Commonly Asked Questions About Long Term Disability

Long Term Disability (LTD) claims can be tricky to navigate and difficult to understand. Below we have listed commonly asked long term disability questions to help ease your mind and address common concerns.

1. What is long term disability insurance?

Long term disability insurance provides financial assistance to those who have suffered an accident, illness, or injury that prevents them from completing their work in their own occupation.

2. What is the difference between short term and long term disability?

If you have suffered an accident, injury, or illness that prevents you from completing your work in your own occupation, you can qualify for short term disability (STD). Short term disability insurance is financial assistance for up to 26 weeks, whereas long term disability insurance can last anywhere from 5-10 years to retirement, depending on your insurance policy.

3. What disabilities would allow me to qualify for long term disability coverage?

Every long term disability claim and policy differs, and your insurer will closely examine your medical findings before deciding if you qualify for long term disability benefits. Some common medical conditions that potentially qualify for benefits are:

  • Depression
  • Anxiety
  • Amputations
  • Autism
  • Panic attacks
  • Scoliosis
  • Carpal tunnel syndrome
  • PTSD (Post-traumatic stress disorder)
  • Fibromyalgia
  • Chronic fatigue syndrome
  • Heart conditions
  • Crohn's Disease
  • Bipolar
  • Arthritis
  • Diabetes
  • Lupus
  • Neck/Cervical/Neurological disorders
  • Cancer

4. What compensation will I receive from my long term disability insurance benefits?

Long term disability benefits are based upon a percentage of your monthly earnings at the time you became disabled. The percentage usually ranges from 60% to 85%, depending on your insurance policy.

For example, when you became disabled, if your monthly earnings were $4000.00, and your long term Disability benefits under the policy were calculated at 60% of your monthly income, the compensation you would receive would be $2400.00 per month.

5. Are my long term disability benefits taxable?

Whether your long term disability benefits are taxable depends on who was making payments for disability coverage premiums, you or your employer. Many large employers offer LTD coverage and pay the full premium directly to the insurance company. In this case the benefit is usually taxable.

If are purchasing your own plan and paying with your own money, any long term disability benefits you receive are likely not taxable.

6. What do I do if my long term disability claim has been denied?

Your long term disability claim can be denied for multiple reasons. Some reasons your claim can be rejected are:

  • Insufficient medical documentation
  • Lack of diagnosis
  • The insurance company has decided that you are able to complete the essential tasks of your occupation
  • You have been receiving benefits for approximately 2 years and test for disability has changed from being able to work at your own occupation to whether you are able to work at any occupation that you may be suited for by way education, training, or experience
  • Surveillance has revealed evidence to suggest you are not disabled

If your LTD claim has been denied, you can appeal the decision. If you decide to appeal the decision, it is wise to get new medical findings that work in favour of supporting your disability. Unless there are significantly new medical findings, the appeal is likely to be denied. Once your insurance company denies your benefits, it is always best to contact a lawyer for a free consultation to discuss your options to dispute the denial.

7. When should I contact a lawyer if my long term disability claim is denied?  

Know that it is not uncommon for a long term disability claim to be denied, even if your disability insurer has been paying you benefits for months or even years. Don’t wait for your insurance company to send you a denial letter! if your insurance company starts to send letters suggesting that they may be terminating your benefits in the future, that is the time to speak with a lawyer.

8. How much will it cost to have a lawyer file a long term disability insurance claim?

If we agree to take on your case, there is no upfront charge. We will fund your case through to the end, and if we do not recover compensation for you, then there is no fee. If you would like more information about our fees and services, please call us at 905-522-9799 or visit one of our locations.

9. How long does it take to settle a long term disability claim denial in court?

Because a denial of disability benefits means that you may receiving little to no income, it is critical that your claim moves swiftly, either to get your benefits re-instated or to settle with your insurance company for a lump sum.

10. Will my long term disability benefits stop if I return to work?

If you return to work on modified hours as part of a return to work plan approved by your disability insurer, then they may continue to pay you some disability benefits if your earned income is below the amount of your disability benefit calculation. In some policies, they may even continue to pay until the combination of your earned income and disability benefit equal 100% of your pre-accident wages. In some cases, if you return to work then your LTD benefit payments may stop regardless of whether you are working modified hours. It is important to read your policy to understand what happens to your disability benefit if you return to work.

11. If I don't return to work, when will my long term disability benefits end?

Depending on your insurance policy and your disability, long term disability benefits are usually payable to age 65. However, make sure to check your disability policy because some policies do not provide benefits to age 65 and instead pay only for a fixed amount of time, such as 5 years from the date disability benefits started.

12. My long term disability Insurer is telling me to apply to Canadian Pension Plan Disability (CPPD) Benefits, what should I do?

If you have been off work and receiving disability benefits for nearly two years your insurance company may be requesting that you apply for CPPD benefits, this is likely because if you are approved for CPPD benefits your insurer will receive a credit equal to the amount of your CPPD monthly benefit payment. For example, if your LTD monthly benefit is $3,000 per month and you are approved for CPPD benefits in the amount of $1,000 per month, then moving forward your monthly LTD benefits will be reduced to $2,000/month from your insurer and you will receive the additional $1,000 from CPPD. If you apply for CPPD, whether you are ultimately approved should have no bearing on whether you meet the test to receive LTD benefits from your insurance company.

At Findlay Law, we know long term disability claims can feel overwhelming, and it's hard not to get lost in the abundance of online information.

If you've been denied your long term disability claim or have had your long term disability benefits unexpectedly cancelled or terminated, Contact Findlay Personal Injury Lawyers today. For a free legal consultation, call us at 905-522-9799.

For more information on long term disability, check out our previous blog post: Change of Definition: What does this mean in a long term disability claim?

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