How Much do Long-term Disability Benefits Pay in Ontario?

Typically, LTD policies will cover 60% to 85% of your base salary. However, there is usually a maximum amount and a specified time in which the benefits will be paid. Note that you may have some offsets that reduce the amount you receive as LTD benefits. Some policies will have specific clauses that exclude some sources of income, such as CPP or WSIB payments. This offset amount will be calculated based on any other benefits you may be receiving. Additionally, you may receive higher payments in the following years due to the cost-of-living adjustment made each year as a result of inflation. This adjustment for inflation may cause your LTD benefits to increase by 1% to 3% every year.

When Should you Expect the LTD Benefits to be Paid?

Typically, LTD benefits are paid from the date the elimination period is completed. This is a unique waiting period stipulated in your policy. Insurance providers typically give an elimination period ranging from 4 months to 52 weeks.

What Medical Conditions Qualify for LTD Benefits?

LTD claims are never based on a diagnosis but rather on the disability that is caused by your medical condition. Every LTD policy will have a specific clause that defines disability. This clause will determine whether the condition you are facing will be considered a long-term disability, as well as how much you are able to collect in LTD benefits. You may have a serious illness but not be considered totally disabled, which could make it difficult to qualify for LTD benefits. To be considered totally disabled, you must have a disability that is preventing you from performing all or at least most of the duties required in your current job.

How Long Can You Stay on Long-term Disability in Ontario?

It’s important to understand when your LTD benefits may stop and start planning in advance. First things first, the duration you will receive benefits varies depending on the type of long-term disability policy you have. Typically, LTD policies will offer financial support for at least two years and so long as you are unable to work and cater for your day-to-day living expenses. Other policies will offer compensation for much longer periods, such as up to 5 years, 10 years or until you reach the age of 65.

Ideally, every policy is different, and the term offered will be clearly highlighted in your policy document. That’s why it’s important to review the documentation of your policy in advance to find out how long you qualify for LTD benefits, whether you are receiving it through your employer or a private insurance provider.

How Long Does Long-term Disability Last in Canada?

LTD policies are designed to provide the financial assistance needed when one is experiencing a disability that is preventing them from working and earning a living. If you are no longer disabled, you may automatically be disqualified from receiving LTD benefits. In fact, most insurance companies that offer such policies will require you to submit to medical testing on a routine basis. You may also be required to undergo rehabilitation which may speed up the recovery. As soon as the insurance provider determines that you have recovered from the disabling medical condition, you may no longer be offered LTD benefits.

How Long Can You Remain on Long-term Disability?

You may be able to receive LTD benefits for as long as you are experiencing a disability that is preventing you from working. If the insurance company believes that you have recovered and can return to work, they may no longer offer you LTD benefits. Some employers may maintain your job while you are under LTD, which enables you to go back as soon as you recover. If your LTD policy ends and your previous employer is no longer willing to give you work, you can still seek employment elsewhere.

What is the Longest Benefit Period Long-term Disability Can Last?

Every long-term disability policy is different and may not last for the same amount of time. There are policies that may expire even before you are fully recovered and can return to work. In such a situation, you will need to look for other alternatives to secure financial support. A suitable option could be the Canada Pension Plan (CPP). CPP allows you to continue receiving disability benefits long after your LTD benefits expire. You can apply for CPP in advance when you know your LTD policy is about to expire.

CPP is a monthly taxable benefit designed to replace part of your income for the rest of your life. Should you qualify for CPP, you will receive a retirement pension every month.

To qualify for CPP, you must:

• Be at least 60 years old
• Have made at least one valid contribution to the CPP (either through employment or from credits you received from a spouse/common-law partner)

CPP retirement pension isn’t automatically issued. You must apply in order to start receiving the payments. The amount you receive will depend on several factors, such as:

• Your average earnings throughout your working life
• How much you contributed to the CPP
• The age that you decide to start receiving the CPP retirement pension

To determine when you collect CPP, review your finances, health, and life expectancy. While you may choose to delay CPP to receive a larger benefit, there is no advantage to taking CPP later than 70 years.

Does Long-term Disability Stop at Age 65?

