The coronavirus pandemic is already taking a toll on Canadians’ mental health. This means that many people will suffer from psychological conditions — and potentially be unable to work because of them.
The Canadian government has passed relief legislation for those out of work, and EI and other programs will pay a fraction of employees’ income.
But for many individuals suffering from disabling psychological conditions directly and indirectly arising from the pandemic, there’s another option: disability insurance.
What is disability insurance?
Many workers have access to short- and/or long-term disability insurance through their employers. If you’re not sure whether you have it, you may need to ask your human resources department. This kind of coverage can also be purchased privately, similar to home and auto insurance.
Short-term disability typically covers 80 to 100 per cent of your pre-disability income, and long-term disability usually covers 60 to 70 per cent.
How to apply for short-term or long-term disability
If you have access to disability insurance and are unable to work because of a disability, such as a psychological condition or illness, consider applying for short- or long-term disability benefits under that insurance.
As part of your application for disability, you will need to ensure that your doctor supports your being off of work because of your disability.
If your doctor does not think you are disabled from working, the insurance company will likely not approve the claim. But if your doctor does think that you are disabled from working and can explain why you can’t work, the insurance company is more likely to approve the claim.
Why insurance companies deny disability claims or stop paying disability benefits
Insurance companies deny disability claims for many reasons.
The provider may reason that a disability is work-related, rather than a generalized disorder that prevents someone from working altogether.
Or the insurance company may approve a claim and pay the benefits, only to cut them off, usually after about two years. The two-year mark is the “change of definition” date, which means that the requirements for being totally disabled change and become more difficult to meet.
At this point, most long-term disability policies require beneficiaries to prove they can’t work in any occupation for which they’re suited by training, education or experience, not just their own occupation.
What to do if you’re denied disability
Many people give up when their insurance company denies their disability claim. Some appeal the denial, which often means their claim is rejected a second time because there is little incentive for the insurer to change their mind. This process can take months or years, during which no benefits are paid out.
Others start a legal claim, which puts more pressure on the insurance company and can lead to a resolution.
Claiming long-term disability during the COVID-19 pandemic
There are signs insurance companies are getting ready to deal with new disability claims arising from the pandemic by resolving current cases faster. Recently, when Samfiru Tumarkin LLP lawyers have gotten involved with disability claims, insurers have come to the table relatively quickly to discuss a settlement or to unilaterally offer to reinstate benefits.
The COVID-19 pandemic has not changed legal rights when it comes to disability insurance, which means it’s important to be aware of coverage you may have. People who are suffering from the effects of the pandemic — and, as a result, are disabled from working — can apply for short- and/or long-term disability under this insurance.
Sivan Tumarkin is a disability lawyer and partner at Samfiru Tumarkin LLP, one of Canada’s leading law firms specializing in disability claims and employment law.
Visit their website to learn more about your rights around disability insurance and disability claims.