a portion of their job income (income loss replacement that covers about 67% of their job income) as a way of reducing financial hardship they suffer when they are unable to return to work due to a medical condition, illness or injury.
In order to receive LTD benefits, most LTD policies provide benefits for the first two years if an employee is unable to meet the requirements for performing their own occupation. However, after two years, the employee must prove they are unable to perform the tasks required by any occupation for which they are reasonably qualified by education, training or experience in order to retain long term disability benefits, in order to keep receiving long term disability benefits.
What Types of Disabilities Allow Employees to Qualify for LTD Benefits?
Most LTD policies cover employees regardless of the type or severity of illness or injury preventing them from working. However, some LTD policies exclude certain illnesses, while others may exclude specific injuries or illnesses which require an employee to apply for WSIB benefits.
Generally, if an employee is unable to do all (or substantially all) of the tasks required by their job, they may qualify for LTD benefits. Essentially, the requirement is that the employee’s illness or injury (disability) prevents them from being able to work. However, this typically requires an employee providing they are unable to work either their own job or any job they should otherwise be qualified to do taking into account the employee’s education, training or experience.
In order to receive LTD benefits, employees are required to complete and file a claim with the insurance company. Generally speaking, employees can apply for LTD on their own. However, if you are an employee who has concerns about your claim being dismissed or disputed by the insurance company due to a disputed diagnosis, or pre-existing medical condition, it is beneficial to consult with an employment and disability lawyer as soon as possible, to get advice on the best way to present your claim. By contacting an employment and disability lawyer, you can get help with:
- reviewing your LTD policy and determining whether you meet the definition of disability under the LTD policy
- reviewing your LTD claim/application
- whether applying for LTD benefits is the best option, or if you can still work, how to seek workplace disability accommodation
Just as importantly, if your LTD benefits are denied, an employment and disability lawyer can also appeal your case to force the insurance company fairly and properly honours its obligations under the LTD policy. If that requires a negotiation or lawsuit, an experienced employment and disability lawyer can help you understand your rights and the options available to you.
Depending on the LTD policy, most LTD benefits can continue for 5 or 10 years, while others can last until an employee reaches the age of 65.
It is also important for employees to review their LTD policies to know the impact of other sources of income. In particular, most LTD policies have rules which allow the insurance company to deduct other sources of income from LTD payments, such as:
- WSIB payments
- Canadian Pension Plan-Disability, Ontario Disability Support Program (ODSP), EI Sickness Benefits, etc.
- Termination pay and severance pay received from an employer following a termination or wrongful dismissal (including a severance package)
Employee Disability and Discrimination Issues
While an employer is not prohibited from termination an employee simply because they are on a medical leave of absence or receiving LTD benefits, they are prohibited from using that as a reason for doing so. In other words, it is illegal and discriminatory under human rights law for an employer to terminate an employee due to their disability. In fact, employers are required to accommodate an employee’s disability to the point of undue hardship (this is called the duty to accommodate), if an employee’s injury or illness does not otherwise prevent them from going to work.
If you are an employee who was recently terminated while on a disability claim, it is important to consult with an experienced employment lawyer as soon as possible so they can advise you on whether or not you are a victim of workplace discrimination.
Contact Employment Lawyer Today
If you are an employee who has questions about their long-term disability entitlements or are seeking advice about appealing an insurer’s decision regarding their long-term disability benefits, call our experienced employment lawyer at Bune Law for help. Contact us by phone 647-822-5492 or fill out the contact form to the side. We would be happy to assist in your employment law matter as quickly as possible.
Disclaimer: The content on this website and blog is not legal advice or legal opinion of any kind, and is only to provide general information. It is in no way particular to your individual case and should not be relied upon in any way. The outcome of a legal matter depends on its unique circumstances, and prior successes are not indicative of future results. No portion or use of this website or blog will establish a lawyer-client relationship with the author, this law firm or any related party. Should you require legal advice for your particular situation, please fill out the form below, or call 647-822-5492, to request an initial consultation.
Employment Lawyer in Toronto | Wrongful Dismissal Lawyer | Employment Law Firm in Toronto | Employment Lawyer in Ontario | Severance Package Lawyer