Does long-term disability end at 65? In many cases, LTD benefits will expire when you turn 65. There are, however, policies that will offer lifelong benefits even though they aren’t as common. If you were contributing the minimum amount to CPP, you might still qualify for benefits that can help offset your financial obligations after age 65. These retirement payments can come in after the age of 65. You can apply for CPP as early as age 60 or as late as 70. If you choose to apply for CPP early, the payments will likely be smaller. CPP applications can take up to 120 days to be processed. This is why it’s recommended that you start the application process long before your LTD benefits expire to avoid a long period in which you are not covered.

Long-term Disability After age 65 in Canada

As lawyers, we educate our clients on what to do when LTD benefits end in Canada. Our team can help you review possible alternatives to ensure you are fully covered long before your LTD benefits cease. Contact us to provide additional answers to your questions on LTD benefits.

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Because of this, it can be incredibly upsetting if your insurance provider denies your claim. They may do this for the following reasons:

1. You missed a deadline: Depending on your policy and provider, there can be deadlines you must meet with regard to filing a long-term disability claim. If you miss a deadline, they could delay or completely deny your benefits.
2. They deemed the claim invalid: Insurance companies will investigate a person’s claim, which could mean following you to take photos or videos. If the information they collect contradicts what you have said in your application, your benefits can be in jeopardy.
3. They believed your condition does not prevent you from working: Insurance providers vary in their definitions of disability. And if they do not think you meet their definition, they may deny a claim. Thus, it is essential that you be honest and forthcoming with all the details of your condition.
4. There was insufficient information: Applications that are missing medical documentation, personal information and other pertinent details may not be successful. Further, some policies require applicants to see an approved physician for an assessment. If you do not do this, the company can deny a claim.

If your insurance provider denies your application for these or any other reasons, do not lose hope. You can request a review and pursue an appeal if you disagree with an insurer’s decision.

It is crucial to understand your rights and options when it comes to pursuing long-term disability benefits. These financial remedies can be vital to your life and well-being when you are coping with a serious injury or illness.

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Under these circumstances, an employee can request accommodations that allow them to work. 

What makes an accommodation reasonable?

Under Ontario’s Human Rights Code, employers have a duty to provide accommodations that ensure employees with disabilities have equal access and benefits as other workers. However, one condition is that the accommodation must be appropriate. 

To be reasonable or appropriate, an accommodation must not be highly disruptive to other employees or fundamentally change the nature of the person’s job. Further, it must not put an undue hardship on an employer in the form of substantial expense or resources.

Some examples of an appropriate accommodation include:

• Ergonomic equipment
• Adjusted work schedule
• Accessibility equipment
• More frequent breaks
• Additional support

These measures can enable a person to perform the essential functions of their job while preserving their dignity and allowing them to participate fully.

Requesting an accommodation

If you are returning to work and could benefit from an accommodation, you can submit your request to your employer. If you are unsure of what an accommodation might specifically look like, you might discuss the options with your supervisor. You can also consult your physicians or a lawyer to discuss possible solutions.

Keep in mind that any accommodation an employer provides should respect an individual’s dignity and promote integration.

It is also crucial to recognize that an accommodation that works for someone else may not be suitable for you. And your needs can change over time, meaning that you may need to make adjustments in the future.

Unfortunately, not every person will get the accommodations they need, either because an employer wrongfully denies them or the individual does not request them. Not only can this make it incredibly difficult to work, but it can also be a violation of a person’s rights.

Thus, if you are preparing to return to work after being on disability leave, assessing your needs and requesting appropriate accommodations should be high on your list of priorities to make the transition easier.

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In some cases, extended periods of physical and mental anxiety due to work actually cause or contribute to serious health problems. This could be the situation for workers struggling with burnout.

What is burnout?

Workers in some occupations experience immense exhaustion due to high-stakes performance requirements, long hours or exposure to dangerous conditions.

Over time, this environment can take a devastating toll on a person’s mental and physical health. They can become cynical, careless and anxious.

Further, according to the Mayo Clinic, a person suffering from job-related burnout can have several different symptoms of this condition, including:

• Depression
• Difficulty sleeping
• Fatigue
• Irritability
• High blood pressure
• Increased risk of becoming sick
• Heart disease

Without addressing the work or expectations causing the burnout, these and other serious symptoms can persist and become worse over time.

Is burnout disabling?

Although job burnout can affect workers in several severe ways, it likely would not be considered disabling in the context of disability benefits.

That said, it is possible for burnout to cause or contribute to conditions that do prevent a worker from performing his or her current job or a similar job. If this sounds like your situation, depending on your insurance, your condition could meet the definition of disability.

