When you experience a particularly severe medical condition, it can take a serious toll on your physical, mental, and financial well-being. If you are experiencing difficulties associated with a long-term injury or illness, you may be worried about your employment or source of income. In Ontario, long-term disability (LTD) insurance plans provide individuals with income replacement in the event that they are unable to work due to a severe or sustained disability.
When pursuing an LTD claim, the application process, claim denials, or filing appeals can be stressful. At Goodman Elbassiouni LLP, our Toronto disability lawyers are available to help you file and collect the LTD benefits you may be entitled to. For more information about your options and how our legal team can help, schedule a consultation with us today.
What is Long-Term Disability (LTD) Insurance?
An individual can become eligible for long-term disability (LTD) benefits when they are unable to work for a period of three or more months due to a prolonged physical or mental disability. You can decide the type of coverage and premium you pay for an LTD insurance plan through your provider, which may be connected to your employer or a private broker. LTD insurance policies usually pay recipients on a monthly basis, and benefits may continue up to the age of 65, depending on the policy.
The amount payable and the terms of your payout will depend on:
- The insurance company you choose
- The long-term disability coverage you purchase
- Your premium payable
Normally, LTD benefits offer sustained financial support at a lower percentage of an individual’s pre-disability earnings. On average, LTD policies pay individuals between 60% to 85% of their pre-disability salary, depending on the terms and conditions of their policy. LTD benefits contrast with short-term disability (STD) benefits, which offer higher overall salaries for a shorter and more temporary period of time.
What Conditions Qualify for Long-Term Disability (LTD) Insurance in Ontario?
LTD insurance plans in Ontario cover a wide range of medical conditions, disabilities, and prolonged illnesses. When assessing an LTD claim, insurance providers will consider a variety of factors. Their decisions will also vary on a case-by-case basis. As a result, there are no specific conditions that automatically trigger LTD benefits. However, common conditions covered by LTD insurance plans in Ontario include:
- Muscuolosekeltal issues, including arthritis, sciatica, scoliosis, carpal tunnel syndrome, and more
- Cancer
- Mental health conditions, including schizophrenia, bipolar disorder, PTSD, depression, and more
- Diabetes
- Neurological disorders, including Parkinson’s disease, multiple sclerosis (MS), ALS, epilepsy, and more
- Chronic pain conditions
- Personal injuries, including slip and fall injuries, head injuries, spinal cord injuries, and more
- Cardiovascular conditions
- Respiratory conditions
- And more
It is important to note that the amount of coverage you are entitled to may depend on your disability and your insurance provider’s particular interpretation of your condition. If you have questions about whether your illness or disability qualifies for LTD, it is always best to speak with a disability lawyer about your options.
How to Pursue a Long-Term Disability Claim
To file an LTD claim, you must be covered under an LTD insurance plan through your employer or an independent insurance broker, and you must have been unable to work for an extended period of time. Steps toward filing an LTD claim normally consist of:
- Determining the ‘waiting period’ for your LTD insurance plan (the duration of time you must be off work for your disability to be considered ‘long-term’ and therefore eligible for benefits)
- Communicating with your doctor about your condition or disability
- Informing your insurance company of your intent to apply for benefits
- Completing and submitting your insurance provider’s unique LTD application package
- Completing and submitting any additional or supporting documentation required by your insurer
- Waiting for your insurance company’s decision regarding your application and LTD claim
By working with a disability lawyer, you can help make sure that you obtain and fill out all necessary paperwork correctly and efficiently. In the event that your LTD claim has been denied by your insurer or you believe your compensation to be insufficient, an experienced disability lawyer can help you identify the compensation you are entitled to. Whether you wish to appeal the denial or file a legal claim against your insurer, your lawyer can facilitate communication with your provider while helping to reinforce your rights.
Schedule a Consultation With Our Toronto Disability Lawyers at Goodman Elbassiouni LLP
At Goodman Elbassiouni LLP, our Toronto disability lawyers want to help you ease the stress of dealing with a long-term disability or illness. If you wish to file a claim for LTD benefits with your insurance provider, it may be beneficial to consult with a disability lawyer about your eligibility and legal options. To pursue your LTD claim or dispute a denial with the aid of a professional, contact our LTD lawyers or receive a free case assessment from our team today.
