Chronic pain isn’t just a symptom—it’s a life-altering condition that affects countless Canadians, making everyday tasks feel insurmountable. Imagine waking up each day to persistent pain that doesn’t go away, pain that limits your ability to work, enjoy hobbies, or even take care of your family. This isn’t just physical discomfort; it’s an all-encompassing burden that can lead to exhaustion, sleep problems, and emotional distress. Conditions like fibromyalgia, osteoarthritis, and chronic back pain exemplify how chronic pain can deeply impact every aspect of life.
When the pain makes it impossible to work or manage daily tasks, you may turn to short-term (STD) and long-term (LTD) disability benefits for support. However, the journey to securing these benefits can feel just as challenging as the pain itself. But it doesn’t have to be.
As a disability lawyer who has helped many clients navigate the complexities of chronic pain claims, I understand the unique hurdles you face. Here’s what you need to know:
Chronic pain as a recognized disability
Yes, chronic pain can be recognized as a disability in Canada. Under various human rights acts across the country, individuals are protected from discrimination based on disabilities, including chronic pain. Insurance companies also recognize chronic pain as a legitimate cause of disability.
Employers are required to provide reasonable accommodations to help those living with chronic pain perform their job duties effectively. These accommodations might include modified work hours, ergonomic adjustments, or even changes in job responsibilities to reduce physical strain.
However, when it comes to STD and LTD benefits, a diagnosis of chronic pain alone isn’t enough to guarantee approval. Insurers generally assess the severity of your condition and its impact on your ability to work. To qualify for benefits, you must demonstrate that your chronic pain causes a level of impairment that meets the specific criteria outlined in your disability benefits plan.
READ MORE: 5 things every employee should know about long-term disability and how to get benefits
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The challenges of proving chronic pain in disability claims
Proving chronic pain as a disabling condition in the context of a disability claim can be challenging. Insurance companies are often skeptical of chronic pain claims because the symptoms are subjective and not easily measured through medical tests. This skepticism can lead to many claim denials.
To successfully claim disability benefits for chronic pain, comprehensive medical documentation is crucial. This includes a diagnosis from a qualified healthcare provider—such as a pain specialist, neurologist, or rheumatologist—who can confirm that chronic pain significantly impairs your ability to work. Additionally, documentation should detail the specific ways in which chronic pain affects your job performance and overall functioning, including the unpredictability of flare-ups and the impact of chronic pain and fatigue on your daily life.
READ MORE: The insurer cut off his benefits. Then his lawyer reviewed his medical assessment
Common pitfalls in chronic pain disability claims
One of the biggest challenges in chronic pain-related disability claims is the misconception that because the condition isn’t visible, it isn’t severe enough to be disabling. Insurers often argue that since chronic pain doesn’t show up on standard medical tests, it isn’t “real” or truly “debilitating.” But for those who live with chronic pain, the reality is far different—the effects can be profound and life-altering.
Another common issue is the fluctuating nature of chronic pain. Symptoms can vary from day to day, with some days being more bearable than others. Insurers may seize on these “good” days as evidence that you can work, but it’s essential to show that, despite these occasional improvements, the overall impact of chronic pain remains significantly debilitating.
What to do if your claim is denied
If your claim for STD or LTD benefits due to chronic pain has been denied, don’t lose hope. Many denials stem from incomplete information or misunderstandings about the nature of chronic pain. This is where legal assistance can make a significant difference, helping to level the playing field in your favor.
READ MORE: Insurer’s medical consultant doesn’t think you’re disabled? 3 things to do
Imagine battling chronic pain daily, only to have your insurance company dismiss your struggles as “inconsistent.” This was the reality for one of our clients at Samfiru Tumarkin LLP. Her benefits were denied because her chronic pain didn’t fit neatly into the insurer’s expectations.
But chronic pain isn’t predictable. It’s a relentless, fluctuating force that can turn even simple tasks into monumental challenges. We knew the key to overturning this denial was to provide a true picture of her experience. We gathered detailed reports from her pain specialist and a meticulous journal she kept, documenting her daily battles with pain and fatigue. This wasn’t just about numbers or test results; it was about showing the human side of her battle.
In the end, the evidence we presented made it impossible for the insurer to ignore the reality of her chronic pain. She won her appeal and secured the benefits she deserved—not just because of the documents we provided, but because we told her story in a way that couldn’t be ignored.
Discover your rights and take action
If you’ve been denied disability benefits for chronic pain or have any questions about how your insurer is handling your claim, don’t navigate this challenging situation alone. Contact my team to understand your rights, gather the necessary evidence, and get the financial support you are owed.
READ MORE: 3 reasons you shouldn’t appeal a denied long-term disability claim
Our firm specializes in assisting individuals across Canada who have been denied short-term and long-term disability benefits. We frequently resolve these claims efficiently and successfully, helping many clients, like Sandra Bullock and Julie Austin, get the support they need.
At Samfiru Tumarkin LLP, we offer free consultations to help you find the best path forward. Your health and well-being are too important to leave to chance.
Concerns about how the insurance company is handling your disability benefits for chronic pain? STD or LTD claim denied?
Contact the firm or call 1-855-821-5900 for a FREE consultation with a disability lawyer. We help Canadians across all provinces (excluding Quebec). Get the advice you need and the compensation you deserve.
Sivan Tumarkin is a disability lawyer a co-founding partner at Samfiru Tumarkin LLP, Canada’s most positively reviewed law firm specializing in long-term disability and employment law claims. The firm provides legal insight on Canada’s only Disability Law Show on TV and radio.