Seeking support for burnout

If you are experiencing mental or physical exhaustion due to your job, it is crucial that you seek support. Such support can include therapy, medical care, job accommodations or a new job altogether. These options can help you cope with stress and treat your symptoms.

Unfortunately, in some cases, burnout and the illnesses it exacerbates or causes makes it impossible for a person to continue working. And being unable to work and collect an income can only make things more stressful. In these situations, it can be critical to examine the options for pursuing disability benefits to help you through this difficult time.

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Below, we explain a few basic aspects of long-term disability benefits and what you might expect in terms of filing a claim.

Types of insurance

There are different types of insurance when it comes to disability, including short-term and long-term disability benefits. There can also be benefits available if an injury occurred on the job.

Regarding long-term disability, there are two types of plans: group plans and individual plans. Understanding the type of coverage you have will be crucial in determining the benefits that may be available. If you are unsure of your coverage, you can talk to a lawyer.

What you may receive in benefits

Though specific benefits and calculations will depend on the type of coverage you have, generally speaking, long-term disability replaces a percentage of a person’s income for a specific amount of time.

As this article notes, most plans will cover between 60-70 percent of a person’s regular income. Benefits may last approximately two years, but they could end sooner or last longer, depending on the details of a claim.

Eligibility requirements

In order to collect long-term disability benefits, a person must meet eligibility requirements. This includes:

• Having a condition that meets the insurance company’s definition of disabling
• Having appropriate coverage
• Being unable to work in either a specific occupation or any occupation, depending on the policy

Problems that can arise

Long-term disability benefits can be crucial to the lives of those who collect them. However, there are issues that can arise and make it difficult for a person to access these critical benefits. This can include wrongful denial of benefits and premature termination of benefits.

Should complications arise involving your long-term disability benefits, it is important that you take steps to understand your legal options. Too often, people assume they have no recourse or they hope the matter will resolve itself. However, these can prove to be costly assumptions, so it is important to discuss your case and possible remedies with your lawyer.

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This is where LTD comes into play. If you have suffered an injury or contracted a disease that prevents you from returning to work, you might be entitled to long-term disability benefits.

An employer’s duty to accommodate

Except under limited circumstances, your employer may not terminate your employment while you are on medical leave. While sadly some employers do fire workers purely because they are unhappy that the employees take medical leave, provincial and federal human rights laws protect workers from such discrimination. No one’s disability may be the grounds for dismissal.

Exceptions

Employment laws require an employer to provide accommodation if you become disabled due to ill health or an injury. Your boss could either modify your duties in a manner that would allow you to continue working or he or she could grant you medical leave. However, if an employer can prove any of the following circumstances, it might justify dismissal:

• Cost: If your employer must spend unreasonable amounts of money to bring about modifications to accommodate you, the court might agree that there was no other option than to dismiss you.
• Undue hardship: If your employer claims that accommodating you during your illness will cause unreasonable hardship for the company, he or she will have to meet a high threshold to motivate such claims.
• Health risk: If you have a condition that is highly contagious, your employer might use that to justify dismissal. However, granting you medical leave would prevent exposure of other employees to your illness.
• Disruption: Some employers claim accommodating an employee’s ill health can hamper workflow, but proving that could be tough.
• Unrelated firing: Your boss might even attempt to convince the court that your termination had nothing to do with your debilitating injury or illness.

Your rights during this trying time

If your employer fires you while you are on medical leave, you have the right to launch a complaint. The employer will then have the burden to prove the need to terminate your employment. Fighting for your rights at a time when you are also battling an illness might be overwhelming, but help is available. The support and guidance from an Ontario lawyer who has experience in dealing with both wrongful terminations and long-term disability insurance may prove to be an invaluable asset to your cause.

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Although you might be entitled to benefits that could ease the financial burden substantially, it is crucial to have thorough medical examinations immediately after the accident along with frequent follow-ups because some the most severe symptoms of brain injuries may not be immediately evident.

What is it like to live with TBI?

While many of those with whom you interact might not notice the physical and mental effects you suffer, your family members and others who are close to you will be very aware because it may also influence their lives. Any of the following changes can occur and become part of living with TBI:

Sleep patterns: The quality of sleep you get can play a role in your quality of life. Every victim is unique, and you might find that you sleep significantly more or less than before your injury, or you might have problems with falling asleep. These changes could adversely influence other symptoms you suffer.

Headaches: These are some of the most frequently reported after-effects of brain injuries, and they tend to become chronic, often with debilitating pain.

Emotional changes: The area of the brain that suffered damage can determine the emotional impact of the injury. You might feel depressed or anxious, and these feelings may come and go. Rapid mood swings can also occur, and you might become disinterested or impartial to pre-injury interests.

Communication skills: Following conversations might be demanding, even more so among groups of people, and you might struggle to express your thoughts in words.

Thinking and concentration: Your ability to concentrate may be impaired, and so could your short-term memory. Furthermore, it might be a struggle to learn and retain new information.

PTSD: The trauma of the accident and the severity of your injury might lead to post-traumatic stress disorder, which could bring about anxiety over your safety and your inability to control your life. Individuals with PTSD often avoid other people, and some even seek refuge in alcohol or drugs to suppress these fears and feelings. Fortunately, help is available to intervene.

Child development: If the victim was your child and not you, even mild brain injuries can hamper the development of his or her brain. Your child might have a continuous struggle to keep up with his or her peers.

Help is available

Even if you suffer only some of these consequences, the impact on your life as you knew it could be severe. Fortunately, under Ontario laws, you have legal rights to recover damages if another party’s negligence caused your injury. Furthermore, other avenues may be available to pursue compensation for losses and even long-term disability benefits. An experienced lawyer can carefully analyze your unique circumstances and guide you through pursuing your most viable options.

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Numerous physical and psychological hazards can put nurses at risk of illness and injury that result in long-term sick leaves.

Typical hazards for workers in the health care industry

As a health care worker, you likely already face high levels of work-related stress. You may be able to limit the impact of these hazards by understanding the following typical causes of work-related illness and injury and by taking appropriate precautions:

• Physical hazards: Various dangerous situations can be present in health care facilities, many of which can lead to physical injuries. Spills and random objects where you have to move about – often at a high pace – can cause slip-and-fall accidents. Also, you may be at risk of objects falling onto you. Sharp objects can result in cuts and stabs, and sterilizing equipment pose risks of burning or scalding. Radiation threats from radioisotopes and x-rays can pose additional risks to your health. TIP: Stay alert and be aware of your surroundings.
• Ergonomic hazards: There may be many situations in which you must bend, stretch, pull and lift weights in awkward positions. Such actions may place extreme physical demands on the muscles, tendons and other soft tissues of your body. Long periods of standing and walking can also exacerbate already-taxed body parts. TIP: Take breaks, avoid overextending and get help for loads you cannot reasonably manage by yourself.
• Psychological hazards: Some aspects of nursing can cause psychological problems. Repeated witnessing of traumatic events and injuries are only part of it. Other causes may come from exposure to violence, having to deal with difficult patients on your own, and occasions in which you have to make stressful and challenging decisions in an instant. TIP: Take time to disconnect, assess your emotional state and find ways to refresh yourself mentally on a regular basis.
• Chemical hazards: Disinfecting, cleaning and sterilizing may expose you to various hazardous chemicals. Furthermore, anesthetic gases, medical waste, medication, drugs and allergies to products such as latex can pose additional hazards. TIP: Make it a habit to always follow proper procedures and prescribed precautions.
• Biological hazards: The threat of contracting infectious and contagious diseases will be ever-present, some of which can result from needle stick injuries. Others sources of contractible illness include air-borne threats such as tuberculosis, blood-borne illnesses like hepatitis B and C as well as AIDS, and physically transmitted diseases such as clostridium difficile. Dangerous organisms that are drug resistant pose additional hazards, and the need for constant hand washing can result in dermatitis. TIP: Use of all applicable safety equipment. A single exception could expose you to danger.

Where to turn for help and support

All of the above hazards are potential long-term disability risks. If you are unable to return to your job duties after suffering any form of work-related harm, you likely have many questions and concerns about the process of filing for your LTD benefits.

There is often confusion and a lack of consistency from insurance companies regarding the interpretation of “total disability” within these insurance policies. If you have already submitted a claim that you believe was wrongfully denied by the insurance company, help is available. An experienced lawyer can carefully evaluate your unique circumstances and then fight to significantly increase your odds of receiving the maximum amount of benefits to which you are entitled.

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